Test A-PHARM

A nurse is preparing to administer to a client 0.9% sodium chloride 1,000 mL IV over 8 hours. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

31 gtt/min

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth.)

6.3mL

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus. B. Aspirate for blood return before injecting. C. Rub vigorously after the injection to promote absorption. D. Place a pressure dressing on the injection site to prevent bleeding.

A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 2 inches away from the umbilicus.

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? A. Carbamazepine B. Sumatriptan C. Atenolol D. Glipizide

A. Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication- metabolizing enzymes.

A nurse is teaching a client who is starting to take ketorolac. Which of the following information should the nurse include in the teaching? A. Check for bruising while taking this medication. B. Take the medication on an empty stomach. C. The medication can cause anxiety. D. Increase iron intake with this medication.

A. Check for bruising while taking this medication. The nurse should instruct the client to check for bruising because ketorolac can increase the risk of bleeding by interfering with platelet aggregation.

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? A. Chest pressure B. White patches on the tongue C. Bruising D. Insomnia

A. Chest pressure Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.

A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium on a daily basis can minimize which of the following adverse effects of morphine?A. Constipation B. Drowsiness C. Facial flushing D. Itching

A. Constipation Constipation is a common adverse effect of morphine that will minimize when the client takes docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (SATA) A. Hemoglobin 7.0 B. Creatinine 1 C. RBC 4.7 million D. Platelets 75,000 E. Potassium 5.2

A. Hemoglobin 7.0 D. Platelets 75,000 E. Potassium 5.2

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? A. Hyperventilation B. Heartburn C. Anorexia D. Swollen ankles

A. Hyperventilation

A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? A. Obtain the client's blood pressure. B. Contact the client's provider. C. Inform the charge nurse. D. Complete an incident report.

A. Obtain the client's blood pressure. The first action the nurse should take to prevent injury to the client when using the nursing process is to assess the client for adverse effects of atenolol, such as hypotension.

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? A. Perform a capillary blood glucose test. B. Provide the client with a protein-rich snack. C. Give the client 120 mL (4 oz) of orange juice. D. Schedule an early meal tray.

A. Perform a capillary blood glucose test. The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (SATA) A. Report muscle pain to the provider. B. Avoid taking the medication with grapefruit juice. C. Take the medication in the early morning. D. Expect a flushing of the skin as a reaction to the medication. E. Expect therapy with this medication to be lifelong.

A. Report muscle pain to the provider. B. Avoid taking the medication with grapefruit juice. E. Expect therapy with this medication to be lifelong.

A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used to treat tuberculosis? (SATA) A. Rifampin B. Mirtazapine C. Temazepam D. InfliximabE. Isoniazid

A. Rifampin E. Isoniazid

A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication? A. Smoked sausage. B. Cottage cheese. C. Green beans. D. Apple pie.

A. Smoked sausage. The nurse should instruct the client to avoid eating smoked sausage because it contains tyramine. Tyramine can interact with MAOIs and result in hypertensive crisis.

The nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? A. Tingling of fingers. B. Constipation. C. Weight gain. D. Oliguria.

A. Tingling of fingers. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? A. Turn the client to a side-lying position. B. Disconnect the client's oxytocin from the maintenance IV. C. Apply oxygen to the client by face mask. D. Increase the client's maintenance IV infusion rate.

A. Turn the client to a side-lying position.

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first DTaP vaccine. The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? A. Birth B. 2 months C. 6 months D. 15 months

B. 2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol? A. Cholelithiasis B. Asthma C. Angina pectoris D. Tachycardia

B. Asthma Asthma is a contraindication to receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome? A. Increase in seizure threshold. B. Decrease in flexor and extensor spasticity. C. Increase in cognitive function. D. Decrease in paralysis of the extremities.

B. Decrease in flexor and extensor spasticity. The client who has a spinal cord injury and takes baclofen can experience a decrease in the frequency and severity of muscle spasms and in flexor and extensor spasticity.

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? A. I will need to get laboratory testing prior to a refill of this medication. B. I will use this medication for a short period of time. C. I will need to take this medication for 1 week before results are seen. D. I will need to change the medications to prevent building up a tolerance.

B. I will use this medication for a short period of time. Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.

A nurse is providing teaching about adverse effects of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider? A. Orange urine B. Watery diarrhea C. Weight gain D. Headache

B. Watery diarrhea The client who takes clindamycin can have an adverse effect of watery diarrhea that can lead to Clostridium difficile- associated diarrhea or pseudomembranous colitis. The client should report these findings immediately to the provider.

A nurse is teaching a client who is to start taking diltiazem. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A. Blurred vision B. Shortness of breath C. Muscle twitching D. Dry cough

B. Shortness of breath The client who is taking diltiazem, a calcium channel blocker, can experience shortness of breath as an adverse effect and should report the finding to the provider immediately.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? A. Troponin B. Total cholesterol C. Creatinine D. Thyroid stimulating hormone

B. Total cholesterol

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report?A. 1000 B. 0900 C. 0830 D. 1200

C. 0830 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? A. Difficulty seeing in the dark. B. Pinpoint pupils. C. Blurred vision. D. Excessive tearing.

C. Blurred vision. Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause distant objects to appear blurry to the client.

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? A. Ondansetron B. Magnesium sulfate C. Flumazenil D. Protamine sulfate

C. Flumazenil Flumazenil is an antidote and the nurse should administer the medication to reverse benzodiazepines, such as diazepam.

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching? A. I should take my medication with antacids to minimize gastric upset. B. This type of medication does not require blood monitoring. C. I should let my dentist know I'm taking this medication. D. I should expect to experience some unusual eye movement when taking this medication.

C. I should let my dentist know I'm taking this medication. Phenytoin commonly causes gingival hyperplasia. As a result, the client should notify his dentist.

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I can apply the patch to a chest area that has hair. B. I can take this medication if using an erectile dysfunction product. C. I will remove the patch after 14 hours. D. I need to apply a new patch to the same area every day.

C. I will remove the patch after 14 hours. The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? A. I should avoid getting rid of the air bubble in the syringe. B. I should inject the insulin into my thigh for the fastest absorption. C. I will store my unopened bottles of insulin in the refrigerator. D. I need to shake the insulin before using it to make sure it is well mixed.

C. I will store my unopened bottles of insulin in the refrigerator.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? A. Infuse 0.9% sodium chloride 1,000 mL IV bolus B. Schedule the client for an electroencephalogram C. Obtain WBC with absolute neutrophil count. D. Place the client on a tyramine-free diet.

C. Obtain WBC with absolute neutrophil count.

A nurse is caring for a client who is taking atenolol. Which of the following findings should indicate to the nurse that the medication is effective? A. The client has an increase in urinary output. B. The client reports an improvement in memory. C. The client has a decrease in blood pressure. D. The client reports having an increase in libido.

C. The client has a decrease in blood pressure. Atenolol, a beta-adrenergic blocking agent, lowers blood pressure by decreasing peripheral vascular resistance.

A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? A. Hypertension B. Low INR C. Constipation D. Bleeding gums

D. Bleeding gums The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant.

A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for long-term complications of prednisone? A. Pulmonary function tests B. Electrocardiograms C. Liver function studies D. Bone density scans

D. Bone density scans The client who is taking prednisone, which is a glucocorticoid, should have regularly scheduled bone density scans to monitor for the adverse effects of osteoporosis.

A nurse is preparing to teach a client who is to start a new prescription for extended- release verapamil. Which of the following instructions should the nurse plan to include? A. Take the medication on an empty stomach. B. Avoid crowds. C. Discontinue the medication if palpitations occur. D. Change positions slowly.

D. Change positions slowly. The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope.

A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to receiving which of the following medications? A. Acetaminophen B. Ipratropium C. Benzonatate D. Doxycycline

D. Doxycycline

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? A. This medication increases your risk for hypertension. B. Avoid potassium-rich foods in your diet. C. Take each dose of medication in the evening before bed. D. Drink a glass of milk with each dose of medication.

D. Drink a glass of milk with each dose of medication. The client should take furosemide with food or milk to reduce gastric irritation.

A nurse is providing teaching to a client who is to start taking lisinopril. Which of the following findings is an adverse effect that the nurse should instruct the client to monitor and report to the provider? A. Hair loss B. Ringing in the ears C. Facial flushing D. Dry cough

D. Dry cough A buildup of bradykinin from taking lisinopril can cause a client to have a dry cough and lead to life-threatening consequences. The client should report the finding to the provider.

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect? A. Tachycardia B. Oliguria C. Xerostomia D. Miosis

D. Miosis Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.

A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include?A. Limit continuous use to 7 to 10 weeks. B. Schedule doses for early morning before breakfast. C. Expect that it will take 4 nights before benefits are noticed. D. Plan to withdraw from the medication gradually.

D. Plan to withdraw from the medication gradually. The nurse should include in the teaching to have the client plan to withdraw from taking temazepam gradually to avoid mild withdrawal syndrome.

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? A. Take beclomethasone to avoid an acute attack .B. Use beclomethasone 5 minutes before using albuterol. C. Limit your calcium and vitamin D intake when taking beclomethasone. D. Rinse your mouth after inhaling the beclomethasone.

D. Rinse your mouth after inhaling the beclomethasone. The client should rinse her mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? A. Chew on the medication stick to release the medication. B. Leave the medication stick in one location of the mouth until melted. C. Allow the medication 1 hr for analgesia effects to begin. D. Store unused medication sticks in a storage container.

D. Store unused medication sticks in a storage container. The nurse should instruct the client to store unused used or partially used medication sticks in the safe storage

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding adverse effects of fentanyl should the nurse plan to give the client and family? A. The provider will prescribe naloxone at home for respiratory depression. B. Remove the patch to reverse the adverse effects immediately. C. Expect an increase in urinary output. D. Take a stool softener on a daily basis.

D. Take a stool softener on a daily basis. Constipation is an adverse effect of opioid use and stool softeners can decrease the severity of this adverse effect.

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication she should complete an incident report? A. The client reports shortness of breath. B. The client is also taking lisinopril. C. The client's pulse rate is 60/min D. The client's WBC count is 14,000

A The client reports shortness of breath. A severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. Shortness of breath can indicate the client is developing anaphylaxis.

A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? A. I have tendonitis, so I haven't been able to exercise. B. I take a stool softener for chronic constipation. C. I take medicine for my thyroid. D. I am allergic to sulfa.

A. I have tendonitis, so I haven't been able to exercise. The nurse should identify tendonitis is a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? A. Administer epinephrine 0.5 mL via IV bolus B. Discontinue the medication IV infusion C. Elevate the client's legs above the level of the heart. D. Collect a blood specimen for ABGs.

B. Discontinue the medication IV infusion

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching? A. I will stop taking ranitidine when my stomach pain is gone. B. I know smoking makes ranitidine less effective. C. I will take ranitidine anytime my stomach hurts. D. I know that ranitidine will turn my stools black.

B. I know smoking makes ranitidine less effective. The nurse should instruct the client that smoking decreases the effectiveness of ranitidine by exacerbating the ulcer manifestations.

A nurse is teaching a client who has an upper respiratory infection about guaifenesin. Which of the following statements should the nurse include in the teaching? A. Constipation is an expected adverse effect of this medication. B. Increase your fluid intake to at least 2 liters each day while taking this medication. C. Store your medication in the refrigerator. D. You can expect to experience insomnia while taking this medication.

B. Increase your fluid intake to at least 2 liters each day while taking this medication. The nurse should instruct the client to increase fluid intake to at least 2 L per day while taking guaifenesin. An increase in fluid intake facilitates the removal of secretions and helps to create a more productive cough.

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? A. Methadone B. Naloxone C. Diazepam D. Bupropion

B. Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication? A. Tachycardia B. Oliguria C. Hyperkalemia D. Weight gain

B. Oliguria Oliguria can indicate renal compromise in a client who is taking amphotericin B. The nurse should report this finding to the provider.

A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? A. Vitamin E B. Orange juice C. Milk D. Antacids

B. Orange juice The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice. However, increasing the dosage of ferrous sulfate can provide the same benefit to increase the amount of iron uptake.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Hypoglycemia B. Orthostatic hypotension C. Bradycardia D. Xanthopsia

B. Orthostatic hypotension The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness in clients who are taking the medication. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position.

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? A. Schedule the client for the last surgery of the day. B. Place monitoring cords and tubes in a stockinet. C. Choose rubber injection ports for fluid administration. D. Ensure phenytoin IV is readily available.

B. Place monitoring cords and tubes in a stockinet. The circulating nurse should place monitoring devices in a stockinet to prevent direct contact with the client's skin. Schedule the client for the last surgery of the day.The circulating nurse should schedule the client for the first surgery of the day to minimize the client's exposure to latex, including latex dust.

A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?A. Serum calcium B. Pregnancy test C. 24 hour urine collection for protein D. Aspartate aminotransferase level

B. Pregnancy test The client who is pregnant or might become pregnant must not take isotretinoin because this medication has teratogenic effects. Pregnancy testing is mandatory before the initial prescription (two tests) and before monthly refills (one test).

A nurse is providing teaching about insulin glargine to a client who has type 1 diabetes mellitus. Which of the following information should the nurse include in the instructions? A. Observe for hypoglycemia when the insulin peaks. B. Administer the insulin immediately before meals. C. Do not mix this medication in a syringe with other insulin. D. Rotate the bottle gently prior to drawing up the insulin.

C. Do not mix this medication in a syringe with other insulin. The client should not mix insulin glargine with any other type of insulin in the same syringe, because this procedure can alter the medication's effects

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? A. Take the medication with food. B. Expect a fine, red rash as a transient effect. C. Drink 8-10 glasses of water daily. D. Store the medication in the refrigerator.

C. Drink 8 to 10 glasses of water daily. The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (64 to 80 oz) a day to decrease the chance of kidney damage from crystallization.

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I will apply the patch once a week for 2 weeks. B. I will leave the existing patch on for 4 hours after applying the new patch. C. I will fold the sticky sides of the old patch together before disposing of it. D. I will apply the patch within 14 days of menses.

C. I will fold the sticky sides of the old patch together before disposing of it.

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? A. I will have increased saliva production. B. I will continue taking the medication until the rash disappears. C. I will taper off the medication before discontinuing it. D. I will report any urinary incontinence.

C. I will taper off the medication before discontinuing it. The client should taper off cyclobenzaprine before discontinuing it to prevent the return of the musculoskeletal condition.

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? A. Decreased blood pressure. B. Increased heart rate. C. Increased cardiac output. D. Decreased serum potassium.

C. Increased cardiac output. Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? A. Diarrhea B. Cough C. Urinary retention D. Increased libido

C. Urinary retention The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention. Increased libido