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B. Metallic taste

A Nurse is teaching a client who is taking metronidazole. Which of the following sense alterations should the nruse include as an adverse effect of metronidazole? A. Olfactory changes B. Metallic taste C. Alterations in touch D. Hearing loss

D. The client developed a tolerance to the medication

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. Which of the following scenarios should the nurse document as the explanation for this situation? A. The client not been taking the medication properly B. The client is experiencing episodes of confusion C. The client has become addicted to the medication D. The client developed a tolerance to the medication

C. Prothrombin time (PT)

A nurse is caring for a client who is prescribed warfafin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? A. Hemoglobin (Hgb) B. Prothrombin time (PT) C. Bleeding time D. Activated partial thromboplastin time (aPTT)

D. Decrease in level of thyroid stimulating hormone (TSH)

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? A. Decrease in level of thyroxine (T4) B. Increase in weight C. Increase in hr of sleep per night D. Decrease in level of thyroid stimulating hormone (TSH)

D. Decrease in level of thyroid stimulation hormone (TSH)

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. which of the following findings indications a therapeutic response to the medication? A. Decrease in level of thyroxine (T4) B. Increase in weight C. increase in hr of sleep per night D. Decrease in level of thyroid stimulation hormone (TSH)

A. Relief of heartburn Rationale: Histamine 2 receptor antagonists are used to treat duodenal ulcers and prevent their return. In over the counter strengths, these medications, such as cimetidine and ranitidine used to prevent heartburn and indigestion.

A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including H2 receptor antagonist (h2RA). Which of the following outcomes indicates the H2RA is Therapeutic? A. Relief of heartburn B. Cessation of diarrhea C. Passage of flatus D. Absence of constipation

A. Iron

A nurse is teaching a client who has a chronic kidney disease and a new prescription for epotein alfa. The nurse should instruct the client to increase dietary intake of which of the following substances. A. Iron B. Protein C. Potassium D. Sodium

D. Documents medication administration prior to administering it.

A charge nurse is observing a newly licensed nurse administer medications to a client. Which of the following actions by newly licensed nurse should prompt the charge nurse to intervene? A. Verifies the medication against the prescription and medication level B. Scans the bar code on the medication record and the client's arm band C. Checks the providers orders and confirmed dosage in a medication reference guide. D. Documents medication administration prior to administering it.

B. Administer a saline solution after injection

A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take? A. Administer the medication 100 mg/min B. Administer a saline solution after injection C. Hold the injection if seizure activity is present D. Dilute the medication with dextrose 5% in water

D. Aspirate for 5 to 10 seconds Rationale: this allows good in a small blood vessel to appear, an indication that the nurse should withdraw the needle and prepare a fresh injection.

A nurse is preparing to use the Z- track technique to administer a medication to a client. Which of the following is an appropriate action during this procedure? A. Pull the skin 1.3 cm (1/2 inch) to the side B. Insert the needle slowly and gently C. use a 45 angle of insertion D. aspirate for 5 to 10 seconds.

B. Bananas Rationale: the nurse should determine that bananas are the best food source to recommend because 1 cup of bananas contains 806 mg of potassium.

A nurse is providing dietary teaching for a client who takes furosemide. The nurse should recommend which of the following foods as the best source of potassium? A. Banana B. Cooked carrots C. Cheddar cheese D. 2% milk

A. I can take this medication with or without food. B. I will eat five small meals each day

A nurse is teaching a client who has a new prescription for ranitidine to treat epic ulcer disease. Which of the following statements by the client indicate an understanding of the teaching? (select all that apply) A. I can take this medication with or without food B. I will eat five small meals each day

100mL/hr

A nurse is preparing to administer clindamycin 300 mg by intermittent IV bolus over 30 min to a client who has a staphylococci infection. Available is clindamycin premixed in 50 mL 0.90% sodium chloride (NaCl). The nurse should set the IV pump to deliver how many mL/hr?

A. Relief of heartburn Rationale: Histamine 2 receptor antagonists are sued to treat duodenal uncles and prevent their return. In over the counter medication

A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including H2 receptors antagonist (H2RA). Which of the following outcomes indications the H2RA is therapeutic? A. Relief of heartburn B. Cessation of diarrhea C. passage of flatus D. Absence of constipation

C. The medication should be applied on a regular schedule for the rest of the client's life. Rationale: medications prescribed for open angle glaucoma are intended to enhance aqueous overflow, or decrease its production, or both. The client must continue the eye drops on an uninterrupted basis for life to maintain interocular pressure at an acceptable level.

A nurse at an ophthalmology clinic is providing teaching to a client who has one angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide? A. The medication is to be applied when the client is experiencing eye pain. B. The medications will be used until the client's intraocular pressure to normal. C. The medication should be applied on a regular schedule for the rest of the client's life. D. The medication is to be used for approximately 10 days , followed by a gradual tapering off.

A. Asthma Rationale: Propranolol, a beta blocker, is contraindicated in clients who have asthma because is can cause bronchospasms.

A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform inform the client that this medication is contraindicated in clients who have a history of which of the following conditions? A: Asthma B. Glaucoma C. cancer

C. Decrease the infusion rate on the IV Rationale: the client is experiencing Red man syndrome, which includes a flushing of the neck, face and upper body.

A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take? A. document that the client experienced an anaphylactic reaction to the medicine B. Change the IV infusion site C. Decrease the infusion rate on the IV D. Apply cold compresses to the neck area.

A. Insomnia Rationale: levothroxine overdose will result in manifestation of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia

A nurse is assessing a client who is taking levothryoxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? A. Insomnia B. Constipation C. Drowsiness

C. Inject the medication into the abdomen above the level of the illac crest

A nurse is beginning to administer heparin to a client. Which of the following actions should the nurse plan to take? A. Use a 22 gauge needle to inject the medication B. Use a 1- inch needle to inject the medication C. Inject the medication into the abdomen above the level of the illac crest. D. Massage the injection site after administration of the medication

A. Shake the container vigorously Rationale: A suspension form of medication refers to one in which the particles of medication are mixed with, but not dissolved in, a fluid.

A nurse is caring for a 2 year old who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? A. Shake the container vigorously B. Be sure the child has not eating within the hour. C. Perform mouth care D. Check the child's blood pressure

A. Offer the child a choice of taking the medication with juice or water.

A nurse is caring for a 4-year old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child's cooperation? A. Offer the child a choice of taking the medication with juice or water B. Tell the child it is candy C. hide the medication in large dish of icecream

C. Taking the medication between meals will help you absorb the medication more efficiently. Rational: Ferrous sulfate provides the iron needed by the body to produce red blood cells.. Taking iron supplements between meals helps to increase the bioavailability of the iron.

A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? A. Taking the medication between meals will help you avoid becoming constipated. B. Taking the medication with foo increases the risk of esophagitis C. taking the medication between meals will help you absorb the medication more efficiently.

D. Body secretions turning a red-orange color

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurses should instruct the client that this medication can cause which of the following adverse effects? A. Constipation B. Black colored stools C. staining of the teeth D. Body secretions turning a red-orange color

C. Draw a trough level immediately prior to administering the medication and a peak level 30 minutes after the dose Rationale: timing of the peak and trough is based on the pharcokinetics of absorption and the half-life of the medication. The trough level is the lowest serum level after pharmacokinetic effects have taken place.

A nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level? A. Draw a trough level at 0900 and a peak level at 2100. B. Draw a peak level 90 min prior to administering the medication and a trough level 90 minutes after the dose. C. Draw a trough level immediately prior to administering the medication and a peak level 30 minutes after the dose.

C. monitor the serum medication levels Rationale: A disadvantage of gentamicin, an aminogycoside, is the association with nephrotoxicity and ototoxicity, both of which are a result of elevated trough levels.

A nurse is caring for a client who has bacterial infection and is receiving gentamicin. Which of the following actions should the nurse take to minimize the risk of an adverse effect of the medication? A. Limit the clients fluid intake B. Instruct the client to report agitation C. Monitor the serum medications D. Administer the medicine with food.

A. Headache Rationale: headache is a common adverse affect of ondansetron. Analgesic relief is often required.

A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy induced nausea. For which of the following adverse effects should the nurse monitor? A. Headache B. dependent edema C. Polyuria D. Photosensitivity

A. Check the clients vital signs Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the clients vital signs B. Request a dietitian consult C. Suggest that the client rest before eating the meal D. request an order of antiemetic

A. Crushing the medication cause you to have a stomachache or indigestion Rationale: the pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing the pill destroys that protection.

A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin po once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? A. Crushing the medication might cause you to have a stomachache or indigestion B. Cushing the medication is as good idea, and can I mix it in some ice cream fro you. C. Crushing the medication would release all medication at once, rather than over time D> Crushing is unsafe, as it destroys the ingredients in the medicine.

D. I feel nauseated and have no appetite

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A. I can walk a mile a day B. I've had a backache for several days C. I am urinating more frequently D. I feel nauseated and have no appetite

A. The medication relieves nausea by promoting gastric emptying

A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how Metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? A. The medication relieves nausea by promoting gastric emptying. B. The medication works by decreasing gastric acid secretions. C. The medication relieves nausea by slowing peristalsis D. The medication works by relaxing gastric muscles.

A. The medication relieves nausea by promoting gastric emptying Rationale: Reglan is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating

A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? A. The medication relieves nausea by promoting gastric emptying B. The medication works by decreasing gastric acid secretions C. The medication relieves nausea by slowing peristalsis D. The medication works by relaxing gastric muscles

B. Check the clients vital signs

A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? A. Notify the client's provider B. Check the patients vitals C. Assess another patient

D. Drink a glass of water after taking the medication

A nurse is completing a medication history for a client who reports using over-the- counter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication? A. Decrease bulk in the direct counteract the adverse effect of diarrhea. B. take the medication with diary products to increase absorption C. Reduce sodium intake D. Drink a glass of water after taking the medication

D. I'll be glad when I can stop taking this medication

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the clients indicates a need for further teaching? A. I will notify my doctor before taking any other medications B. I have made an appointment to see my dentist next week C. I know that I cannot switch bands of this medication D. I'll be glad when I can stop taking this medicine

B. Lubricate index finger E. Insert suppository just beyond internal sphincter

A nurse is preparing to administer bisacodly suppository to a client. Which of the following actions should the nruse take? (select all that apply) A. Don sterile gloves B. Lubricate index finger C. Use rectal applicator for insertion D. Position client supine with knees bent E. Insert suppository beyond internal sphincter.

D. Position the syringe to the side of the infant's tongue

A nurse is preparing to administer oral medication to a 3-month old infant. Which of the following actions should the nurse plan to take? A. Measure elixir using a medicine cup B. Mix medication with formula C. Place infant supine in the crib D. Position the syringe to the side of the infant's tongue,

B. I will use both medications immediately after exercising Rationale: The client should always use the broncodilater (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronco dilated first allows the airways to be opened, ensuring that the maximum dose of medication will get to the clients lungs.

A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the clients indicates an understanding of the teaching? A. If my breathing begins to feel tight , I will use the cromolyn immediately. B. I will be sure to take the albuterol before taking the cromolyn. C. I will use both medications immediately after exercising

C. Rinse the mouth after administration Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication.

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? A. Check the pulse after medication administration. B. Take the medication with meals C. Rinse the mouth after administration D. Limit caffeine intake

B. specific characteristics of the medication

A nurse is reviewing a client's admission record. The nurse notes that there are prescriptions for several medications. Which of the following factors should the nurse recognize is of primary consideration when determining the schedule of administration? A. Instituitonal policies regarding medication administration times. B. Specific characteristics of the medication C. Schedule of administration that the client follows at home

A. Keep the open vial of insulin at room temperature

A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? A. Keep the open vial in use at room temperature to minimize tissue injury and to reduce the risk for lipodystrophy B. Inject the insulin into a large muscle C. Aspirate the medication prior to administration D. Administer the insulin in two separate injections

D. You should report any tendon discomfort you experience while taking this medication.

A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciproflaxacin. Which of the following instructions should the nurse give to the client? A. if the medication causes an upset stomach, take an antacid at the same time. B. Limit you daily fluid while taking this medication C. This medication can cause photophobia, be sure to wear sunglasses outdoors. D. You should report any tendon discomfort you experience while taking this medication.

A. The client hold his breath for 10 seconds after inhaling this medication

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? A. The client holds his breath for 10 seconds after inhaling this medication B. The client takes a quick inhalation while releasing the medication from the inhaler C. the client exhales as the medication is released from the inhaler D. The client waits 10 minutes between inhalations

b. adrenocortical insufficiency

A nurse is teaching a client who has been taking a prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects. A. Hyperglycemia B. Adrenocortical insufficiency C. Severe dehydration

C. Vomiting is an indication of toxicity. Rationale: Since vomiting and diarrhea are early signs of lithium toxicity, the client should omit the next dose of lithium and call the provider.

A nurse is teaching a client who has bipolar disorder and prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates understanding of the teaching.? A. I will report any loss of appetite. B. increased flatulence is an indication of toxicity. C. vomiting is an indication of toxicity. D. I will call my provider if I experience any headaches.


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