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A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered-dose inhaler. Which of the following statements by the parents indicates the need for further teaching? a) "i will give my child a dose as soon as wheezing starts" b) "my child should rinse out his mouth after using inhaler" c) "my child Should exhale completely before placing the inhaler in his mouth" d) "if my child has difficulty breathing in the dose, a spacer can be used"
A) "i will give my child a dose as soon as wheezing starts" cromolyn is a mast cell inhibitor that has a slow onset and is given for a prophylactic treatment of asthma. It is not a rescue medication.
A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? a) Amantadine b) Bupropion c) Phenelzine d) Hydroxyzine
A) Amantadine the client is experiencing Parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian med used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.
A nurse is assessing client who is taking varenicline for smoking cessation. Which of the following findings is the nurse priority? a) mood changes b) nausea c) altered sense taste d) skin rash
A) mood changes
A nurse is teaching a client who is taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the teaching has been effective? a) "i should eat a snack at bedtime to avoid low blood glucose" b) "i should stay away from people who are ill" c) "i should increase my fluid intake to about 3 quarts per day" d) " I'll val my provider if I am experiencing too much sedation"
B) "i should stay away from people who are ill" this med is a glucocorticoid that decreases inflammation by affecting the clients immune system. As a result, the client is susceptible to infection and should avoid large crowds as well as people who are ill.
A nurse is administering an enteric-coated tablet to a client and explaining the pharmaceutical preparation. Which of the following statements should the nurse make? a) "this coated tablet dissolves better in your stomach and intestines." b) "you are less likely to have an upset stomach with this pill because of the coating on the tablet" c) "the coating on the tablet improves the absorption of the med" d) "the coating on the tablet allows a gradual release of the med"
B) "you are less likely to have an upset stomach with this pill because of the coating on the tablet" enteric coating preparations have an outside coating of a substance that dissolves in the intestines instead of in the stomach. This protects the med from acids and enzymes in the stomach and protects the stomach from ingredients in the med that can cause gastric upset.
A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the clients risk for reduced clearance of the medication? a) alanine aminotranferase (ALT) 60 international units/L b) creatinine clearance 35 mL/min c) HbA1c 5% d) BMI 31
B) creatinine clearance 35mL/min creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidneys ability to excrete waste. A creatinine clearance of 35 is below the expected range of 87-139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs with moderate renal impairment.
A nurse is providing teaching to a client who has chronic constipation and a new prescription for psyllium. Which of the following instructions should the nurse provide? a) "this medication is for short-term use only" b) "you should eat a low residual diet while taking this med" c) "mix this medication with water and follow with an additional glass of liquid" d) "the medications adverse effects of stomach cramps and nausea will go away in time"
C) "mix this medication with water and follow with an additional glass of liquid" the nurse should direct the client to administer the medication mixed in a full glass of water or juice followed by an additional glass of liquid. The client should also be instructed to increase intake of fluids to help decrease constipation.
A nurse is caring for a client who receives gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subq? a) 0600 b) 0630 c) 0645 d) 0730
C) 0645 lispro is rapid acting insulin with an onset of 15 min. The nurse should administer the insulin dose 15 min PRIOR to the feeding.
A nurse in a providers office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects? a) development of gastric ulcers b) development of milk intolerance c) allergic reactions to the medication d) alterations in gastrointestinal flora
D) alteration in gastrointestinal flora the typical gastrointestinal flora are often destroyed by broad spectrum antibiotics like amoxicillin, causing poor digestion and possible superinfection with other bacteria.
A nurse manager is instructing a newly licensed nurse about the routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue? a) oral b) topical c) parenteral d) sublingual
D) sublingual
A nurse is administering epinephrine for a client experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? a) hypotension b) hyperthermia c) hypoglycemia d) tachycardia
D) tachycardia adverse effects of epinephrine an adrenergic against, can include tachycardia and dysrhythmias due to cardiac stimulation.
A nurse is caring for a client who has been taking metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of this medication? a) decreased vitamin b12 levels b) decreased blood glucose levels c) abdominal bloating and diarrhea d) decreased LDL levels
B) decreased blood glucose level a client who has taken metformin for 6 months should experience the expected therapeutic effect of a decrease in blood glucose levels. Metformin is a non-insulin medication for clients who have type 2 diabetes mellitus.
A nurse is caring for patient in PACU for more than 1hr, has a RR of 9/min and is difficult to arouse. The nurse should expect a prescription for which of the following meds? a) pentazocine b) naloxone c) naltrexone d) butorphalol
B) naloxone this med displaces opiate meds from receptor sites which reversed the respiratory depression, sedation and analgesia that the opiates cause
A nurse is assessing a client who takes oral theophylline for chronic bronchitis relief. The nurse should recognize that which of the following findings indicates toxicity to theophylline? A) constipation b) tremors c) fatigue d) bradycardia
B) tremors theophylline is a xanthine-derivative bronchodilator. An early manifestation of toxicity is CNS simulation, often seen as tremors. Seizures can occur if blood levels continue to rise.
A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. Which of the following pieces of information should the nurse include in the teaching? a) lidocaine toxicity will cause the client to develop tachycardia b) most clients develop a headache from spinal anesthesia c) hypotension is an adverse effect of spinal anesthesia d) urinary urgency occurs when the client has spinal anesthesia
C) hypotension is an adverse effect of spinal anesthesia
A nurse is teaching self-administration of NPH insulin to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? a) alternate injecting doses between the abdomen and the thigh b) shake the vial before withdrawing the dosage c) rotate injection sites within the same area d) discard the vial of the insulin is cloudy
C) rotate injection sites within the same area to prevent lipodystrophy, the client should rotate injection sites and keep them about 2.5cm (1 inch) apart within the same anatomical area.
A nurse is teaching a client who is experiencing age-related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching? a) this med should be used daily b) this med should Be applied externally c) this med has fewer systemic effects than oral estrogen d) this med can increase your risk of bone loss
C) this med has fewer systemic effects than oral estrogen nurse should instruct client that intravaginal estradiol cream has few systemic side effects bc it is applied topically. However, oral estrogen can cause serious systemic effects
A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which of the following statements by the client indicates an adverse effect of the medication that should be reported to the provider immediately? a) "i have had occasional constipation." b) "i have had some gas" c) "my head has been hurting for some days" d) "my legs feel weak and achy"
D) my legs feel weak and achy when using the urgent vs nonurgent approach to client care, the nurse should determine that the priority findings is muscle pain and weakness. A serious adverse effect of this medication is muscle injury, which can progress to severe myositis. The client should report any unusual onset of muscle pain or tenderness to the provider immediately.
A nurse is providing discharge teaching to a client who has heart failure and a prescription of digoxin 0.125 mg PO daily and furosemide 20 mg daily. Which of the following statements by the client indicates an understanding of the teaching? a) "i know that blurred vision is expected" b) "i will measure my urine output" c) "i will skip dose if my heart rate is below 72 bpm" d) "i will eat fruits and vegetables that have a high potassium content every day"
D.) "i will eat fruits and vegetables that have a high potassium content each day." hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain potassium level between 3.5-5.0mg/dL to avoid digoxin toxicity.
