ATI Pharmacology Proctored

A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero.

0.8

A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.

125

A nurse is preparing to administer Haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.

2

A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.

200

A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.

22

A nurse is preparing to administer Amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Do not use a trailing zero.)

4

A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.

6.5

A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral solution 10 mg/1 mL. how many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

8

A nurse is teaching a client who has a new prescription for Verapamil to control Hypertension. Which of the following instructions should the nurse include? A. Increase the amount of dietary fiber in the diet. B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet. D. Withhold food for 1 hr after the medication is taken

A (Increasing dietary fiber intake can help prevent constipation, an adverse effect of verapamil)

A nurse in the post‑anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications? A. Neostigmine B. Naloxone C. Dantrolene D. Vecuronium

A (Neostigmine is a cholinesterase inhibitor used to reverse the effects of nondepolarizing neuromuscular blockers)

A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Hallucinations B. Increased salivation C. Diarrhea D. Discoloration of urine

A (Pramipexole can cause hallucinations within 9 months of the initial dose and might require discontinuation.)

A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia

A (Propranolol is a nonselective beta‑adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is contraindicated in clients who have asthma)

A nurse is teaching a female client who has tobacco use disorder about Nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching? A. "I should avoid eating right before I chew a piece of nicotine gum." B. "I will need to stop using the nicotine gum after 1 year." C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." D. "I must chew the nicotine gum quickly for about 15 minutes.

A (The client should avoid eating or drinking 15 min prior to and while chewing the nicotine gum)

A nurse is teaching a client who has a new prescription for Beclomethasone. Which of the following instructions should the nurse include? A. "Rinse your mouth after each use of this medication." B. "Limit fluid intake while taking this medication." C. "Increase your intake of vitamin B12 while taking this medication." D. "You can take the medication as needed.

A (The client should rinse her mouth after each use to reduce the risk of oral fungal infection)

A nurse is providing information to a client who has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include? A. Take the medication with food. B. Plan to take the medication at bedtime. C. Expect increased swelling of the ankles. D. Fluid intake should be limited in the morning.

A (The client should take hydrochlorothiazide with or after meals to prevent gastrointestinal upset)

A nurse is teaching a client who has a prescription for long‑term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A.Weight gain B.Nervousness C.Bradycardia D.Constipation

A (Weight gain and fluid retention are adverse effects of oral prednisone due to the effect of sodium and water retention)

A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include? A. "Notify the provider if you plan to become pregnant." B. "Take the medication 1 hr before you plan to go to sleep." C. "Allow at least 6 hr for sleep when taking zolpidem." D. "To increase the effectiveness of zolpidem, take it with a bedtime snack.

A (Zolpidem is Pregnancy Risk Category C. The client should notify the provider if she plans to become pregnant)

A nurse is teaching a client who has OCD and has a new prescription for Paroxetine. Which of the following instructions should the nurse include? A. "It can take several weeks before you feel like the medication is helping." B. "Take the medication just before bedtime to promote sleep." C. "You should take the medication when needed for obsessive urges." D. "Monitor for weight gain while taking this medication."

A. "It can take several weeks before you feel like the medication is helping." (Paroxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit.)

A nurse is providing discharge teaching to a client who has a new prescription for Fluoxetine for PTSD. Which of the following statements should the nurse include in the teaching? A. "You may have a decreased desire for intimacy while taking this medication." B. "You should take this medication at bedtime to help promote sleep." C. "You will have fewer urinary adverse effects if you urinate just before taking this medication." D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication.

A. "You may have a decreased desire for intimacy while taking this medication." (Decreased libido is a potential adverse effect of fluoxetine and other SSRIs)

A nurse is teaching a school‑age child and his parents about a new prescription for Lisdexamfetamine. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. An adverse effect of this medication is CNS stimulation. B. Administer the medication before bedtime. C. Monitor blood pressure while taking this medication. D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop. E. This medication raises the levels of dopamine in the brain

A. An adverse effect of this medication is CNS stimulation. C. Monitor blood pressure while taking this medication. E. This medication raises the levels of dopamine in the brain (A. An adverse effect of lisdexamfetamine is CNS stimulation such as insomnia and restlessness. C. The nurse should instruct the client to monitor his blood pressure due to potential cardiovascular effects of lisdexamfetamine. E. Lisdexamfetamine, a CNS stimulant, works by raising the levels of norepinephrine and dopamine in the CNS)

A nurse is caring for a client who takes Paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage Bruxism? (Select all that apply.) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of a mouth guard D. Changing to a different class of antidepressant medication E. Increasing the dose of paroxetine

A. Concurrent administration of buspirone C. Use of a mouth guard D. Changing to a different class of antidepressant medication (A. Concurrent administration of a low dose of buspirone is an effective measure to manage the adverse effects of paroxetine C.Using a mouth guard during sleep can decrease the risk for oral damage resulting from bruxism. D. Changing to different class of antidepressant medication that does not have the adverse effect of bruxism is an effective measure)

A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply) A. Cough B. Dizziness C. Decreased libido D. Alopecia E. hypotension

A. Cough B. Dizziness C. Decreased libido (A.Cough and dyspnea can indicate that the client has developed bronchitis, which is an adverse effect of venlafaxine. B.Dizziness is a common adverse effect of venlafaxine. C.Sexual dysfunction, such as decreased)

A nurse is preparing to perform a follow‑up assessment on a client who takes Chlorpromazine for the treatment of Schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.) A. Disorganized speech B. Bizarre behavior C. Impaired social interactions D. Hallucinations E. Decreased motivation

A. Disorganized speech B. Bizarre behavior D. Hallucinations (A. A client who takes a conventional antipsychotic medication, such as chlorpromazine, should have the greatest improvement in positive symptoms such as disorganized speech. B. A client who takes a conventional antipsychotic medication, such as chlorpromazine, should have the greatest improvement in positive symptoms such as bizarre behavior D. A client who takes a conventional antipsychotic medication, such as chlorpromazine, should have the greatest improvement in positive symptoms such as hallucinations.)

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply.) A. Lorazepam B. Diazepam C. Disulfiram D. Naltrexone E. Acamprosate

A. Lorazepam B. Diazepam (A. Lorazepam is a benzodiazepine used during alcohol withdrawal to decrease anxiety and reduce the risk for seizures. B. Diazepam is a benzodiazepine used during alcohol withdrawal to decrease anxiety and reduce the risk for seizure)

A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.) A. Maintain skill competency. B. Determine the dosage. C. Monitor for adverse effects. D. Safeguard medications. E. Identify the client's diagnosis

A. Maintain skill competency. C. Monitor for adverse effects. D. Safeguard medications. (A.maintaining skill competency and using appropriate administration techniques are legal responsibilities of the nurse C. A nurse is legally responsible for monitoring for side and adverse effects of medication D. Safeguarding of medications, such as controlled substances, is a legal responsibility of the nurse)

A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication,and obtain a blood specimen 30 min late

A. Obtain a blood specimen immediately prior to administering the next dose of medication. (To verify trough levels of a medication, the nurse should obtain a blood specimen immediately before administering the next dose of medication.)

A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four

A. One (Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect to administer this medication once a day.)

A nurse is caring for a client who has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss

A. Orthostatic hypotension (Orthostatic hypotension is an adverse of effect of mAOIs, including phenelzine.)

A nurse is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse? A. Perform immediate gastric lavage. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test

A. Perform immediate gastric lavage. (Gastric lavage is appropriate for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. This action will lower the client's lithium level.)

A nurse is caring for a client who has a new prescription for Valproic Acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.) A. Thrombocyte count B. Hematocrit C. Amylase D. Liver function tests E. Potassium

A. Thrombocyte count C. Amylase D. Liver function tests (A.Treatment with valproic acid can result in thrombocytopenia. The client's thrombocyte count should be monitored periodically. C.Treatment with valproic acid can result in pancreatitis. The client's amylase should be monitored periodically. D.Treatment with valproic acid can result in hepatotoxicity. The client's liver function should be monitored periodically.)

A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.) A. Use of herbal teas B. Daily fluid intake C. Current health status D. Previous surgical history E. Food allergies

A. Use of herbal teas C. Current health status E. Food allergies (A. The nurse should inquire about the client's use of herbal products, which often contain caffeine, prior to medication administration because caffeine can affect medication biotransformation C. The nurse should review the client's current health status because new prescriptions can cause alterations in current health status E. The nurse should inquire about food allergies during the preassessment to identify any potential reactions or interactions)

A nurse is teaching an adolescent client who has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication? A. Wear sunglasses when outdoors. B. Check your temperature daily. C. Take this medication in the morning. D. Add extra calories to your die

A. Wear sunglasses when outdoors. (Wearing sunglasses when outdoors will decrease photophobia, an anticholinergic effect associated with TCA use)

A nurse is teaching the family of a child who has Cystic Fibrosis and a new prescription for Acetylcysteine. Which of the following information should the nurse include in the instructions? A. "Expect this medication to suppress your cough." B. "Expect this medication to smell like rotten eggs." C. "Expect this medication to cause euphoria." D. "Expect this medication to turn your urine orange."

B (Acetylcysteine has a sulfur content that causes a rotten‑egg odor)

A nurse is instructing a client who has a new prescription for Timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication? A. Bony orbit B. Nasolacrimal duct C. Conjunctival sac D. Outer canthus

B (Pressing on the nasolacrimal duct blocks the lacrimal punctum and prevents systemic absorption of the medication)

A nurse is teaching a client about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I should use the spray every 4 hours while I am awake." B. "It can take as long as 3 weeks before the medication takes a maximum effect." C. "This medication can also be used to treat motion sickness." D. "I can use this medication when my nasal passages are blocked.

B (The client can see some benefits of the medication within a few hours, but the maximum benefits can take up to 3 weeks.)

A nurse is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the nurse include? A. "You can take this medication to abort an acute asthma attack." B. "Tremors are an adverse effect of this medication." C. "Prolonged use of this medication can cause hyperglycemia." D. "This medication can slow skeletal growth rate."

B (Tremors can occur due to excessive stimulation of beta2 receptors of skeletal muscles)

A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching? A. Take the albuterol at the same time each day. B. Administer the albuterol inhaler prior to using the beclomethasone inhaler. C. Use beclomethasone if experiencing an acute episode. D. Avoid shaking the beclomethasone before us

B (When a client is prescribed an inhaled beta2‑agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone), the client should take the beta2‑agonist first. The beta2‑agonist promotes bronchodilation and enhances absorption of the glucocorticoid.)

A nurse is caring for a client who states she has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B (When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications, such as phenylephrine)

A nurse is teaching a client who has a new prescription for Ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication? A. Baked potato B. Fried chicken C. Whole‑grain bread D. Citrus fruits

B (high‑fat foods, such as fried chicken prolong the absorption of ramelteon and should be avoided)

A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process? A. "A second nurse enters the prescription into the client's medical record." B. "Another nurse should listen to the phone call." C. "The provider can clarify the prescription when he signs the health record." D. "I should omit the 'read back' if this is a one‑time prescription

B. "Another nurse should listen to the phone call." (A second nurse should listen to a telephone prescription to prevent errors in communication.)

A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. "This medication can safely be taken during pregnancy." B. "Eliminate grapefruit juice from your diet." C. "You will need to have a complete blood count and carbamazepine levels drawn periodically." D. "Notify your provider if you develop a rash." E. "Avoid driving for the first few days after starting this medication.

B. "Eliminate grapefruit juice from your diet." C. "You will need to have a complete blood count and carbamazepine levels drawn periodically." D. "Notify your provider if you develop a rash." E. "Avoid driving for the first few days after starting this medication. (B. Grapefruit juice affects carbamazepine metabolism and should be avoided. C. Carbamazepine blood levels and the CBC should be monitored during therapy. The client is at risk for bone marrow depression while taking carbamazepine and should notify the provider for a sore throat or other manifestations of an infection. D. Carbamazepine can cause Stevens‑Johnson syndrome, which can be fatal. The client should notify the provider promptly if a rash occurs. E. CNS effects such as drowsiness or dizziness can occur early in treatment with carbamazepine and the client should avoid activities requiring alertness until these effects subside)

A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching? A. "Add extra snacks to your diet to prevent weight loss." B. "Notify the provider if you develop breast enlargement." C. "You may begin to have mild seizures while taking this medication." D." This medication is likely to increase your libido."

B. "Notify the provider if you develop breast enlargement." (Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur.)

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.) A. A client at 8 weeks of gestation who asks for an Influenza immunization B. A client who takes Prednisone and has a possible Fungal infection C. A client who has chronic liver disease and is taking Hydrocodone D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide E. A client who has a prosthetic heart valve, takes Warfarin, and reports a suspected pregnancy

B. A client who takes Prednisone and has a possible Fungal infection C. A client who has chronic liver disease and is taking Hydrocodone E. A client who has a prosthetic heart valve, takes Warfarin, and reports a suspected pregnancy (B. Glucocorticoids should not be taken by a client who has a possible systemic fungal infection. The nurse should recognize a contraindication and notify the provider. C. Acetaminophen is contraindicated due to toxicity for a client who has a liver disorder. The nurse should notify the provider, who can prescribe a medication that does not contain acetaminophen. E. Warfarin is a Pregnancy Category X medication, which can cause severe birth defects to the fetus. The nurse should notify the provider about the suspected pregnancy)

A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.) A. Have the client lie on her side. B. Ask the client to look up at the ceiling. C. Tell the client to blink when the drops enter her eye. D. Drop the medication into the center of the client's conjunctival sac. E. Instruct the client to close her eye gently after instillation

B. Ask the client to look up at the ceiling. D. Drop the medication into the center of the client's conjunctival sac. E. Instruct the client to close her eye gently after instillation (B. The client should look upward to keep the drops from falling onto her cornea. D. The nurse should drop the medication into the center of the conjunctival sac to promote distribution. E. The client should close her eye gently to promote distribution of the medication)

A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects? A. Take the medication in the morning to prevent insomnia. B. Chew sugarless gum to moisten the mouth. C. Use cooling measures to decrease fever. D. Take an antacid to relieve nausea

B. Chew sugarless gum to moisten the mouth. (Chewing sugarless gum can help the client cope with dry mouth, a potential anticholinergic effect of fluphenazine)

A nurse is assessing a client who takes Lithium Carbonate for the treatment of Bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? A. Severe hypertension B. Coarse tremors C. Constipation D. Muscle spasm

B. Coarse tremors (Coarse tremors are an indication of toxicity)

A nurse is providing teaching to a client who has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects? A. Diarrhea B. Dry mouth C. Insomnia D. Hypertension

B. Dry mouth (Dry mouth is a common adverse effect associated with clonidine use)

A nurse is caring for a client who has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome? A. Bruising B. Fever C. Abdominal pain D. Rash

B. Fever (Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline)

A nurse working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? A. Administer flumazenil. B. Identify the client's level of orientation. C. Infuse IV fluids. D. Prepare the client for gastric lavage

B. Identify the client's level of orientation. (The first action the nurse should take when using the nursing process is to assess the client. Identifying the client's level of orientation is the priority action.)

A nurse is preparing to administer medications to a 4‑month‑old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.) A. Infants have a more rapid gastric emptying time. B. Infants have immature liver function. C. Infants' blood‑brain barrier is poorly developed. D. Infants have an increased ability to absorb topical medications. E. Infants have an increased number of protein‑binding sites.

B. Infants have immature liver function. C. Infants' blood‑brain barrier is poorly developed. D. Infants have an increased ability to absorb topical medications. (B. Infants have immature liver function until 1 year of age. The nurse should administer medications the liver metabolizes in smaller dosages. C. Infants have a poorly developed blood‑brain barrier, which places them at risk for adverse effects from medications that pass through the blood‑brain barrier. The nurse should administer these medications in smaller dosages. D. Because infants have more blood flowing to the skin and their skin is thin, their medication absorption is increased, making them prone to toxicity from topical medications)

A nurse is teaching the parents of a school‑age child about transdermal Methylphenidate. Which of the following instructions should the nurse include? A. Apply one patch twice per day. B. Leave the patch on for 9 hr. C. Apply the patch to the child's waist. D. Use opened tray within 6 months.

B. Leave the patch on for 9 hr. (Transdermal methylphenidate is administered for 9 hr/day.)

A nurse is caring for a school‑age child who has a new prescription for Atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication? A. Kidney toxicity B. Liver damage C. Seizure activity D. Adrenal insufficiency

B. Liver damage (Liver damage is an adverse effect of atomoxetine. The nurse should monitor for manifestations such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes)

A nurse is assessing a male client who recently began taking Haloperidol. Which of the following findings is the highest priority to report to the provider? A. Shuffling gait B. Neck spasms C. Drowsiness D. Impotence

B. Neck spasms (Neck spasms are an indication of acute dystonia which is a crisis situation requiring rapid treatment. This is the greatest risk to the client and is therefore the priority finding.)

A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? A. Constipation B. Suicidal thoughts C. Photophobia D. Dry mouth

B. Suicidal thoughts (The greatest risk to this client is injury from a suicide attempt; therefore, this is the priority. Desipramine can cause suicidal thoughts and behaviors which puts the client at risk. The parents should monitor and report any indication of increased depression or thoughts of suicidal behavior.)

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take? A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D.Administer an oral antihistamine at the same time

B. Withhold the medication. (The nurse should withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed. Allergic reactions to penicillin can range from mild to severe anaphylaxis, and prior sensitization should be reported to the provider.)

A nurse is caring for a client who has a prescription for Bethanechol to treat urinary retention. The nurse should recognize that which of the following findings is a manifestation of muscarinic stimulation? A. Dry mouth B. Hypertension C. Excessive perspiration D. Fecal impaction

C (Bethanechol is a muscarinic agonist. muscarinic stimulation can result in sweating)

A nurse is teaching a client who has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching? A. "This medication can stain your contacts." B. "This medication can cause your pupils to constrict." C. "This medication can absorb into your contacts." D. "This medication can slow your heart rate."

C (Brimonidine can absorb into soft contact lenses. The client should remove his contacts then instill the medication and wait at least 15 min before putting in his contacts back in.)

A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

C (Delirium and other mental status changes can occur in thiocyanate toxicity when IV nitroprusside is infused at a high dosage. monitor thiocyanate level during therapy to remain below 10 mg/dL.)

A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Diarrhea B. Anxiety C. Sedation D. Palpitations

C (Dextromethorphan can cause sedation. Advise the client to avoid activities that require alertness)

A nurse is caring for a client who has increased intracranial pressure and is receiving Mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose 150 mg/dL B. Urine output 40 mL/hr C. Dyspnea D. Bilateral equal pupil size

C (Dyspnea is a manifestation of heart failure, an adverse effect of mannitol. The nurse should stop the medication and notify the provider.)

A nurse is caring for a client who is receiving moderate sedation with Diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client? A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine

C (Flumazenil is a competitive benzodiazepine antagonist used to reverse the sedation and other effects of benzodiazepines)

A nurse is caring for a client who has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia

C (Neutropenia is a serious adverse effect that can occur in clients taking an ACE inhibitor. The nurse should monitor the client's CBC and teach the client to report indications of infection to the provider.)

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. Serum Sodium 144 mEq/L B. Urine output 120 mL in 4 hr C. Serum Potassium 5.2 mEq/L D. Blood Pressure 140/90 mm Hg

C (Serum potassium of 5.2 mEq/L indicates hyperkalemia. Because spironolactone causes potassium retention, the nurse should withhold the medication and notify the provider)

A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle‑closure Glaucoma. Which of the following findings are indicative of this condition? A. Insidious onset of painless loss of vision B. Gradual reduction in peripheral vision C. Severe pain around eyes D. Intraocular pressure 12mm Hg

C (Severe pain around eyes that radiates over the face is a manifestation of acute angle‑closure glaucoma)

A nurse is teaching a client who has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A.Increase intake of protein‑rich foods. B.Expect muscle twitching to occur. C.Take this medication with food. D.Anticipate relief of manifestations in 24 h

C (The client should take this medication with food to reduce GI effects.)

A nurse in the operating room is caring for a client who received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and his body temperature begins to rise. The nurse should anticipate a prescription for which of the following medications? A. Neostigmine B. Naloxone C. Dantrolene D. Vecuronium

C (muscle rigidity and a sudden rise in temperature is a manifestation of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia.)

A nurse is teaching a client who has a new prescription for Escitalopram for treatment of generalized Anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A. "I should take the medication on an empty stomach." B. "I will follow a low‑sodium diet while taking this medication." C. "I need to discontinue this medication slowly." D. "I should not crush this medication before swallowing."

C. "I need to discontinue this medication slowly." (When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome.)

A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I will clean the site with an alcohol swab before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." D. "I will place the new patch on the site of the old patch.

C. "I will apply the patch to an area of skin with no hair." (The client should apply the patch to a hairless area of skin to promote absorption of the medication.)

A nurse is caring for a client who is taking oral Oxycodone The client states he is also taking Ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication C. An increase in the expected therapeutic effect of both medications D. An increase in expected adverse effects for both medications

C. An increase in the expected therapeutic effect of both medications (These medications work together to increase the pain‑relieving effects of both medications. Oxycodone is a narcotic analgesic, and ibuprofen is an NSAID. They work by different mechanisms, but pain is better relieved when they are taken together)

A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.) A. Stop the infusion. B. Apply alcohol to the insertion site. C. Apply warm compresses to the insertion site D. Elevate the client's arm. E. Obtain a specimen for culture at the insertion site

C. Apply warm compresses to the insertion site D. Elevate the client's arm. (C. Warm compresses can help promote healing of a hematoma. D. Elevation of the arm helps reduce edema, which can cause pressure and pain and additional bleeding in the area of the hematoma.)

A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? A. Cardiovascular B. Immune C. Central nervous D. Gastrointestinal

C. Central nervous (The nurse should realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications, such as typical antipsychotic medications)

A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Expect therapeutic effects in 24 to 48 hr. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth

C. Change positions slowly to minimize dizziness. E. Chew sugarless gum to prevent dry mouth (C. Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline E. Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline)

A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for Propranolol. Which of the following information should the nurse to include in the teaching? A. Increases the risk for seizure activity B. Provides a form of aversion therapy C. Decreases cravings D. Results in mild hypertension

C. Decreases cravings (Propranolol is an adjunct medication used during withdrawal to decrease the client's craving for alcohol)

A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take? A. Use a disposable razor to remove excess hair on the extremity. B. Select the back of the client's hand to insert the IV catheter. C. Distend the veins by using a blood pressure cuff. D. Direct the client to raise his arm above his heart

C. Distend the veins by using a blood pressure cuff. (The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein,which can result in a hematoma)

A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis? (Select all that apply.) A. Pallor B. Dampness C. Erythema D. Coolness E. Pain

C. Erythema E. Pain (C. Erythema at the insertion site is a manifestation of phlebitis. E.Pain at the insertion site is a manifestation of phlebitis.)

A nurse in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to this client? A. Varicella vaccine B. Rubella vaccine C. Inactivated influenza vaccine D. Measles vaccine

C. Inactivated influenza vaccine (During influenza season, providers recommend the inactivated influenza vaccine for women who are pregnant)

A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.) A. Increased renal secretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication the same pathway metabolizes

C. Liver failure E. Concurrent use of medication the same pathway metabolizes C. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage. E. When the same pathway metabolizes two medications, they compete for metabolism, thereby increasing the concentration of one or both medications. This requires decreasing the dosage of one or both

A nurse on a medical‑surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A. Reduced cardiac function B. First‑pass effect C. Reduced hepatic function D. Increased gastric motility

C. Reduced hepatic function (Older adults have reduced hepatic function, which can prolong the effects of medications the liver metabolizes. The client probably needs a lower dosage of the hypnotic medication)

A nurse reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription? A. Single B. Stat C. Routine D. Standing

C. Routine (A routine or standard prescription identifies medications to give on a regular schedule with or without a termination date or a specific number of doses. The nurse will administer this medication every day until the provider discontinues it.)

A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority? A. Administer the clonidine on the prescribed schedule. B. Provide ice chips at the client's bedside. C. Educate the client on the effects of clonidine. D. Obtain baseline vital signs

D (Assessment is the initial step of the nursing process. Obtaining the client's baseline vital signs is the priority nursing action)

A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic? A. Peptic ulcer disease B. Breast cancer C. Diabetes mellitus D. Schizophrenia

D (Ketamine can produce psychological effects, such as hallucinations. Therefore, schizophrenia can be a contraindication for the use of Ketamine)

A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The nurse should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions? A. Bursitis B. Sinusitis C. Depression D. Glaucoma

D (Oxybutynin is an anticholinergic and can increase intraocular pressure. It is contraindicated for clients who have glaucoma)

A nurse is teaching a client about preventing Otitis Externa. Which of the following instructions should the nurse include? A. Clean the ear with a cotton‑tipped swab daily B. Place earplugs in the ears when sleeping at night. C. Use a cool water irrigation solution to remove earwax. D. Tip the head to the side to remove water from the ears after showering

D (The client should remove water from the ear after showering or swimming to reduce the risk for otitis externa)

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? A. "Be sure to limit your potassium intake while taking the medication." B. "You should check your blood pressure every 8 hours while taking this medication." C. "Your medication dosage will be increased if you develop tachycardia." D. "Change positions slowly when you move from sitting to standing."

D. "Change positions slowly when you move from sitting to standing." (Orthostatic hypotension is a common adverse effect of antihypertensive medications. The client should move slowly to a sitting or standing position and should be taught to sit or lie down if lightheadedness or dizziness occurs)

A nurse is providing teaching to a client who has a new prescription for Buspirone to treat Anxiety. Which of the following information should the nurse include? A. "Take this medication on an empty stomach" B. "Expect optimal therapeutic effects within 24 hr." C. "Take this medication when needed for anxiety" D. "This medication has a low risk for dependency."

D. "This medication has a low risk for dependency." (Buspirone has a low risk for physical or psychological dependence or tolerance.)

A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism? A. Performing hand hygiene before and after IV insertion B. Rotating IV sites at least every 72 hr C. Minimizing tourniquet time D. Avoiding reinserting the needle into an IV catheter

D. Avoiding reinserting the needle into an IV catheter (The nurse manager should remind the members of the team to avoid reinserting the stylet needle into an IV catheter. This action can result in severing the end of the catheter and consequently cause a catheter embolism)

A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider? A. Name B. Dosage C. Route D. Frequency

D. Frequency (This prescription does not include the time or frequency of medication administration. The nurse must clarify this with the prescribing provide)

A nurse is caring for a client who has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B. Restrict intake of foods rich in sodium. C. Decrease fluid intake to less than 1,500 mL daily D. Limit aerobic activity in hot weather

D. Limit aerobic activity in hot weather (The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity)

A nurse is providing discharge teaching to a client who has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching? A. "You should have a high‑carbohydrate snack between meals and at bedtime." B. "You are likely to develop hand tremors if you take this medication for a long period of time." C. "You may experience temporary numbness of your mouth after each dose." D."You should have your white blood cell count monitored every week.

D."You should have your white blood cell count monitored every week. (Due to the risk for fatal agranulocytosis weekly monitoring of the client's WBC count is recommended while taking clozapine)

A nurse in a provider's office is instructing a parent of a toddler how to administer ear drops. Which of the following instructions should the nurse include? (Select all that apply.) A."Place the child on his unaffected side when you are ready to administer the medication." B."Warm the medication by gently rolling it between your hands for a few minutes." C."Gently shake medication that is in suspension form." D."keep the child on his side for 5 minutes after instillation of the ear drops." E."Tightly pack the ear with cotton after instillation of the ear drops.

a, b, c, d (A. The parent should have the child on his unaffected side to allow access to the affected ear and to promote drainage of the medication by gravity into the ear. B. The parent should warm the medication by rolling it between his hands. Administering the medication cold can cause dizziness. C. The parent should gently shake medication that is in suspension form to evenly‑ disperse the medication. D.The parent should keep the child on his side to promote drainage of the medication by gravity into the ear)

A nurse in the post‑anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply.) A. Place a cooling blanket on the client. B. Administer oxygen at 100%. C. Administer iced 0.9% sodium chloride. D. Administer potassium chloride IV. E. Monitor core body temperature

a, b, c, e (A. The nurse should apply a cooling blanket and apply ice to the axilla and groin. B. The nurse should administer oxygen at 100% to treat decreased oxygen saturation. C. The nurse should take action to decrease the client's body temperature by administering iced IV fluids. E. The nurse should monitor core body temperature to prevent hypothermia and to determine progress with treatment measures)

A nurse is reviewing a new prescription for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply.) A."Use caution if given a prescription for a diuretic medication." B."Consider using an alternate form of contraception if you are using oral contraceptives." C."Chew gum to increase saliva production." D."Avoid driving until you see how the medication affects you." E."Notify your provider if you develop a skin rash

a, b, d, e (A. Diuretic medications are administered with caution because of the high risk for hyponatremia when taking oxcarbazepine. B. An alternate form of contraception is recommended for clients taking oral contraceptives because oxcarbazepine decreases oral contraceptive levels D. The client should avoid driving if CNS effects of dizziness, drowsiness, and double vision develop. E. The client should notify the provider if a skin rash occurs because life‑threatening skin disorders can develop.)

A nursing is planning care for a client who is receiving Furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Assess for tinnitus. B. Report urine output 50 mL/hr. C. Monitor serum potassium levels. D. Elevate the head of bed slowly before ambulation. E. Recommend eating a banana daily

a, c, d, e (A. An adverse effect of furosemide is ototoxicity. manifestations of tinnitus should be reported to the provider C. A decrease in serum potassium levels is an adverse effect of furosemide, and the nurse should notify the provider. D. Slowly elevating the head of the bed will prevent the client from developing orthostatic hypotension, which is a manifestation of hypovolemia. E. A banana is high in potassium. The nurse should encourage the client to eat foods high in potassium to prevent hypokalemia.)

A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select all that apply.) A. Dry mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation

a, d, e (A. Dry mouth is an anticholinergic manifestation that can occur when a client takes diphenhydramine D. Drowsiness is an adverse reaction of this medication. Diphenhydramine is administered to treat insomnia. E. Urinary retention is an anticholinergic manifestation that can occur when a client takes diphenhydramine.)

A nurse is providing instructions to a client who has been experiencing Insomnia and has a new prescription for Temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply.) A. Incoordination B. Hypertension C. Pruritus D. Sleep driving E. Amnesia

a, d, e (A. Due to CNS depression, incoordination is an adverse effect of temazepam D. Sleep driving (driving after taking the medication without memory of doing so) is an adverse effect of temazepam. E. Retrograde amnesia, the inability to remember the events that occurred after taking the medication, can occur as an adverse effect of temazepam)

A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (Select all that apply.) A.Thickening the cervical mucus B.Inducing maturation of ovarian follicle C.Increasing development of the corpus lupus D.Altering the endometrial linin E Inhibiting ovulation

a, d, e, (A. Oral contraceptives cause thickening of the cervical mucus, which slows sperm passage D. Oral contraceptives alter the lining of the endometrium, which inhibits implantation of the fertilized egg. E. Oral contraceptives prevent pregnancy by inhibiting ovulation.)

A nurse is teaching a client who has a new prescription for Baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) A. "I will stop taking this medication right away if I develop dizziness." B. "I know the doctor will gradually increase my dose of this medication for a while." C. "I should increase fiber to prevent constipation from this medication." D. "I won't be able to drink alcohol while I'm taking this medication." E. "I should take this medication on an empty stomach each morning."

b, c, d (B. The provider starts the client on a low dose, and the dose is increased gradually to prevent CNS depression. C. The client should increase fluids and fiber to reduce the risk for constipation. D. The intake of alcohol and other CNS depressants can exacerbate the CNS depressant effects of baclofen. Therefore, the client is instructed to avoid CNS depressants while taking baclofen)

A nurse is planning caring for a client who is has a new prescription for Torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medications? (Select all that apply.) A. Respiratory acidosis B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias

b, c, d, e (B. The nurse should plan to monitor for hypokalemia, which is an adverse effect of a loop diuretic. C. The nurse should plan to monitor for hypotension. D. The nurse should plan to monitor the client for ototoxicity. E. The nurse should plan to monitor for ventricular dysrhythmias, which is a manifestation of hypokalemia, an adverse effect of torsemide)

A nurse is planning to administer a first dose of Captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren

b, d, e (B.hydrochlorothiazide, a thiazide diuretic, is often used to treat hypertension. Diuretics can intensify first‑dose orthostatic hypotension caused by captopril and can continue to interact with antihypertensive medications to causehypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril and keep the client safe from injury D. Clonidine, a centrally acting alpha2 agonist, is an antihypertensive medication that can interact with captopril to intensify first‑dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury. E. Aliskiren, a direct renin inhibitor, is an antihypertensive medication that can interact with captopril to intensify its first‑dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury)

A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications to the client? (Select all that apply.) A. Phenytoin B. Ethosuximide C. Gabapentin D. Carbamazepine E. Valproic acid F. Lamotrigine

b, e, f (B. Ethosuximide's only mechanism of action is to treat a client who has absence seizures E. Valproic acid has a therapeutic effect when treating a client who has absence seizures and all other forms of seizures. F. Lamotrigine has a therapeutic effect when treating a client who has absence seizures and all other forms of seizure)