ATI Pharmacology

A nurse is reviewing lab results for a patient who has chronic asthma and is taking prednisone (deltasome) every other day. Which of the following lab values should the nurse report to the doctor?

Blood glucose 200 mg/dl

A nurse is caring for a client taking atorvastatin (Lipitor). Which of the following should the nurse recognize should be monitored for this client?

CK - creatinine kinase

A client with a history of hypertension tells the nurse that he uses over the counter oral decongestant for nasal congestion. The nurse should advise client that decongestants?

Can constrict blood vessels

A nurse is planning teaching for a child who has been prescribed fluticasone propionate (Flovent) for treatment of chronic asthma. The nurse plans to teach the child to use a spacer to minimize the risk for which of the following:

Candidiasis of the mouth

A nurse is assessing a patient who is taking oral contraceptives. Which of the following medications will interfere with the effectiveness of the oral contraceptives?

Carbamazepine (tegretol)

A nurse is preparing to administer warfarin (coumadin) to a client diagnosed with afib. Which action should the nurse take before administering warfarin?

Check INR results

A nurse caring for a client who was admitted to the hospital with congestive heart failure (CHF) and is taking digoxin (Lanoxin) 0.25 mg daily. The patient refused breakfast and is complaining of nausea and generalized weakness. Which of the following actions should the nurse perform 1st?

Check the patient's VS

A nurse is caring for a client who has asthma and is prescribed chewable Montelukast (Singular). The nurse should instruct the child's parent to administer the medication?

Daily at bedtime

A nurse is administering baclofen (lioresal) for a client with a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome?

Decrease flexor & extension spasticity

A client is experiencing acute angle closure glaucoma and IV mannitol (osmitrol) 25% is prescribed. Which of the following client findings should the nurse recognize as being the best indication that the medication is achieving its therapeutic effect?

Decrease in IOP

A client is taking IV heparin and oral warfarin (coumadin) for deep vein thrombosis. The client's aPTT is 4x the normal vailue and his INR is 2. Which of the following actions whould the nurse plan to take?

Decrease the heparin

A clinic nurse is giving instructions to a mother on the proper technique of applying ointment to her pre-school-age child. Who has conjunctivitis. Which should the nurse include in the instructions?

Discard the first bead of ointment before each application

The nurse is caring for a client who is in labor. The client is receiving oxytocin (pitocin) by continuous IV infusion, piggy backed into a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first?

Discontinue the client's IV meds

A nurse is providing teaching about insulin glargine (Lantus) to a client who has Type 1 diabetes mellitus. Which of the following should the nurse include in the instructions?

Do not mix this medication in a syringe with other insulins

A nurse is caring for a patient who has pneumonia. The patient tells the nurse that she is pregnant, but has not told the provider. Which of the following medication order should the nurse question?

Doxycycline (doxycin)

A nurse is providing teaching to a patient who has hypertension and is to start a new prescription for lisinopril (zestril). For which of the following should the nurse instruct the client to monitor and report to the PCP?

Dry cough

A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin (Bufferin) 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

ESR

A nurse is providing teaching to a female client who has been newly diagnosed with a seizure disorder and has begun phenyotin (Dilantin). The nurse should tell the client that phenytoin can decrease the effectiveness of which of the following?

Ethinyl estradiol/desogestrel (Cyclessa)

A nurse is teaching a patient with tuberculosis about the adverse effects of isoniazid (INH). The nurse restricts the client to notify the PCP immediately if which of the following occurs?

Feelings of isolation

A nurse is monitoring a patient who has been prescribed amphotericin B (fungizone) intermittent IV bolus for histoplasmosis. What adverse effects should you notify the PCP of?

Fever

A nurse is teaching a patient who has peptic ulcer disease and is to start a new prescription for sucralfate (carafate). The nurse explains to the patient this medication:

Forms a protective barrier over ulcers

A nurse is reviewing a client's daily lab findings before administering 0.125 mg of digoxin (lanoxin). The client's serum digoxin level is 0.7 ng/ml. Which of the following actions should the nurse take?

Give the medication

A nurse is caring for an older adult patient who is taking ranitidine (Zantac) for GERD. For which of the following findings should the client be instructed to monitor and report to provider?

Green sputum

A nurse is assessing a 5 year old child's need for pain medication. Which of the following actions by the nurse will best determine whether the child needs for pain medication?

Have the child rate the pain using the FACES pain scale

A nurse is caring for a client receiving zidovudine (retrovir). For which of the following lab results should the nurse prepare to monitor?

Hemoglobin

A nurse is caring for a patient who has cancer and is experiencing breakthrough pain every 6 to 8 hours. The client report pain level of 8 on a scale of 0 to 10. Which of the following analgesics should the nurse anticipate administering?

Hydromorphone (dilaudid)

A nurse enters an older adult patient's room to insert a saline lock. The client ask the nurse, 'Why do I need that, I am drinking plenty of fluids?" Which of the following responses by the nurse is appropriate?

The provider has prescribed antibiotics therapy to be administered IV every 6 hours

A patient newly diagnosed with hypothyroidism is prescribed levothyroxine (synthroid) 0.25 mg PO daily. After 6 weeks of treatment the nurse determines that the medication was effective if the:

Thyroid stimulating hormone (TSH) level is 2 microunits/ml

A patient has been receiving aspirin for treatment of arthritis. Which symptom should indicate the client is beginning to exhibit salicylism?

Tinnitus

A nurse reported to the nurse manager that another staff member was observed signing out meperidine hydrochloride (Demerol), which was not administered to the patient. The nurse manager should know that potential opiate abuse by the employees may be manifested by which of the following symptoms?

Tremors

A nurse is caring for a client who has hypovolemic shock. The client is being administered mannitol (Osmitrol) by IV bolus. Which of the following findings is the best indicator of the medication's effectiveness?

Urine output 50 ml/hr

A nurse is providing teaching for a patient with acute cystitis and is prescribed phenazopyridine HCL (pyridium). Which side effect will be normal for the patient to see?

Urine will turn red-orange color

A nurse is providing teaching to a patient with chronic asthma, is prescribed beclomethasone (QVAR). What instructions should be included in the nursing care plan?

Use inhaler as soon as asthma attack begins

A nurse is instructing a client who experiences migraines and is starting oral sumatriptan (Imitrex) therapy. Which of the following should the nurse include in teaching?

Use the medication as soon as migraine symptoms appear

A patient has been prescribed trimethoprim/sulfamethoxazole (bactrum DS). Which of the following should the nurse report?

Vesicular, crusty rash

A nurse is caring for a patient who is hospitalized with active pulmonary tuberculosis and is to be started on ethambutol (myambutol) therapy. The nurse should understand that which of the following should be monitored?

Visual activity

A nurse is caring for a client receiving filgrastim (Neupogen) for neutropenia. Which of the following laboratory values indicates that the treatment has been effective?

WBC 8,000/mm3

A nurse is assessing a client who has numerous bruises on his upper extremities. The patient reports that he has taken warfarin (coumadin) daily for the past 3 months. Which of the following statements by the client indicates the client needs further teaching?

I have started taking ginger root to treat my joint stiffness

Which of the following statements made by a client after a teaching session about warfarin (coumadin) indicates a need for further teaching?

I may take aspirin as needed for pain

A nurse is teaching a client about the use of risedronate (Actonel) to treat osteoporosis. Which of the following client statements indicates a need for further teaching?

I need to take the risedronate with food

A nurse is providing teaching to a patient who is prescribed phenytoin (Dilantin). Which statement by the patient indicates further teaching?

I should expect a rash to develop

A nurse is providing teaching to a client who has a new prescription for phenytoin (Dilantin). Which of the following statements by the client indicates an understanding of the teaching?

I should let my dentist know that I'm taking this medication

A nurse is teaching a client about the use of risedronate (Actonel) for the treatment of osteoporosis. Which of the following client statements indicates an understanding of the teaching?

I should sit up for 30 minutes after taking the risedronate

A nurse is providing teaching to an adolescent and her family regarding a new prescription of phenytoin (Dilantin) for the newly diagnosed seizure disorder. Which of the following client statements indicates the understanding of the teaching?

I will keep a seizure frequency chart

A nurse is providing discharge instructions for a client who has a prescription for colesevelam (WelChol). Which of the following indicates the client needs additional teaching?

I will mix the medication with 30 ml of water

A nurse providing teaching to a client who has just been prescribed prazosin (Minipress) which of the following client statement indicates understanding of teaching?

I will move slowly from sitting to standing to prevent falls

A nurse is teaching a client who has a prescription for pilocarpine (Pilocar) eye drops. Which of the following client statements should indicate to the nurse a need for additional teaching:

I will stop using the drops as soon as my vision improves

A nurse instructing on appropriate placement of the client's nitroglycerin transdermal patch (minitran) understands teaching with this statements:

I will take the patch off right after my evening meal

A nurse is teaching a client who has heart failure about a new prescription for captopril (capoten). Which of the following statements by the client indicates a need for further teaching?

I will use a salt substitute with my meals

A nurse is obtaining a medication history from a client who is prescribed tobramycin sulfate. Which of the following medications should the nurse notify the provider concerning concurrent use?

Ibuprofen (Motrin)

A nurse is providing discharge teaching for a patient that has a prescription for morphine. The nurse should:

Increase fiber intake

A nurse is caring for the following patient with acute ST elevation myocardial infarction. The patient is receiving nitroglycerin (nitro-bid IV) by continuous IV infusion to maintain a systolic BP between 130-10 mmHg

Increase the dose when the systolic BP is 160 mmHg

A nurse is assessing a client who is receiving epoetin alfa (procit) to treat anemia. For which should the nurse monitor related to this medication?

Increased BP

A nurse is caring for a client who is receiving oprelvekin (interlukin II). Which should the nurse document to indicate the effectiveness of the therapy?

Increased platelet count

A nurse is providing teaching to a client taking bupropion (zyban) as an aid to quit smoking. For which of the following side effects should the nurse assess the client?

Insomnia

A nurse is caring for a patient who has erectile dysfunction and is interested in taking sildenafil (Viagra). The nurse informs the patient that sildenafil is contraindicated due to the fact that the client also takes which one of the following medications?

Isosorbide (Isordil)

A nurse is precepting a newly licensed nurse who us caring for four clients. Which of the following actions should be noted in an incident report? The nurse administers:

Isosorbide mononitrate (Imdur) to a client who has a BP 82/60 mmHg

A nurse is assessing a client who comes to the clinic for a seasonal influenza vaccine. The client says he read about an influenza vaccine that is given as a nasal spray and wants to receive it. Which of the following is a contradiction for the patient to receiving the live attenuated influenza vaccine (LAIV)?

Just turned 62

A nurse is caring for a school age child prescribed methylphenidate (Ritalin) for ADHD. The nurse has initiated interventions to minimize adverse effects. Which of the following indicates a successful intervention?

Maintains age appropriate weight

A nurse is planning teaching for a client who has depression and is to start a new prescription for tranylcypromine (parnate). Which of the following should be included in the teaching?

Move slowly when changing to a standing position

A nurse is caring for a client in the PACU. The client is 1 hour postoperative, is difficult to arouse, and is hypotensive. The nurse should administer which of the following?

Naloxone (narcan)

A nurse assesses a patient with chronic back pain who is receiving 650 mg acetaminophen (tylenol) every 4 hours for pain. PCP has prescribed oxycodone/acetaminophen (percocet) every 4 to 6 hours PRN for breakthrough pain. Which action should the nurse take?

Notify the PCP

A client is being treated for heart failure and is receiving digoxin (Lanoxin) and furosemide (Lasix). Based on the chart findings, which of the following actions should the nurse take first?

Obtain an order for serum digoxin level

A nurse is caring for a client receiving heparin IV at 1,000 units/hr. Which of the following should the nurse recognize as an adverse reaction to this medication:

Pink tinged urine

A nurse is caring for a 20 year old female who has been prescribed isotretinoin (Accutane) for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests will be required:

Pregnancy test

A nurse is caring for a client with nausea. The client is prescribed intravenous metoclopramide (Reglan) as needed. The nurse knows that Reglan is an effective antiemetic because it

Promotes gastric emptying

A nurse is receiving a telephone prescription for an antibiotic from a client's provider. Which of the following is the nurse required to do?

Read the prescription back to the provider after transcribing

A nurse is caring for a client who is receiving nifedipine (Procardia). The nurse checks the client's blood pressure before administering medication and reports 98/58. Which of the following actions should the nurse first take?

Recheck the client's BP

A nurse is providing teaching to a client who is prescribed an MAOI. Which of the following should the nurse instruct the client to avoid while taking this medication?

Red wine

A nurse in the PACU is caring for a client who has received midazolam (Versed) IV bolus prior to an endoscopy. Which of the following findings indicate to the nurse to administer flumazenil (Romazicon) IV?

Respiratory depression

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 recognizes is of primary consideration when determining the schedule of administration?

Specific characteristics of the medication

A nurse is providing teaching to a client who is diagnosed with migraine headaches. The client is prescribed ergotamine (Ergostat) sublingual. Which of the following should the nurse include in the instructions?

Take 1 sublingual tablet at onset of migraine

A nurse is providing teaching to a client regarding the administration of ferrous sulfate (Feosol). Which of the following instructions should the nurse include in her teaching?

Take the tablet on an empty stomach

A nurse is caring for a patient who is taking clarithromycin (Biaxin). The nurse includes a diagnosis of "risk for altered sensory perception" in the client's plan of care. This is appropriate because many client's on clarithromycin have an altered sense of which of the following?

Taste

A client informs the nurse at the primary care providers office that he received a prescription for timolol (timoptic) to treat glaucoma. Which of the following in the client's history should concern you?

The client has a history of bradycardia

A nurse is caring for a client who has been receiving parenteral morphine sulfate following a thoracic procedure. Which of the following findings should the nurse recognize is the most reliable indicator that the client's pain is being adequately managed?

The client is able to breathe deeply and cough

A nurse administers ceftazidime (fortaz) to a client who has a severe penicillin allergy. Which of the following client findings requires an incident report?

The client reports shortness of breath

A patient diagnosed with acute bronchitis is beginning a short course of prednisone (Deltasone) therapy. The patient asks the nurse to give him the required vaccinations because he is joining the peace corp. The nurse appropriately responds by stating, "You should":

Wait until you have completed your medication therapy before receiving the vaccinations

A nurse is obtaining the medication history of a client who is starting a new prescription for allopurinol (Zyloprim). Which of the following medications should the nurse contact the provider regarding a potential interaction?

Warfarin (Coumadin)

A nurse is caring for a client who is receiving chlorpromazine (Thorazine) and is given a pass to attend a family outing on a sunny day. Which of the following is the most important for the nurse to include in the client's teaching about the side effects of chlorpromazine?

Wear a hat and long sleeved shirt

A nurse is to administer a new prescription for amoxicillin/clavulanic acid (Augmentin) IV bolus. The client tells the nurse they have an allergy to penicillin. Which should be done first?

Withhold the medication

A client who has hypothyroidism and is breastfeeding tells the nurse that she is taking levothyroxine (Synthroid) and is concerned that it will be excreted in her breast milk. Which of the following responses by the nurse is appropriate?

You will need to take the medication after breastfeeding the infant each morning

A nurse is caring for an older adult client. The client received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hour as prescribed. Which of the following entries is the appropriate documentation of this occurrence in the client's medical record?

0.9% sodium chloride 1 L IV infused over 4 hours. VS stable

A nurse is caring for an older adult client who is hospitalized. Which of the following medication is likely to put the client at risk for orthostatic hypotension. (Select all that apply):

1. Furosemide (Lasix) 2. Telmisartan (Micardis) 3. Phenelzine sulfate (Nardil)

A nurse is caring for a client diagnosed with sickle cell anemia who is taking hydroxyurea (droxia). Whcih findings should the nurse report? Select all that apply:

1. Hemoglobin 4.2 g/dl 4. Platelets 75,000/mm3 5. Neutrophils 1,400/mm3

A nurse administers naloxone (Narcan) as prescribed for a client who is 8 hr. postoperative adverse effects after administration of opioid analgesia. Which of the following interventions should the nurse plan to take following naloxone administration? (Select all that apply)

1. Observe the client for bleeding 2. Assess the client for N/V

A nurse is caring for several patients who have bipolar disorder. The nurse should recognize that which of the following medications are appropriate for treating this condition (Select all that apply):

1. Paroxetine (Paxil) 2. Lithium (Lithane) 4. Valproic acid (Depakote) 6. Carbamazepine (Tegretol)

A mom of a newborn asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine (dtap). Which of the following should the nurse say?

2 months

A nurse is caring for a client who is taking tamoxifen (nolvadex) for treatment of breast cancer. The nurse should inform the client that which of the side effects can develop, select all that apply:

2. Menstrual Irregularities 4. Hot flashes 5. Vaginal discharge

A nurse is instructing a client who has asthma. The client is currently taking albuterol (Proventil) every 4 hours PRM for bronchial spasms. He is to start a new prescription for montelukast (Singulair). Which of the following instructions should the nurse include: (Select all that apply)

4. Report any increased need to use albuterol 5. Take montelukast once a day in the evening

Older adult taking procainamide (pronestyl) is admitted to ER with an acute myocardial infarction and ventricular premature beats. Which finding should indicate to the nurse to withhold the medication and notify PCP?

A QRS widening increase than 50%

Provide teaching for a new prescription: exenatide (byetta) for type 2 diabetes. What should the nurse monitor and report?

Abdominal pain

A nurse is caring for a client who has just been transferred from the PACU to the medical surgical unit following a colon resection. The client reports pain of an 8 on a scale from 0 to 10 and has a prescription for morphine sulfate 4 mg IV bolus PRN pain every 2 hr. Which of the following actions should the nurse take first?

Check the client's PACU medication record

A nurse is caring for a client who has cancer and is taking oral morphine sulfate and docusate sodium (Colace). Which of the following side effects will be minimized by taking the docusate sodium on a daily basis?

Constipation

A nurse is planning teaching for a client who has a new diagnosis of exercise-induces asthma. Which of the following medications should the nurse instruct the client to use prior to physical activity?

Cromolyn sodium (Intal)

A patient has been taking propylthiouracil (PTU) for 4 weeks. What should an outcome be?

Decrease HR

A nurse is monitoring a client receiving an IV infusion of magnesium sulfate for preterm labor. Which of the following indicates to the nurse that the client is experiencing magnesium toxicity?

Decreased LOC

A nurse is providing teaching to a client who is prescribed trimethoprim/sulfamethoxazole (Bactrim DS). Which of the following instructions should the nurse include in her teaching?

Drink 8 to 10 glasses of water daily

A nurse is administering donepezil (Aricept) to a client who has Alzheimer's disease. Which of the following documented findings should the nurse report to the provider immediately?

Dyspnea

A nurse is evaluating a client who has been prescribed oral metformin (Glucophage) and glipizide (Glucotrol) 3 months ago to control diabetes mellitus. The nurse should identify which of the following laboratory findings as indicative of client compliance over time?

HbA1c 6.5%

A nurse is caring for a client who has heart failure and is prescribed enalapril (Vasotec) and spironolactone (Aldactone). For which of the following potential side effects should the nurse plan to monitor?

Hyperkalemia

A client who is postoperative has received 2 mg of hydromorphone (Dilaudid) IV bolus every 2 hours. The client continues to rate his pain at a 7 on a scale from 0 to 10. which of the following client findings should the nurse attend to first?

Hypotension

An older adult client who has an infection is prescribed gentamicin (Garamycin). Which of the following client statements indicates a side effect of this medication and should be reported to the provider immediately?

I have to turn the volume up on the TV to hear it

A nurse is providing teaching to a client who has rheumatoid arthritis and is prescribed methotrexate (Rheumatrex). Which of the following statements by the client indicates an understanding of the teaching?

I should call the doctor if I develop sores in my mouth

A nurse is providing teaching to a client who has just been prescribed prazosin (Minipress). Which of the following client statements indicates an understanding of the teaching?

I will move slowly from sitting to standing to prevent falls

A child is prescribed amoxicillin-clavulanic acid (Augmentin) for the treatment of an ear infection. The child's mother asks the nurse why her child is receiving this combination of two medications. The nurse appropriately responds by stating that this medication is:

More effective

A client is receiving a heparin infusion for deep vein thrombosis. The nurse should discontinue the medication infusion for which client findings:

Platelets 96,000/mm3

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following is the client prescribed chlordiazepoxide (Librium)?

Prevent delirium tremors

A nurse caring for a client that has undergone a liver transplant and is taking cyclosporine (Sandimmune). Which of the following laboratory findings indicates an adverse effect of the medication?

Serum creatinine 2.5 mg/dl

A nurse is caring for a patient with chronic renal failure and states she has heartburn. Prescribes aluminum hydroxide (Amphojel). The patient asks the nurse "why cant I just take the antacid magadrate (Reopan) my husband has at home". The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following:

Serum phosphorus levels

At 0900 a nurse is preparing a client's medications. Based on the chart findings, which of the following medications should the nurse give first?

Sodium polystyrene sulfate (Kayexalate)

A client who has diabetes mellitus insulin lispro and is prescribed metoprolol (Lopressor) for hypertension. Which of the following should the nurse observe for in this client as an early indicator of hypoglycemia?

Sweating

A nurse is providing teaching to a client who has a new pancrelipase (Pancrease). Which of the following should the nurse include in the teaching?

Take the medication with each meal and snack

A client is prescribed amitriptyline (Elavil). Which of the following adverse effects should the nurse instruct the client to report?

Urinary retention

A nurse is caring for a client who is starting a new prescription for warfarin (Coumadin). Which of the following medications should the nurse plan to administer if the client experiences bleeding?

Vitamin K

A nurse is educating a client who has a new prescription for simvastatin (zocor). Which of the following instructions should the nurse include in the teaching plan? Select all that apply:

1. Report muscle pain to provider 2. Do not take the medication with grapefruit juice 4. Minimize the intake of alcoholic beverages 5. Expect therapy with the medication to be life long

A nurse is caring for postoperative patient with PCA of morphine sulfate. The nurse assesses a respiratory rate of 10/ min and is unable to arouse the patient with verbal or tactile stimulation. Which of the following actions should the nurse first take?

Administer naloxone (narcan) IV to the client

A nurse is caring for a client who is receiving haloperidol (haldol). For which of the following adverse effects should the nurse be observing?

Akathisia

A home health nurse is reviewing the medication list of an older adult patient who reports falling a couple of times over the past week. Which of the following meds should the nurse suspect is contributing to the client's falls?

Alprazolam (Xanax)

A client has a history of myocardial infarction (MI) is prescribed aspirin (Ecotrin) 325 mg. The nurse correctly understands that the aspirin is ordered due to its action as a?

Antiplatelet aggregate

A nurse is caring for a client who has heart failure and is receiving furosemide (lasix) and digoxin (lanoxin). Routine lab results reveal a potassium level of 2.6 mEq/L. Which of the following actions should the nurse take first?

Apply a cardiac monitor

A client is being started on ferrous sulfate. To enhance absorption, the nurse should advise the client to take the medication with which of the following?

Ascorbic acid

A nurse is planning to provide medication education for a client who will begin a course of therapy with metronidazole (flagyl). Which of the following should the nurse instruct the client to avoid during the course of therapy?

Beer