ATI Pharm final Practice
A. Administer the medication into the client's abdomen The heparin should be administered into the client's abdomen.
A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22-gauge needle to administer the medication
B. Diltiazem The nurse should anticipate the provider to prescribe diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation.
A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin
B. Naloxone The nurse should expect a prescription for naloxone. This medication displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia that opiates cause.
A nurse is caring for a client who has been in the PACU for more than 1 hr, has a respiratory rate of 9/min, and is difficult to arouse. The nurse should expect a prescription for which of the following medications? A. Pentazocine B. Naloxone C. Naltrexone D. Butorphanol
A. Grapefruit juice Grapefruit juice is contraindicated for a client who is taking simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism.
A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room? A. Grapefruit juice B. Hardboiled eggs C. Coffee D. Oatmeal
B. Nitroglycerin The nurse should anticipate a prescription for nitroglycerin, which is indicated for a client who has unstable angina. Nitroglycerin is an organic nitrate and a vasodilator that acts by relaxing or preventing spasms in the coronary arteries, thereby decreasing the oxygen demand of the heart along with ventricular filling.
A nurse is caring for a client who has unstable angina. The nurse should anticipate a prescription from the provider for which of the following medications? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine
B. "You should increase your fluid intake." The nurse should inform the client that an adverse effect of morphine is constipation. Therefore, the nurse should encourage the client to increase oral fluids to promote motility of the bowel.
A nurse is teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? A. "You might notice that you see better in dim areas." B. "You should increase your fluid intake." C. "You should expect to have excessive urination." D. "You might experience difficulty sleeping."
A. Tuberculosis Isoniazid and rifampin are first-line antitubercular medications used to treat active tuberculosis. The medications are used in combination therapy.
A nurse in a community health clinic is assessing a new client who has prescriptions for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. Tuberculosis B. Hypertension C. Diabetes D. Cirrhosis
D. Alterations in gastrointestinal flora The typical gastrointestinal flora are often destroyed by broad-spectrum antibiotics like amoxicillin, causing poor digestion and possible superinfection with other bacteria.
A nurse in a provider's office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects? A. Development of gastric ulcers B. Development of milk intolerance C. Allergic reactions to the medication D. Alterations in gastrointestinal flora
A. Decreased intraocular pressure Brimonidine is an alpha-2 adrenergic agonist used for the long-term treatment of open-angle glaucoma. It decreases intraocular pressure by reducing aqueous humor production.
A nurse is administering brimonidine eye drops to a client who has glaucoma. Which of the following ocular effects should the nurse expect? A. Decreased intraocular pressure B. Blocked growth of new blood vessels C. Paralysis of accommodation D. Mydriasis
B. Nitroglycerin The nurse should anticipate administering nitroglycerin to a client who has unstable angina. This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries, which increases oxygenation and blood flow.
A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine
D. "My legs feel weak and achy." When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is muscle pain and weakness. A serious adverse effect of this medication is muscle injury, which can progress to severe myositis. The client should report any unusual onset of muscle pain or tenderness to the provider immediately.
A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which of the following statements by the client indicates an adverse effect of the medication that should be reported to the provider immediately? A. "I have had occasional constipation." B. "I have had some gas." C. "My head has been hurting for some days." D. "My legs feel weak and achy."
B. Aspirin Aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect. The client should chew the first dose of aspirin to allow rapid absorption.
A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. Nitroglycerin B. Aspirin C. Morphine D. Metoprolol
C. Assess the client's apical pulse Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with an assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider about a change in the client's status, she must first collect adequate data from the client. An assessment will provide the nurse with the knowledge needed to make an appropriate decision.
A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first? A. Notify the provider B. Contact the nursing supervisor C. Assess the client's apical pulse D. Complete an incident report
C. Hypotension Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage.
A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia
C. Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.
A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia
C. Bleeding Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee-ground emesis, black tarry stools, ecchymosis, or any indication of bleeding.
A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation
C. Assessment The assessment step of the nursing process involves collecting pertinent data, which includes the identification of the client's allergies.
A nurse is caring for a client who has multiple medication allergies. During which of the following steps of the nursing process should the nurse identify the client's allergies? A. Planning B. Evaluation C. Assessment D. Implementation
D. Acetaminophen Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding.
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Ibuprofen B. Naproxen C. Aspirin D. Acetaminophen
B. The client's respiratory rate is 10/min. The nurse should identify that morphine can cause respiratory depression. Therefore, if the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider.
A nurse is caring for a client who is experiencing acute pain and is receiving morphine. Which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? A. The client reports an inability to void. B. The client's respiratory rate is 10/min. C. The client has hypoactive bowel sounds. D. The client has vomited once in the last 4 hours.
B. Peptic ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black or tarry stools occur.
A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? A. Weight loss B. Peptic ulcer C. Hyperkalemia D. Diplopia
C. 0645 Lispro is a rapid-acting insulin with an onset of 15 minutes. The nurse should administer the insulin dose 15 min prior to the feeding.
A nurse is caring for a client who receives gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously? A. 0600 B. 0630 C. 0645 D. 0730
A. Decreased platelet aggregation Ginkgo biloba can decrease platelet aggregation by inhibiting the ability of platelets to clump together. The nurse and the client should discuss the potential increase in bleeding tendencies when taking Ginkgo biloba and other antiplatelet aggregates, such as NSAIDs and clopidogrel.
A nurse is caring for a client who takes Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement? A. Decreased platelet aggregation B. Prevention of migraine headaches C. Increased risk of deep-vein thrombosis D. Lowered cholesterol and triglyceride levels
A. Small stature for age The nurse should identify that an adverse effect of the long-term use of inhaled glucocorticoids can be a slowing in the rate of growth in children.
A nurse is caring for a school-aged child who has cystic fibrosis (CF) and has been using a corticosteroid inhaler for long-term treatment. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication? A. Small stature for age B. Decreased weight C. Poor dentition D. Atrophied muscles
B. Garlic Many dietary supplements can affect clotting or interact with other medications that affect clotting, thereby increasing the client's risk of bleeding. Examples of these dietary supplements include garlic, ginger, and ginkgo biloba. The nurse should notify the provider immediately about this potential risk.
A nurse is performing a preoperative assessment of a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? A. Soy B. Garlic C. Black cohosh D. Green tea
Correct Answer: 63 To solve, follow this sequence: Step 1: What is the unit of measurement the nurse should calculate? mL/hr Step 2: What is the volume the nurse should infuse? 250 mL Step 3: What is the total infusion time? 4 hr Step 4: Should the nurse convert the units of measurement? No Step 5: Set up an equation and solve for X. Volume (mL)/Time (hr) = X mL/hr 250 mL/4 hr = X mL/hr X = 62.5 Step 6: Round if necessary. 62.5 = 63 Step 7: Reassess to determine if the amount to administer makes sense. If the amount prescribed is 250 mL of enteral feeding through an NG tube infused over 4 hr, the nurse should set the pump to deliver the enteral feeding through the NG tube at 63 mL/hr.
A nurse is preparing to administer an enteral feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)
15 Follow these steps for the dimensional analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the quantity of the dose available? 5 mL Step 3: What is the dose available? 50 mg Step 4: What is the dose the nurse should administer? 150 mg Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 5 mL/50 mg x 150 mg/ X = 15 Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to administer makes sense.
A nurse is preparing to administer azithromycin 150 mg liquid suspension PO every 12 hr to a client. The amount available is azithromycin 50 mg/5 mL. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)
A. History of cirrhosis The nurse should identify that dantrolene is contraindicated for clients who have active liver disease because it is hepatotoxic and can cause liver failure. Liver function tests are monitored for clients throughout treatment with this medication.
A nurse is preparing to administer dantrolene to a client who has muscle spasticity. Which of the following findings from the client's medical history should the nurse identify as a contraindication to the administration of this medication? A. History of cirrhosis B. History of multiple sclerosis C. History of cerebral palsy D. History of malignant hyperthermia
25 Step 1: What is the unit of measurement the nurse should calculate? gtt/min Step 2: What is the quantity of the drop factor available? 15 gtt/min Step 3: What is the total infusion time? 10 hr Step 4: What is the volume the nurse should infuse? 1,000 mL Step 5: Should the nurse convert the units of measurement? Yes (hr does not equal min) 1 hr/60 min = 10 hr/X min X = 600 min Step 6: Set up an equation and solve for X. X = Quantity/1 mL x Conversion (hr)/Conversion (min) x Volume (mL)/Time (min) X gtt/min = 15 gtt/1 mL x 1,000 mL/600 min X = 25 Step 7: Round if necessary. Step 8: Reassess to determine if the amount to administer makes sense.
A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL for infusion over 10 hr. 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? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)
Correct Answer: 11 Follow these steps for the dimensional analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the quantity of the dose available? 1 mL Step 3: What is the dose available? 50 mg Step 4: What is the dose the nurse should administer? 550 mg Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/50 mg x 550 mg/ X = 11 Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to administer makes sense.
A nurse is preparing to administer fosphenytoin 550 mg via IV bolus to a client who is having a seizure. Fosphenytoin 50 mg/1 mL is available. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)
Correct Answer: 21 To solve using dimensional analysis: Step 1: What is the unit of measurement the nurse should calculate? gtt/min Step 2: What is the quantity of the drop factor available? 10 gtt/min Step 3: What is the total infusion time? 8 hr Step 4: What is the volume the nurse should infuse? 1,000 mL Step 5: Should the nurse convert the units of measurement? Yes (hr does not equal min) 1 hr/60 min = 8 hr/X min X = 480 min Step 6: Set up an equation and solve for X. X = Quantity/1 mL x Conversion (hr)/Conversion (min) x Volume (mL)/Time (min) X gtt/min = 10 gtt/1 mL x 1,000 mL/480 min X = 20.833 Step 7: Round if necessary. 20.833 = 21 Step 8: Reassess to determine if the amount to administer makes sense.
A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV infused over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number and use a leading zero if applicable. Do not use a trailing zero.)
C. QID The abbreviation "QID" indicates the medication should be administered 4 times per day, which is the greatest frequency of the options provided.
A nurse is preparing to administer medication to a client. The nurse should understand that which of the following abbreviations indicates the greatest frequency of medication administration? A. BID B. TID C. QID D. Q8h
A. Aspirin EC 325 mg per NG tube daily The nurse should clarify the prescription for aspirin EC 325 mg per NG tube daily, as enteric-coated tablets should not be crushed
A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? A. Aspirin EC 325 mg per NG tube daily B. Atorvastatin 40 mg per NG tube daily C. Propranolol 20 mg per NG tube daily D. Sucralfate 2 g oral suspension per NG tube BID
B. 1 ½ inch In general, needle lengths for IM injections are 1 to 1 ½ inches, unless the client is obese. A BMI of 23 is considered to be an optimal weight.
A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication? A. ½ inch B. 1 ½ inch C. 2 ½ inch D. 3 inch
Correct Answer: 2 Follow these steps for the dimensional analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the quantity of the dose available? 1 mL Step 3: What is the dose available? 5 mg Step 4: What is the dose the nurse should administer? 10 mg Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/5 mg x 10 mL/ X = 2 mL Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to give makes sense.
A nurse is preparing to administer metoclopramide 10 mg IM to a client who is postoperative and nauseated. The amount available is metoclopramide 5 mg/1 mL. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)
Correct Answer: 2.2 Follow these steps for the dimensional analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the quantity of the dose available? 1 mL Step 3: What is the dose available? 2.5 mg Step 4: What is the dose the nurse should administer? 5.5 mg Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/2.5 mg x 5.5 mg/ X = 2.2 mL Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to give makes sense.
A nurse is preparing to administer verapamil 5.5 mg via IV bolus to a client who has hypertension. The amount available is verapamil 2.5 mg/1 mL. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)
A. "Verapamil is used to treat both high blood pressure and angina." Verapamil is a calcium channel blocker that is used for both hypertension and anginal pain because of its ability to dilate arteries and decrease afterload.
A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make? A. "Verapamil is used to treat both high blood pressure and angina." B. "You should talk to your provider to make sure the prescription is correct for you." C. "Are you concerned that you might have high blood pressure?" D. "Your provider has prescribed verapamil so that you will not develop high blood pressure."
D. Dietary fiber helps prevent constipation. The nurse should inform the client that constipation is an adverse effect of opioids. Increasing dietary fiber consumption can help manage opioid-induced constipation. The nurse should also instruct the client to increase physical activity and fluid intake. A stool softener and a laxative might also be needed to prevent the complications associated with opioid-induced constipation.
A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as a rationale for increasing the client's daily intake of fiber? A. Fiber binds with the medication to relieve pain. B. Dietary fiber prevents nausea caused by opioids. C. Fiber promotes the absorption of opioids. D. Dietary fiber helps prevent constipation.
D. "Take hydrochlorothiazide in the morning." The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and to prevent nocturia.
A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. "Take hydrochlorothiazide as needed for edema." B. "Check your weight once each week." C. "Take hydrochlorothiazide on an empty stomach." D. "Take hydrochlorothiazide in the morning."
B. Stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and the herbal supplement St. John's wort increases the client's risk of serotonin syndrome.
A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together. B. Stop taking the herbal supplement while taking the medication. C. Take the herbal supplement and the medication at least 2 hr apart. D. Take an antacid with both the herbal supplement and the medication.
C. "This medication is less effective for people who smoke." The nurse should instruct the client that smoking interferes with the effectiveness of famotidine. If a client taking famotidine smokes, the nurse should encourage the client to quit smoking or, if unable quit, to avoid smoking after the last dose of the day.
A nurse is providing teaching to a client who has a prescription for famotidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching? A. "This medication is more effective when taken on an empty stomach." B. "You should take this medication with an antacid for pain control." C. "This medication is less effective for people who smoke." D. "You should expect to experience dizziness when taking this medication."
C. Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure since erythropoietin is produced by the kidney.
A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils
D. Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver
A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. Prevents esophageal bleeding C. Decreases heart rate D. Reduces ammonia levels
C. "You should eat foods that are high in potassium while taking this medication." The nurse should instruct this client who has a prescription for furosemide to consume foods that are high in potassium. Furosemide is a high-ceiling loop diuretic that depletes potassium, sodium, chloride, magnesium, and water.
A nurse is providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A. "You can take ibuprofen for headaches while taking this medication." B. "You may experience increased swelling in your lower extremities while taking this medication." C. "You should eat foods that are high in potassium while taking this medication." D. "You should take this medication at bedtime."
A. Reye's syndrome Aspirin should not be given to children or adolescents who have a viral infection like chickenpox or influenza due to the risk of developing Reye's syndrome.
A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's syndrome B. Visual disturbances C. Diabetes mellitus D. Wilms' tumor
A. "I will give my child a dose as soon as wheezing starts." Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication.
A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered-dose inhaler. Which of the following statements by the parent indicates the need for further teaching? A. "I will give my child a dose as soon as wheezing starts." B. "My child should rinse out his mouth after using the inhaler." C. "My child should exhale completely before placing the inhaler in his mouth." D. "If my child has difficulty breathing in the dose, a spacer can be used."
D. Albuterol Albuterol is a short-acting beta-2 adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One or two puffs every 4 to 6 hours PRN is the usually prescribed dose for a school-age child. If higher or more frequent doses are needed, the provider should evaluate the client for worsening asthma.
A nurse is providing teaching to the parents of a school-age child with asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack? A. Salmeterol B. Cromolyn C. Fluticasone D. Albuterol
C. Serum creatinine 2.5 mg/dL Vancomycin is nephrotoxic and can result in renal failure, which is indicated by elevated levels of creatinine above the expected reference range of 0.5 to 1.3 mg/dL. The nurse should report this laboratory value to the provider prior to administering any further doses of the medication.
A nurse is reviewing laboratory reports for a client who has Clostridium difficile infection and is receiving vancomycin. Which of the following results should the nurse report to the provider before administering the next dose? A. Hematocrit 46% B. Serum glucose 110 mg/dL C. Serum creatinine 2.5 mg/dL D. Serum potassium 4.8 mEq/L
B. Reduce the infusion rate An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause anticoagulation. The nurse should contact the provider, reduce the infusion rate, and assess the client for bleeding.
A nurse is reviewing the laboratory values of a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 sec. Which of the following actions should the nurse prepare to take? A. Administer vitamin K B. Reduce the infusion rate C. Give the client a low-dose aspirin D. Request an INR
B. Chronic use of salicylates Chronic use of salicylates such as aspirin can lead to ototoxicity, which can manifest as tinnitus or hearing loss.
A nurse is reviewing the medical record of a client who might have hearing loss. Which of the following data from the client's medical record should the nurse identify as a risk factor for hearing loss? A. Frequent use of steroids B. Chronic use of salicylates C. Intermittent use of antacids D. Habitual use of laxatives
B. Levothyroxine 75 mcg PO q AM before breakfast Levothyroxine can be crushed because it is not extended-release, sublingual, or enteric-coated. If crushed, the medication should be mixed with 5 to 10 mL of water.
A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? A. Aspirin EC 80 mg PO daily B. Levothyroxine 75 mcg PO q AM before breakfast C. Metformin XR 500 mg PO daily D. Nitroglycerin 0.3 mg SL PRN chest pain, may repeat q 5 min for 2 additional doses
B. Albuterol sulfate The nurse should anticipate a client who has mild intermittent asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short-acting beta2-agonist that activates beta2-receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.
A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? A. Ipratropium B. Albuterol sulfate C. Tiotropium D. Budesonide
B. "I should change positions slowly when getting out of bed." The nurse should identify that isosorbide mononitrate is an antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects of orthostatic hypotension.
A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? A. "I can take my second dose of medication no later than 9:00 PM." B. "I should change positions slowly when getting out of bed." C. "If I miss a dose, I should double the next dose." D. "I should notify my provider if I experience a headache while taking this medication."
A. "I should let my doctor know if I have yellowing of my eyes." The nurse should include in the teaching that jaundice can be an adverse effect of ezetimibe as a result of hepatitis. The client should notify the provider if this occurs
A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I should let my doctor know if I have yellowing of my eyes." B. "This medication will stop my liver from making cholesterol." C. "I should expect to experience some bruising when I begin this medication." D. "I will take this medication at the same time as my gemfibrozil."
C. "Enteric-coated medications cause less gastric irritation." Enteric-coated medications do not dissolve until they reach the small intestine, which reduces the risk of gastric irritation.
A nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. The client asks the nurse why the provider prescribed an enteric-coated medication. Which of the following responses should the nurse give? A. "The enteric coating allows a lower dosage to be given." B. "Enteric-coated medications have better absorption in the body." C. "Enteric-coated medications cause less gastric irritation." D. "The enteric coating provides a steady release of the medication over time."
C. "I'll avoid contact sports like football." The most common adverse effect of taking anticoagulants is bleeding. Therefore, the client should avoid any activities that have a high risk of causing injury, such as contact sports.
A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I'll use a safety razor to shave each day." B. "I'll be sure to eat lots of spinach." C. "I'll avoid contact sports like football." D. "I'll take ibuprofen if I get a headache."
C. "Insulin lispro has an onset of about 15 minutes." Insulin lispro is a rapid-acting insulin and has an onset of 15 to 30 minutes.
A nurse is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? A. "The effects of the insulin lispro can last for 8 to 12 hours." B. "Administer insulin lispro 30 to 60 minutes before eating." C. "Insulin lispro has an onset of about 15 minutes." D. "This insulin can be given as a continuous intravenous bolus."
D. Store the vials in the refrigerator The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up to the printed expiration date.
A nurse is teaching a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching? A. Store the vials in the freezer B. Store the vials at room temperature C. Store the vials by a window D. Store the vials in the refrigerator
A. "A full therapeutic response may take several months to happen." The nurse should inform the family member that although levodopa is the most effective medication for Parkinson's disease, a full therapeutic response might not occur for several months.
A nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. Which of the following pieces of information should the nurse include? A. "A full therapeutic response may take several months to happen." B. "The medication should be taken with high-protein foods." C. "A full therapeutic response might cause vivid dreams." D. "The medication is given at the onset of mild symptoms."
B. Methadone The nurse should anticipate a prescription from the provider for methadone for a client who is experiencing opioid withdrawal. Methadone is an opioid medication that is used for pain management and treatment of withdrawal manifestations in clients who have opioid use disorder.
A nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing withdrawal. The nurse should anticipate a prescription for which of the following medications from the provider? A. Methylnaltrexone B. Methadone C. Naloxone D. Hydromorphone
A. Arthritis treated with ibuprofen every 8 hours as needed The nurse should identify that ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can cause gastrointestinal bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate and mucus secretion. This environment promotes the secretion of gastric acid and needs to be reported to the provider.
A nurse working in the emergency department is admitting a client who has a gastric ulcer and gastrointestinal (GI) bleeding. Which of the following factors in the client's medical history should the nurse report to the provider? A. Arthritis treated with ibuprofen every 8 hours as needed B. Previous tobacco smoking with cessation 5 years ago C. Negative H. pylori breath test 1 year prior D. Prescribed bismuth subsalicylate as needed for GI upset
