ATI Pharm quiz week 6

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching?

"I will avoid drinking grapefruit juice." Grapefruits and grapefruit juice can reduce metabolism of atorvastatin, which increases the risk for toxicity.

A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?

Infection Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.

A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include?

"You should avoid grapefruit juice." Grapefruit inhibits the drug-metabolizing enzyme CYP3A4 which slows the metabolism of simvastatin, This can cause an increase in serum simvastatin. Potential adverse effects include elevated liver enzymes, and rhabdomyolysis.

A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

42 units

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).

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 result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia.

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include?

Discard regular insulin that appears cloudy.

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?

Keep the open vial of insulin at room temperature. The client should keep the vial in use at room temperature to minimize tissue injury and to reduce the risk for lipodystrophy.

A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching?

Monitor for a cough. Captopril is an ACE inhibitor used to treat hypertension. The client should monitor and report a cough and dyspnea.

A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Monitor weight daily. Increase calcium intake. Monitor weight daily is correct. Pioglitazone may lead to fluid retention and worsen heart failure. Clients should monitor weight and report any rapid gains to the provider, Increase calcium intake is correct. Pioglitazone increases the risk of fractures in women. Clients should be advised to exercise and ensure adequate intake of vitamin D and calcium to protect bone health.

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect?

Muscle weakness Myopathy is an adverse effect of this medication. Signs of myopathy include muscle aches, tenderness, and muscle weakness.

A nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements?

Soy The nurse should instruct the client to avoid soy because soy can reduce the effectiveness of the levothyroxine.

A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via an external insulin pump. Which of the following statements by the client indicates a need for further teaching?

"I will use insulin glargine in my insulin pump."

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?

A decrease in urine output The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response.

A nurse is reviewing the medical record of a client who has hypertension and new prescription for metoprolol. Which of the following findings should the nurse investigate further?

Diet-controlled Type 2 diabetes mellitus Metoprolol does not suppress beta, mediated glycogenolysis, so it can be used more safely than other beta blockers in clients who have diabetes mellitus, especially for a client who is diet-controlled and not taking diabetic medications. The nurse should instruct the client that manifestations of hypoglycemia can be masked with this medication.

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Expect the NPH insulin to peak in 6 to 14 hr. NPH insulin is an intermediate-acting insulin. Its onset of action is 1 to 2 hr, peaking at 6 to 14 hr. Its duration of action is 16 to 24 hr. The client is at risk for hypoglycemia during the peak time.

A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?

Insulin glargine has a duration of 18 to 24 hr.