ATI Pharm

A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates understanding of the teaching?

"I'll watch for increased breast tissue growth while taking this medication" Spironolactone, which is derived from steroids, can cause adverse endocrine effects such as gynecomastia, impotence in med, and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur. -Spironolactone is a potassium sparing diuretic -limit foods high in potassium -Do not use salt substitutes because they contain potassium

A nurse is caring for a client who has multiple sclerosis and is receiving interferon beta-1a. The nurse should identify that which of the following client statements indicates a potential adverse effect of the medication?

"My body aches all over" The adverse effects of interferon beta-1a can include flu-like symptoms such as general body and muscle aches.

A nurse is providing discharge teaching to a client who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of information should the nurse include?

"Seizures can occur with this medication" The nurse should tell the client that seizures can occur when receiving imipenem. The client should notify the provider immediately if these occur.

The nurse is teaching a client who is experiencing age-related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching?

"This medication has fewer systemic effects than oral estrogen" The nurse should instruct the client that intravaginal estradiol cream has few systemic side effects because it is applied topically. However, oral estrogen can cause serious systemic effects. -Estradiol cream should be used 1-3 days per week -Applied internally for the relief of manifestations related to vaginal atrophy -Decreases the risk of postmenopausal bone loss, which can cause osteoporosis.

A nurse is teaching a client who has allergic rhinitis about a new prescription for \brompheniramine. Which of the following pieces of information should the nurse include in the teaching?

"You might find that you develop a dry mouth" A client taking first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Treating frequent sips of liquid or sucking on a hard , sugarless candy can help relieve dry mouth.

A nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication?

Abdominal pain

A nurse is providing teaching to a client who has a new prescription for guaifenesin (mucinex), what info regarding the action of guaifenesin should the nurse include in the teaching?

Guaifenesin (mucinex) increases cough production

A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the patient to notify the provider?

Muscle pain

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. A severe allergy to which of the following medications is a contraindication to cefriatxone?

Piperacillin Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross-sensitivity reaction to ceftriaxone, a third generation cephalosporin.

A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily. The client reports taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?

Urine specific gravity 1.035 Oliguria, an increased urine concentration, and an increased urine specific gravity (>1.030) are expected findings in clients who are dehydrated.

A nurse is providing teaching to a client who has a new prescription for levothyroxine (Synthroid), which statement indicates understanding of the teaching?

"I might not realize the full effect of the medication for several weeks" Take on an empty stomach with a glass of water, first thing in the morning 30-60 minutes prior to breakfast.

A nurse is preparing to administer verapamil to a client who is 2 days post myocardial infarction. The nurse should monitor the client for which of the following outcomes as therapeutic response to the medication?

Decreased anginal pain

A nurse is teaching to a client who has systemic lupus erythematosus about a new prescription for oral glucocorticoid therapy. Which of the following client statements indicates an understanding of the teaching?

"I should take a calcium supplement while on this medication" An adverse effect of systemic glucocorticoid therapy is osteoporosis. Increasing calcium rich foods in the diet and adding calcium and vitamin D supplements should be encouraged to prevent osteoporosis and decrease the risk of fractures.

A nurse is caring for a client who has diabetes insipidus. Which of the following laboratory values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder?

Creatinine clearance 50mL/min Creatinine clearance should be above 85 for a female and 107 for a male. A creatinine clearance of 50 indicates renal impairment and is a contraindication to receiving vasopressin. Renal impairment increases the likelihood of the life threatening effect of water intoxication.

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?

Decrease in level of thyroid stimulating hormone (TSH) In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop which results in a decreased level of TSH.

A nurse is preparing to administer amlodipine to a client who has hypertension. The nurse should plan to monitor the client for which of the following adverse effects of the medication? (Select all that apply)

Dizziness Palpitations Peripheral edema The nurse should monitor this client who is taking amlodipine for dizziness, palpitations, and peripheral edema as adverse effects of the medication. The nurse should advise the client to avoid activities that require alertness until the effect of the medication is known and to notify the provider if any of these adverse effects occur.

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 supplements?

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, echinacea and ginkgo biloba. The nurse should notify the provider immediately about this potential risk.

A nurse is caring for a client who is taking fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect of the medication?

Hypokalemia The nurse should identify that hypokalemia is an adverse effect of fludrocortisone due to excessive sodium and water retention, resulting in the loss of excess amounts of potassium. -Fludrocortisone works on the kidneys to promote the retention of sodium and water. -Adverse effects: hypertension, weight gain, fat redistribution to the abdomen, face, and upper back, increased appetite and nausea

A nurse is caring for a client who was recently diagnosed with Addison's disease and has been placed on long-term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy?

Mineralocorticoids maintain electrolyte and fluid balance. Mineralocorticoids (specifically aldosterone) are necessary for the regulation of fluid and electrolyte balance (particularly sodium, potassium, and water). Addison's disease results in a deficiency of cortisol and aldosterone production and requires supplementation with glucocorticoids and mineralocorticoids. Fludrocortisone is the only mineralocorticoid available.

A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse include in the teaching?

Plan to use a type of short-duration insulin in the infusion pump. -The client should plan to use short-duration insulin such as regular, lispro, aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal. -The pump should be changed ever 1-3 days -The pump should not be turned off except for special occasions to avoid the sugar dropping. -The client should move the catheter infusion site at least 1 inch away from the old site to maintain tissue integrity.

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client?

Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the clients airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions including hypertension. Blocking the beta receptors prevents the action of beta-agonists such as albuterol.

A nurse is preparing to administer IV nitroprusside for a client who had a myocardial infarction. Which of the following actions should the nurse take?

Regulate the infusion pump rate using the client's weight in the calculation. Sodium nitroprusside is a potent vasodilator that works faster than any other medication available and is administered as a continuous IV infusion to clients who require a rapid reduction of blood pressure. The nurse should monitor the clients BP either continuously with an arterial line or at least q15m as this medication can cause a rapid reduction of BP that can be life threatening. -Medication solution should be a light brown color. The solution should be covered with an opaque bag because the medication can be degraded by light.

A nurse is caring for a client who has rheumatoid arthritis and a new prescription for etanercept. Which of the following values should the nurse view prior to the administration of this medication?

Result of last purified protein derivative (PPD) test The nurse should identify that a client who is taking etanercept is at risk for infections such as TB. To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving etanercept. During treatment with etanercept, the client should be monitored closely for the development of TB. -Etanercept is administered via injection, the clients ability to swallow should not affect the administration of this medication.

A nurse is caring for a client who has a prescription for subdermal etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history?

Takes St. Johns wart St. John's wart can reduce the effects of subdermal etonogestrel because it stimulates hepatic drug metabolizing enzymes. Therefore, the nurse should alert the provider about the client's use of st johns wort and it should be discontinued.

A nurse is assessing a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement?

The client is having 1-2 bowel movements per day 1-2 bowel movements per day indicates adequate absorption of food and a therapeutic response to pancreatic enzyme replacement for clients who have cystic fibrosis. Frequent stooling defined as more than 1-2 bowel movements per day indicated inadequate replacement.

A nurse is assessing a client who has heart failure and is taking digoxin. The nurse should monitor the client for which of the following manifestations as an indication of digoxin toxicity?

Vomiting (N/V, anorexia, blurred vision)

A nurse is providing teaching to a client who has a new prescription for beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance, what should the nurse instruct?

You should gargle with water after each use of this inhaler

A nurse is providing teaching for a patient with a prescription for oral metronidazole. What is the priority teaching point?

You should report a rash to your provider. May be an indication of Sevens-Johnson syndrome

A nurse is caring for a client who is due to receive general anesthesia. The clients asks the nurse, "What is the difference between an analgesic and anesthesia?" Which of the following statements should the nurse make?

"Anesthesia can cause loss of consciousness" General anesthesia reduces or causes a complete loss of consciousness. -Analgesics do not affect sensory interpretation such as temperature, touch, or taste.

A nurse is caring for a client who has tuberculosis and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of the medication?

"I have noticed my urine is orange in color" The nurse should identify that an adverse effect of rifampin can be red-orange colored urine, saliva, sweat, and tears as the medication is excreted from the body. The nurse should also inform the client that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The client should inform the proivder if urine becomes dark in color since this can be an indication of hepatotoxicity.

A nurse is teaching a client who is about to start taking propylthiouracil to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective?

"I will need laboratory tests to check my liver function" Propylthiouracil is hepatotoxic and can cause severe liver injury. The nurse should instruct the client to report dark urine and yellowing of the eyes, which can indicate an injury to the liver.

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?

"You should eat foods that are high in potassium while taking this medication" The nurse should instruct the 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 preparing to administer a PRN medication to a group of clients. Which of the following clients should the nurse administer medication to first?

A client who is attending postoperative physical therapy and requests pain medication.

A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

Administer a small test dose before giving the full dose. A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. A small test dose should be administered over 5 minutes before giving the full dose. The client should be monitored carefully for an allergic reaction during and for a period of time following the test dose.

A nurse is caring for a client who has asthma and a prescription for zileuton. Which of the following laboratory values should the nurse monitor while the client is taking this medication?

Alanine aminotransferase (ALT) The nurse should identify that ALT is a liver function test. Zileuton is a leukotriene modifier that can affect the liver, causing increased ALT levels.

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication, I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?

Ammonia Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the CNS causing hepatic encephalopathy or coma.

A nurse in a provider's office is assessing a client who reports taking dietary supplement to reduce hot flashes related to menopause. Which of the following supplements should the nurse expect the client to report taking?

Black Cohosh Black cohosh is an herb that is used for the treatment of menopausal symptoms such as hot flashes, vaginal dryness, irritability, and sleep disturbance.

A nurse is planning a staff education session of AE of meds, what info should the nurse discuss about anticholinergic adverse effects?

Blurred vision Tachycardia Constipation

A nurse is assessing a client who has been using beclomethasone for 2 weeks to manage her asthma, what is the priority to report to the provider?

Bronchospasms

A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication?

Cardiac dysrhythmias The nurse should identify cardiac dysrhythmias as an adverse effect of phenytoin IV. As a result of the potential complication, cardiac monitoring is required. -Hypotension may occur is this medication is administered too quickly

A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following clinical manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect?

Constipation Mydriatic eye drops can cause systemic anticholinergic effects such as constipation, dry mouth, photophobia, and tachycardia.

A nurse is reviewing the medical record of a client who is requesting a prescription for sildanfil citrate. Which of the following data in the client's record should the nurse identify as a contraindication to the use of this medication?

Current use of isosorbide to treat heart failure Taking any nitrates such as isosorbide and nitroglycerin is a contraindication for sildenafil, a medication that treats erectile dysfunction. Taking it concurrently with nitrates can cause life threatening hypotension.

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change?

Detrimental inhibitory interaction A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects.

A nurse is caring for a client who is receiving cefotetan 1 g via intermittent IV bolus to treat a postoperative infection. Which of the following manifestations should the nurse monitor for as an adverse effect of the medication

Epistaxis Cefotetan is an antibiotic that affects vitamin K levels, which can result in bleeding and epistaxis. The nurse should monitor the client for bleeding and notify the provider if this manifestation occurs so the medication can be discontinued. -Monitor the client for diarrhea -Cefotetan is a second generation cephalosporin, an antibiotic.

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

Hyperuricemia The nurse should monitor the client who is receiving IV furosemide for hyperuricemia, hypocalcemia, hypochloremia and hyponatremia. The nurse should instruct the client to notify the provider for any tenderness or swelling of the joints.

A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?

Insomnia Levothyroxine overdose will resulting in manifestations of hyperthyroidism, which includes insomnia, tachycardia, and hyperthermia.

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider?

Lorazepam The nurse should identify that lorazepam can cause central nervous system depression, which can result in increased respiratory depression and sedation when administered with an opioid. The nurse should clarify the prescription with the provider.

A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching?

Maintain a consistent sodium intake.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels. Contraindicated for patients who have anemia or malnutrition.

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

Prednisone Glucose intolerance and hyperglycemia, patient might require increased dosage of hypoglycemic med

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?

Prothrombin time (PT) This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy, should typically be approximate 2-3 times the normal value, depending on the indication for therapeutic anticoagulation.

A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion if insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis?

Regular Insulin Treatment for DKC is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this medication?

Report of pain The nurse should identify that naloxone is used to reverse the effects of opioid overdose administered for pain, sedation euphoria, and respiratory depression. Excess doses of naloxone can cause the return of pain but can improve the client's respiratory rate.

A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take?

Withhold the client's medication