ATI Questions

a nurse is preparing to administer heparin 8,000 units subcutaneously every 8hr. heparin 10,000 units/1mL is available. how many mL should the nurse administer per dose?

0.8

a nurse is preparing to administer 150 units/hr of regular insulin to a client. regular insulin is available at 1,500 units in 0.9% sodium chloride 500 mL. the nurse should set the IV pump to deliver how many mL/hr?

1,500 units/500 mL = 150 units/X mL X = 50 mL

a nurse is preparing to administer 150 units.hr of regular insulin to a client. regular insulin is available at 1,500 units in 0.9% sodium chloride 500 mL. the nurse should set the IV pump to deliver how many mL/hr?

1,500 units/500mL = 150 units/XmL 50

a nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr

10,000 units /1mL = 8,000 mg/X mL X = 0.8 mL

a nurse is preparing to administer cefepime 1g in 5% dextrose in water (D5W) 50mL over 30 min to a client who has pneumonia. the drop factor of the manual IV tubing is 15gtt/mL. the nurse should set the manual IV infusion to deliver how many gtt/min?

15gtt/1mL x 50mL/30min

a nurse is preparing to administer an IV fluid bolus of 1 L of 0.9% sodium chloride over 2 hours to a client who is dehydrated. the nurse should set the IV pump to deliver how many mL/hr?

1L/1L = 1,000 mL/X mL 1,000 mL/2 hr = X mL/hr X = 500

a nurse is preparing to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. the amount available is chlorothiazide oral suspension 250 mg/5mL. how many mL should the nurse administer per dose?

28.6 lb/2.2lb = 13kg 20mg x 13kg = 260 mg/day which is 130mg every 12 hrs 250mg/5mL = 130mg/xmL x = 2.6mL

a nurse is preparing to administer lactated ringer's 700 mL IV by infusion over 24 hr to a pediatric client. the drop factor of the manual IV tubing is 60 gtt/mL. the nurse should set the manual IV infusion to deliver how many gtt/min?

29 gtt/min

a nurse is preparing to administer cefixime 4 mg/kg PO twice daily to a preschooler who weighs 31 lb. how many milligrams should the nurse administer with each dose?

4 mg x 14 kg = 56 mg

a nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. the amount available is codeine oral solution 15 mg/5 mL. how many mL should the nurse plan to administer per dose?

5 mL/15 mg x 30 mg X = 10 mL

a nurse is providing discharge teaching for a client who has a new prescription for metoprolol. which of the following instructions should the nurse include? a. "do not stop taking this medication abruptly b. "take the medication right before bedtime" c. "avoid exposure to sunlight" d. "count your radial pulse daily" e. "change positions slowly"

a, d, e client who stop taking metoprolol abruptly increase their risk of angina, hypertension, and myocardial infarction. they should reduce the dosage gradually over 1-2 weeks. clients should count the radial pulse daily, and report a heart rate slower than 60/min. metoprolol can cause orthostatic hypotension; to prevent injury, the client should move slowly from lying down or sitting to standing

a nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. which of the following pieces of information should the nurse include? a. "A full therapeutic response may take several months to happen" b. "The medication should be taken with high-protein foods" c. "A full therapeutic response might cause vivid dreams" d. "The medication is given at the onset of mild symptoms"

a. "A full therapeutic response may take several months to happen" the nurse should inform the family member that although levodopa is the most effective medication for parkinson's disease, a full therapeutic response might not occur for several months.

a nurse is teaching a female client who has a new prescription for misoprostol to treat peptic ulcer disease. which of the following client statements should indicate to the nurse that the teaching was effective? a. "I should avoid taking NSAIDs while using this medication" b. "misoprostol is used to treat stress-induced gastric ulcers" c. "I should avoid becoming pregnant while taking this medication" d. "this medication is also used to treat dysmenorrhea"

a. "I should avoid taking NSAIDs while using this medication" the nurse should identify that misoprostol is contraindicated during pregnancy and is classified as pregnancy risk category X by the Food and Drug Administration. it has the potential to stimulate uterine contractions, and the use of misoprostol during pregnancy has been known to cause partial or complete expulsion of the developing fetus.

a nurse is teaching a client who is about to start taking propylthiouracil to treat hyperthyroidism. which of the following statements should the nurse identify as an indication that the teaching has been effective? a. "I will need laboratory tests to check my liver function" b. "I should take this medication once daily" c. "If I get a rash, I am probably having an allergic reaction" d. "If I have difficulty sleeping, it is probably because of this medication"

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

a charge nurse is teaching a newly licensed nurse about the purpose of a client being prescribed a transdermal fentanyl patch. which of the following client should the charge nurse include in the teaching as a client who requires this medication? a. a client who is opioid-tolerant b. a client who has difficulty swallowing c. a client who has severe intermittent pain d. a client who is postoperative following abdominal surgery

a. a client who is opioid-tolerant the charge nurse should include in the teaching that a client who is opioid tolerant can be prescribed a fentanyl patch to manage pain

a nurse is preparing to administer iron dextran IV to a client. which of the following actions should the nurse plan to take? a. administer a small test dose before giving the full dose b. infuse the medication over 30 seconds c. monitor the client closely for hypertension after the infusion d. administer cyanocobalamin as an antidote if iron dextran toxicity occurs

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

a nurse is preparing to administer a hydromorphone IV infusion to a client for pain. which of the following actions should the nurse take? a. administer the medication over 4-5 minutes b. place the client in a high-fowler's position c. assess the client's pain level after administering the medication d. review the client's last set of vital signs

a. administer the medication over 4-5 minutes the nurse should administer the IV injection of this opioid medication over 4-5 minutes to prevent the adverse effects of the medication such as respiratory depression and cardiac arrest

a nurse is preparing to administer a hydromorphone IV infusion to a client for pain. which of the following actions should the nurse take? a. administer the medication over 4-5 minutes b. place the client in a high-fowler's position c. assess the client's pain level after d. review the client's last set of vital signs

a. administer the medication over 4-5 minutes the nurse should administer the IV injection of this opioid medication over 4-5 minutes to prevent the adverse effects of the medications such as respiratory depression and cardiac arrest.

a nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. which of the following findings should the nurse identify as an adverse effect of receiving this medication? a. bleeding b. increased clot formation c. shortness of breath d. blockage of the central venous catheter

a. bleeding the nurse should identify that an adverse effect of alteplase is bleeding. severe bleeding can occur as a result of the alteplase-plasminogen complex, which catalyzes the conversion of other plasminogen molecules that digest fibrin clots. this action of the medication can contribute to hemorrhage

a nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. the nurse should anticipate that the client will receive which of the following medication-delivery devices for the treatment of asthma? a. dry-powder inhaler b. metered-dose inhaler c. respimat d. nebulizer

a. dry-powder inhaler the nurse should identify that DPIs do not require hand-breath coordination and are easier to use for client who have deformities of the hands. DPIs are used to deliver medications in a dry, micronized powder directly to the lungs

a nurse is teaching a client who has chemotherapy induced anemia and a prescription for epoetin alfa. the nurse should instruct the client to report which of the following findinging as an adverse effect of epoetin alfa? a. hypertension b. leukocytosis c. bone pain d. neutropenia

a. hypertension the nurse should instruct the client to report hypertension, which is an adverse effect of epoetin alfa. other adverse effects can include headaches, seizures, heart failure, and thromboembolic events related to increased hemoglobin levels.

a charge is teaching a newly licensed nurse about a client who has severe allergy-related asthma and a new prescription for omalizumab. which of the following pieces of information should the charge nurse include to describe the medication's mechanism of action? a. it reduces the number of immunoglobulin E molecules on mast cells b. it stabilizes the cellular membrane of mast cells c. it decreases the synthesis and release of inflammatory mediators d. it relaxes the smooth muscles by blocking adenosine receptors

a. it reduces the number of immunoglobulin E molecules on mast cells the charge nurse should include in the teaching that the mechanism of action of omalizumab reduces the number of IgE molecules on mast cells. this limits the ability of allergens to trigger immune mediators that cause bronchospasm.

a nurse is caring for a client who developed hypoglycemia following an insulin injection. the client is conscious and responds appropriately to verbal stimuli. which of the following medications should the nurse plan to administer a. oral glucose tablet b. 50% dextrose intravenously c. glucagon intramuscularly d. epinephrine intravenously

a. oral glucose tablet evidence-based practice indicates that a client who has mild hypoglycemia and is conscious and able to swallow should receive an oral agent such as an oral glucose tablet. if the client is unresponsive to the oral glucose tablet, another, more invasive form of treatment can be initiated

a nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. for which of the following adverse effects should the nurse monitor? a. orthostatic hypotension b. diarrhea c. urinary frequency d. bradycardia

a. orthostatic hypotension orthostatic hypotension is an adverse effect of chlorpromazine. other adverse effects include palpitation, tachycardia, constipation, sedation, and photosensitivity.

a nurse is caring for a client who has tuberculosis and is taking rifampin. the nurse should monitor the client for which of the following adverse effects of rifampin? a. red-tinged urine b. tinnitus c. blurred vision d. dry mouth

a. red-tinged urine the nurse should identify that red-tinged urine, saliva, and tears and adverse effects of rifampin

a nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. the nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis a. regular insulin b. insulin lispro c. insulin aspart d. insulin glargine

a. regular insulin treatment for diabetic ketoacidosis is directed at correcting hyperglycemia and acidosis. therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.

a nurse is caring for a client who received naloxone for a suspected opioid overdose. which of the following findings should the nurse identify as an adverse effect of this medication? a. report of pain b. respiratory rate 8/min c. report of numbness d. report of abdominal cramping and diarrhea

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

a nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. which of the following pieces of information should the nurse include in the teaching? a. respiratory depression can occur 7 min after the morphine is administered b. the morphine will peak in 10 min c. withhold the morphine if the client has a respiratory rate of less than 16/min d. administer the morphine over 2 min

a. respiratory depression can occur 7 min after the morphine is administered respiratory depression can occur within 7 minutes of the administration of IV bolus morphine. the nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine

a nurse is evaluating a 20-month old child who received a hepatitis. a immunization 3 days ago. the parent reports that the child has exhibited a loss of appetite following the immunization. which of the following actions should the nurse take? a. tell the parent that this reaction should only last for a couple of days b. notify the provider immediately c. prepare an antidote to administer to the child d. request that the provider order a serum titer level

a. tell the parent that this reaction should only last for a couple of days the nurse should tell the parent that a loss of appetite is a mild reaction in response to the hepatitis A vaccine and will usually last 1-2 days.

a nurse in a long-term care facility is administering medications to a group of older adult clients. which of the following factors of pharmacokinetics should the nurse consider when caring for this age group? a. the excretion of medication is reduced b. the percentage of medication absorbed is increased c. the liver metabolizes medication more quickly d. the rate at which the liver metabolizes medication declines with age

a. the excretion of medication is reduced

a nurse is preparing to administer an IV injection to a client. for which of the following reasons should the nurse inject the medication slowly? a. to reduce toxicity risk b. to improve absorption pattern c. to prevent medication dilution d. to protect against embolism

a. to reduce toxicity risk prior to injecting an IV medication, the nurse should plan to infuse the medication slowly over 1 minute to reduce the risk for toxicity to the central nervous system. manifestations of CNS toxicity can become evident as soon as 15 seconds after initiating the injection. if the injection is done slowly, only a small amount of the total dose will have been administered when manifestations of toxicity appear. if the nurse is able to discontinue the administer immediately, adverse effects can be much less severe than if the entire dose had been give quickly

a nurse is preparing to administer an IV injection to a client. for which of the following reasons should the nurse inject the medication slowly? a. to reduce toxicity risk b. to improve absorption patter c. to prevent medication dilution d. to protect against embolism

a. to reduce toxicity risk prior to injecting an IV medication, the nurse should plan to infuse the medication slowly over 1 minute to reduce the risk of toxicity to the central nervous system. manifestations of CNS toxicity can become evident as soon as 15 seconds after initiating the injection.

a nurse in a community health clinic is assessing a new client who has prescriptions for isoniazid and rifampin. which of the following disorders should the nurse expect the client to have? a. tuberculosis b. hypertension c. diabetes d. cirrhosis

a. tuberculosis isoniazid and rifampin are the first-line antitubercular medications used to treat active tuberculosis. these medication are used in a combination therapy

a nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily. the client reports taking extra doses to promote weight loss. which of the following findings should indicate to the nurse that the client is dehydrated? a. urine specific gravity 1.035 b. distended neck veins c. BUN 18 mg/dL d. bounding radial pulses

a. urine specific gravity 1.035 oliguria, an increased urine concentration, and an increased urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.

a nurse is teaching about taking donepezil with a client who has recently diagnosed with early alzheimer's disease. which of the following instructions should the nurse include in the teaching? a. "you should chew the medication thoroughly prior to swallowing" b. " you should take this medication late in the evening" c. "you should take this medication with food" d. "if you miss taking a dose for a day, take 2 doses the following dat"

b. " you should take this medication late in the evening" the nurse should instruct the client to take donepezil late in the evening, just before going to bed"

a nurse is providing discharge teaching to a client who has a kidney transplant and has a prescription for oral cyclosporine. which of the following statements by the client indicates an understanding of the teaching? a. "I will be able to stop taking this medication within 6 months after my surgery" b. "I am likely to develop higher blood pressure while taking this medication" c. "I am likely to lose my hair while taking this medication" d. "I am taking this medication to boost my immune system"

b. "I am likely to develop higher blood pressure while taking this medication" half the clients who take cyclosporine develop a 10%-15% increase in blood pressure and might need to start antihypertensive therapy

a nurse is teaching a client who has a new prescription for alosetron. which of the following client statements indicates an understanding of the teaching? a. "nausea is a common adverse effect of this medication" b. "I should contact my provider immediately if I experience constipation" c. "If I do not respond to treatment at the lowest dosage, my provider may continue to increase the dosage at weekly intervals" d. "abdominal pain with diarrhea can indicate a serious complication"

b. "I should contact my provider immediately if I experience constipation" the nurse should identify that constipation is an adverse effect of this medication and requires the provider to be notified. the provider may adjust the dose or withhold the medication and then instruct the client to resume taking it one the constipation has resolved.

a nurse is providing teaching to a client who has a new prescription for a fentanyl transdermal patch. which of the following statements by the client indicates an understanding of the teaching? a. "the patch will not cause constipation like other pain medications do" b. "I will have to stop drinking grapefruit juice while using the patch" c. "I will place a heating pad over the patch to boosts its effectiveness" d. "the patch will give me relief from my pain faster than pills can"

b. "I will have to stop drinking grapfruit juice while using the patch" the nurse should instruct the client to avoid drinking grapefruit juice while using the fentanyl transdermal patch. grapefruit juice can increase the absorption of the medication, raising the amount of fentanyl in the client's blood. this effect can place the client at risk for CNS and respiratory depression.

a nurse is teaching a client about taking tetracycline PO. which of the following statements should the nurse include in the teaching? a. "take this medication on a full stomach" b. "limit your consumption of dairy products while taking this medicine" c. "take the medication with your regular iron supplement" d. "take antacids if you have an upset stomach from using tetracycline"

b. "limit your consumption of dairy products while taking this medicine" the nurse should tell the client to avoid or limit the consumption of dairy products while taking tetracycline. an interval of at least 2 hours should separate tetracycline ingestion and the ingestion of products that can chelate this medication such as milk or calcium.

a nurse is providing teaching about benzodiazepines to a client who is discontinuing long-term alprazolam use. which of the following pieces of information should the nurse include in the teaching? a. "You might experience somnolence" b. "plan to taper the dose slowly over several months" c. "call the provider if you have muscle weakness" d. "confusion is common during this process"

b. "plan to taper the dose slowly over several months" the nurse should instruct the client to plan to taper the alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal.

a nurse is teaching a client who has asthma and a prescription for a fluticasone dry powder (DPI). which of the following instructions should the nurse include in the teaching? a. "this medication should be taken at the start of your symptoms." b. "rinse your mouth after administering this medication." c. "shake the canister prior to administering this medication." d. "this medication relaxes your airways to decrease your symptoms."

b. "rinse your mouth after administering this medication." the nurse should include in the teaching that this medication is an oral corticosteroid. oral corticosteroids increase the risk of the development of oral candidiasis, also known as thrush. in order to prevent this effect, the nurse should advise the client to rinse the mouth after the administration of this medication.

a nurse is teaching a client who is postmenopausal and has a prescription for alendronate. which of the following statements should the nurse include in the teaching? a. "you can lie down 15 mins after taking this medication" b. "take this medication on an empty stomach" c. crush this medication to improve absorption" d. "avoid taking antacids or supplements that contain calcium while taking this medication"

b. "take this medication on an empty stomach" the nurse should instruct the client to avoid taking alendronate with foods or liquids other than water because it can decrease absorption. the client should only take this medication with water 30 minutes before breakfast.

a nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. which of the following instructions should the nurse include in the teaching? a. "use the inhaler just before exercise" b. " the medication's therapeutic effects can take up to several weeks to develop" c. "you will shake the medication container for 3 seconds" d. "you will need to exhale slowly after you inhale"

b. "the medication's therapeutic effects can take up to several weeks to develop" the nurse should include in the teaching that the therapeutic effect of cromolyn can take up to several weeks to develop

a nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. the nurse should anticipate the onset of action of the insulin at which of the following times? a. 0800 b. 0745 c. 0900 d. 1030

b. 0745 insulin glulisine has a very short onset of action of 15 minutes. the nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following the administration of the insulin

a nurse is evaluating how a client who is pregnant is responding to a medication. which of the following physiological effects of pregnancy should the nurse take into consideration? a. increased intestinal transit rate b. accelerated excretion of fluids c. reduced renal blood flow d. decreased hepatic metabolism

b. accelerated excretion of fluids there are physiological changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow. this results in increased glomerular filtration. to compensate for accelerated excretion, dosages of medications that glomerular filtration eliminates must be increased to achieve a comparable therapeutic effect.

a nurse is reviewing the medication history of a client who has mild intermittent asthma. the nurse should anticipate a prescription for which of the following inhalers for the client? a. ipratropium b. albuterol sulfate c. tiotropium d. budesonide

b. albuterol sulfate the nurse should anticipate a client who has mild intermittent asthma to be prescribed albuterol sulfate. albuterol sulfate is a short-acting beta2 agonist that activates beta2-receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.

a nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. which of the following actions should the nurse take? a. cover the applied ointment with cotton gauze b. apply the ointment using a dose-measuring applicator c. apply the ointment using the index finger d. massage the ointment into the client's skin

b. apply the ointment using a dose-measuring applicator the nurse should apply the ointment using a dose-measuring applicator. this allows the nurse to measure the correct dose the client is to receive.

a nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. the client has a prescription for depot medroxyprogesterone acetate. at which of the following times should the nurse schedule the client to receive the first dose of the medication? a. after 3 months postpartum b. at 6 weeks postpartum c. within the first 5 days postpartum d. during the first week of the first postpartum menstrual cycle

b. at 6 weeks postpartum the nurse should tell the client that the first dose should be administered at 6 weeks postpartum if the client is exclusively breastfeeding and after ensuring the client is not pregnant

a nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. which of the following instructions should the nurse include in the teaching? a. take ibuprofen as needed for headaches or other minor pains b. carry a medical alert ID card c. report to the laboratory weekly to have blood drawn for aPTT d. increase intake of dark green vegetables

b. carry a medical alert ID card a client who is taking warfarin is at increased risk for bleeding. in the case of an emergency, any medical personnel must be aware of the client's medication history.

a nurse is checking a client who is receiving an IV infusion of telavancin for Streptococcus pyogenes. which of the following actions should the nurse include? a. check to see if the client's urine is blue in color b. check the client for pruritus c. check for hypertension d. check for numbness in the limbs

b. check the client for pruritus the nurse should monitor a client who receives telavancin for pruritus, which can occur if the client develops generalized exfoliative dermatitis from infusing the medication too rapidly. manifestations of this condition can include flushing, rash, pruritus, urticaria, tachycardia, and hypotension

a nurse is assessing a client who has AIDS an is taking zidovudine. which of the following findings is the priority for the nurse to report to the provider? a. nausea and vomiting b. decreased hemoglobin c. decreased appetite d. anxiety

b. decreased hemoglobin the nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest risk to the client.

a nurse is caring for a client who has an acute glomerulonephritis and a prescription for furosemide. the nurse should monitor the client for which of the following therapeutic effects of this medication? a. hypotension b. diuresis c. increased blood glucose level d. weight gain

b. diuresis the nurse should identify that furosemide is a high-ceiling loop diuretic indicated for the treatment of clients who have severe renal impairment such as acute glomerulonephritis. furosemide blocks the reabsorption of sodium and chloride, thereby preventing the reabsorption of water. diuresis is a therapeutic response to the administration of furosemide.

a nurse is caring for a client who is taking selegiline. the nurse should monitor the client for which of the following adverse effects of selegiline and notify the provider if it occurs? a. bruising b. drowsiness c. coughing d. constipation

b. drowsiness drowsiness can be an adverse effect of selegiline and a manifestation of serotonin syndrome. the nurse should notify the provider about this finding immediately.

a nurse is caring for a client who is taking streptomycin. which of the following medications increases the client's risk of developing ototoxicity when taken with streptomycin? a. cefoxitin b. furosemide c. naproxen d. amphotericin B

b. furosemide furosemide, a high-ceiling (loop) diuretic, increases the risk of developing ototoxicity when taken with streptomycin, an aminoglycoside

a nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. which of the following factors in the client's medical history should the nurse identify as a contraindication to receiving sumatriptan? a. renal impairment b. ischemic heart disease c. severe osteoporosis d. cirrhosis

b. ischemic heart disease the nurse should identify that ischemic heart disease is a contraindication to receiving sumatriptan. sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm. this medication is also contraindicated in clients who had a myocardial infarction or client who have coronary artery disease, uncontrolled hypertension, or other types of heart disease.

a nurse is reviewing the medication administration record of a client who has impaired swallowing. the nurse should crush the medication when administering which of the following prescriptions? a. aspirin EC 80 mg PO daily b. levothyroxine 75 mcg PO q AM before breakfast c. Metformin XR 500 mg PO daily d. nitroglycerin 0.3 mg SL PRN chest pain, may repeat q 5 min for 2 additional doses

b. levothyroxine 75 mcg PO q AM before breakfast Levothyroxine can be crushed because it is not extended-release, sublingual, or enteric-coated. if crushed, the medication should be mixed with 5-10 mL of water.

a nurse is administering a medication to a client. the nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes? a. protein-binding ability b. lipid solubility c. hepatic metabolism d. slow dissolution

b. lipid solubility a medication being lipid soluble and the presence of a transport system both facilitate the ability of medication to cross cell membranes that separate the medication from the blood.

a nurse is reviewing the medical record of a client who has a prescription for a combination oral contraceptive. the nurse should identify that which of the following findings is a contraindication to receiving this medication? a. high cholesterol levels b. liver disease c. family history of ovarian cancer d. client report of hypermenorrhea

b. liver disease the nurse should identify that liver disease or abnormal liver function is a contraindication to receiving a combination oral contraceptive. therefore, the nurse should notify the client's provider. other contraindications include thrombophlebitis or breast cancer.

a nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing withdrawal. the nurse should anticipate a prescription for which of the following medications from the provider? a. methylnaltrexone b. methadone c. naloxone d. hydromorphone

b. methadone the nurse should anticipate a prescription from the provider for a methadone for a client who is experiencing opioid withdrawal. methadone is an opioid medication that is used for pain management and treatment of withdrawal manifestations in clients who have opioid use disorder.

a nurse is reinforcing teaching with a newly licensed nurse about contraindications to vaccines. which of the following examples should the nurse provide as a true contraindication for all vaccines? a. previous local reaction to an injectable vaccine b. moderate illness without a fever c. recent exposure to an infectious disease d. family history of an allergy to penicillin

b. moderate illness without a fever the nurse should identify that a client who has a moderate or severe illness with or without a fever has a true contraindication to receiving a vaccine. the nurse should postpone the immunization until the client has recovered from the illness

a nurse is caring for a client who has unstable angina. the nurse should anticipate a prescription from the provider for which of the following medication? a. epinephrine b. nitroglycerin c. lidocaine d. atropine

b. nitroglycerin the nurse should anticipate a prescription for nitroglycerin, which is indicated for a client who has unstable angina. nitroglycerin is an organic nitrate and a vasodilator that acts by relaxing or preventing spasms in the coronary arteries, thereby decreasing the oxygen demand of the heart along with ventricular filling

a nurse is reviewing the medical record of a client who has been taking a vitamin D supplement. which of the following findings from the client's record should the nurse identify as a risk factor for developing vitamin D deficiency? a. middle-age b. obesity c. dark-colored eyes d. light pigmented skin

b. obesity the nurse should identify that a client who is obese is at risk for vitamin D deficiency. a screening can be prescribed to determine if a deficiency is present.

a home health nurse is visiting an older adult client who has Alzheimer's disease. his caregiver tells the nurse she has been administering prescribed lorazepam 1 mg 3 times per day, to the client for restlessness and anxiety over the past few days. for which of the following adverse effects should the nurse assess the client? a. low-grade fever b. sedation c. diuresis d. tonic-clonic seizures

b. sedation lorazepam is a benzodiazepine with anti-anxiety and sedative effects. older adult clients are especially at risk for central nervous system depression, even with low doses of benzodiazepines. clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.

a nurse in a provider's office is providing teaching to a client with osteoporosis who has a new prescription for alendronate sodium. which of the following pieces of information should the nurse include? a. alendronate sodium can be administered by IV once yearly b. take alendronate sodium with a full class of water on an empty stomach c. side effects of alendronate sodium include leukopenia d. alendronate sodium should be taken with calcium-containing foods to increase absorption

b. take alendronate sodium with a full class of water on an empty stomach alendronate sodium should be taken with at least 230 mL of water 30 min before ingesting foods. an upright position is recommended after taking alendronate sodium to decrease the risk of esophagitis.

a nurse is preparing to administer an IM injection for a client. which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route? a. the medication is a depot preparation b. the client is taking an anticoagulant c. the medication is a particulate suspension d. the client has been vomiting

b. the client is taking an anticoagulant because of the risk of bleeding from the injection site, anticoagulation therapy is a contraindication to receiving medications via the IM route.

a nurse is caring for a client who is experiencing acute pain and is receiving morphine. which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? a. the client reports an inability to void b. the client's respiratory rate is 10/min c. the client has hypoactive bowel sounds d. the client has vomited in the last 4 hours

b. the client's respiratory rate is 10/min the nurse should identify that morphine can cause respiratory depression. therefore, if the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider

a nurse caring for a client who is experiencing acute pain and is receiving morphine. which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? a. the client reports an inability to void b. the client's respiratory rate is 10/min c. the client has hypoactive bowel sounds d. the client has vomited once in the last 4 hours

b. the clients respiratory rate is 10/min the nurse should identify the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider

a nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer. which of the following client statements indicates an understanding of the teaching? a. "I should take this medication with meals and at bedtime" b. "I should only have to take this medication for about 2 weeks" c. "I should wait at least 30 minutes before taking this medication after I take an antacid" d. "I should swallow these tablets whole"

c. "I should wait at least 30 minutes before taking this medication after I take an antacid" the nurse should recognize that antacids can raise the gastric pH above 4, which can interfere with the effects of sucralfate. to minimize these interactions, sucralfate should be taken at least 30 minutes apart from antacids

a nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. which of the following statements by the client indicates an understanding of the teaching? a. "I will administer a spray into each nostril daily" b. "I should expect nasal bleeding for the first week" c. "I will need to depress the side arms to activate the pump" d. "I should expect to take this medication for a short-term course of treatment"

c. "I will need to depress the side arms to activate the pump" the nurse should instruct the client to activate the pump for the initial use by holding the bottle upright and depressing both white side arms toward the bottle 6 times

a nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. the client asks the nurse why the provider prescribed an enteric-coated medication. which of the following responses should the nurse give? a. "the enteric coating allows a lower dosage to be given" b. "enteric-coated medications have better absorption in the body" c. "enteric-coated medications cause less gastric irritation" d. "the enteric coating provides a steady release of the medication over time"

c. "enteric-coated medications cause less gastric irritation" enteric-coated medications do not dissolve until they reach the small intestine, which reduces the risk of gastric irritation

a nurse is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. which of the following statements should the nurse include in the teaching? a. "the effects of the insulin lispro can last for 8-12 hours b. "administer insulin lispro 30-60 minutes before eating" c. "insulin lispro has an onset of about 15 minutes" d. "this insulin can be given as a continuous intravenous bolus"

c. "insulin lispro has an onset of about 15 minutes" insulin lispro is a rapid-acting insulin and has an onset of 15-30 minutes

a nurse is assessing an infant during a routine checkup. the parent asks the nurse about the infant's immunization schedule. which of the following responses should the nurse make? a. "immunizations for children are recommended to start at the age of 2" b. "if your child misses an immunization, she should restart a new schedule" c. "it is recommended that your infant receives 6 immunizations at 2 months of age" d. "the recommended immunization schedule can be customized to fit your child's needs"

c. "it is recommended that your infant receives 6 immunizations at 2 months of age" an infant who is 2 months of age should receive 6 immunizations, followed by immunization at 4 months of age. the monovalent hepatitis B vaccine is administered within 12 hours of the infant's birth

a nurse is providing teaching to a client who has a prescription for famotidine to treat a gastric ulcer. which of the following statements should the nurse include in the teaching? a. "this medication is more effective when taken on an empty stomach." b. "you should take this medication with an antacid for pain control" c. "this medication is less effective for people who smoke." d. "you should expect to experience dizziness when taking this medication"

c. "this medication is less effective for people who smoke." the nurse should instruct the client that smoking interferes with the effectiveness of famotidine. if a client taking famotidine smoke, the nurse should encourage the client to quit smoking or, if unable quit, to avoid smoking after the last dose of the day.

a nurse is teaching a client who has been taking an NSAID to treat rheumatoid arthritis. during the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen. which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication? a. "your current medication was not strong enough to manage this condition" b. "once your blood levels of methotrexate are within the therapeutic range, the NSAID will be discontinued" c. "this medication was added to delay the disease progression" d. "treating this disease with 2 medications will help protect you from becoming treatment-resistant"

c. "this medication was added to delay the disease progression" the nurse should inform the client that the provider prescribed methotrexate to be added to the medication regimen along with an NSAID to delay the progression of the disease and to delay joint damage or deformity that can result from the disease.

a nurse is preparing to administer medication to a client. the nurse should understand that which of the following abbreviations indicates the greatest frequency of medication administration? a. BID b. TID c. QID d. q8hr

c. QID the abbreviation "QID" indicated the medication should be administered 4 times per day, which is the greatest frequency of the options provided.

a nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma. prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication? a. hypertension b. peripheral vision loss c. asthma d. increased intraocular pressure

c. asthma the nurse should identify that asthma is a contraindication to receiving timolol. timolol is a beta-blocker that can cause the beta2-receptors, causing bronchospasm. a client who has a history of asthma is a candidate for an alternate medication to treat this condition such as betaxolol.

a nurse is caring for a client with pseudomonas infection who has a new prescription for ticarcillin-clavulanate. which of the following data should the nurse collect before administering this medication? a. indications of superinfection b. peak and trough medication levels c. baseline BUN and creatinine d. history of allergy to aminoglycoside antibiotics

c. baseline BUN and creatinine ticarcillin-clavulanate is a penicillin antibiotic and is excreted by the kidneys. therefore, any renal impairment could result in a toxic level of the medication. the nurse should assess baseline and creatinine levels and monitor these values throughout therapy.

a nurse is caring for a client who has asthma and requires long-term treatment. the nurse should identify that which of the following medications used for long-term treatment places the client at an increased risk of asthma-related death? a. salmeterol b. fluticasone c. budesonide d. theophylline

c. budesonide the nurse should identify that salmeterol is a long-acting agonist. when this medication is used alone for the long-term treatment of asthma, this class of medication increases the client's risk of asthma, this class of medication increases the client's risk of asthma-related death. to decrease this risk, the client should be prescribed both a long-acting beta2-agonist along with an inhaled corticosteriod.

a nurse is providing teaching to a client who has gout and a new prescription for allopurinol. the nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? a. nausea b. metallic taste c. fever d. drowsiness

c. fever a fever can indicate a potentially fatal hypersensitivity reaction. the client should discontinue allopurinol and notify the provider if a fever or rash develops.

a nurse is teaching a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long term therapy. the nurse should instruct the client to report which of the following as an adverse effect of prednisone? a. thrombosis b. immunosuppression c. gastric ulceration d. liver toxicity

c. gastric ulceration the nurse should instruct the client to monitor for gastric ulceration as an adverse effects of long term use of prednisone. other adverse effects of this medication include osteoporosis and adrenal suppression.

a nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests should an elevated level of the enzymes aspartate aminotransferase and alanine aminotransferase. the nurse should recognize that these findings are potential indications of which of the following conditions? a. renal dysfunction b. myelotoxicity c. hepatic toxicity d. cardiac dysrhythmia

c. hepatic toxicity the nurse should identify that elevated levels of aspartate aminotransferase and alanine aminotransferase are indications the client might be at risk for hepatic toxicity. AST and ALT are enxymes that test liver function. therefore, this should indicate to the nurse that the medication the client is taking is damaging to the liver. the client should undergo liver function tests, and the nurse should notify the provider of this finding.

a nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. the nurse notes that the client reports also taking a multivitamin daily. which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? a. hyperkalemia b. hypermagnesemia c. hypercalcemia d. hypernatremia

c. hypercalcemia the nurse should identify that vitamin D increases plasma calcium levels by increasing reabsorption from bone, decreasing excretion by the kidney and increasing absorption from the intestine. clients who take vitamin D supplement along with multivitamin daily might be taking too much calcium.

a nurse is caring for a client who reports crushing chest pain. the nurse reviews the client's ECG results and notes ST changes. which of the following medications should the nurse administer? a. simvastatin b. furosemide c. nitroglycerin d. sildenafil

c. nitroglycerin the nurse should identify the need to administer nitroglycerin, which is used to treat angina. nitroglycerin acts directly on vascular smooth muscle to promote vasodilation.

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 if 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 2.5 cm apart within the same anatomical areas

a nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. for which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs? a. nasal congestion b. tremors c. tinnitus d. frontal headache

c. tinnitus loop diuretics such as furosemide can cause ototoxicity. the client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.

a nurse is caring for a client who has severe asthma and allergic rhinitis. the client is taking theophylline. which of the following medications should the nurse identify as being incompatible with theophylline? a. cromolyn b. albuterol c. zafirlukast d. methylprenisolone

c. zafirlukast the nurse should identify that zafirlukast is a leukotriene receptor antagonist prescribed for asthma maintenance. concurrent use of zafirlukast along with theophylline suppresses the metabolism of theophylline, which can lead to toxicity. therefore, another medication should be used.

a nurse is providing teaching to a client who has multiple sclerosis and a new prescription for baclofen PO. which of the following pieces of information should the nurse include? a. "You should take the medication on an empty stomach to increase absorption" b. "You can stop taking the medication once your back spasms disappear" c. "You can expect to experience urinary frequency when you first start taking this medication" d. "You should change positions slowly while taking this medication"

d. "You should change positions slowly while taking this medication" the nurse should teach the client that dizziness and hypotension are adverse effects of this medication. the client should change positions slowly to minimize orthostatic hypotension.

a nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. the nurse instructs the client to eat foods that are rich in potassium. which of the following statements by the client indicates an understanding of the teaching? a. "this medication will not work unless I have enough potassium" b. "potassium will increase the therapeutic effect of my blood pressure medication" c. "potassium will lower my blood pressure" d. "this medication can cause a loss of potassium"

d. "this medication can cause a loss of potassium" hydrochlorothiazide can result in hypokalemia cause by excessive potassium excretion from the kidneys. the client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.

a nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. which of the following instructions should the nurse include in the teaching? a. "if you miss a pill, take the missed pill with your next dose" b. "if you miss 2 pills during the second and third week, discard the inactive placebo pills and begin a new pack" c. "if you miss 3 pills during the second week, take a pill as soon as possible and continue with your scheduled doses" d. "you can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks"

d. "you can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks" the nurse should instruct this client that up to 7 days can be missed with little or no increase in the chance of getting pregnant, provided that the client took the pills continuously for the previous 3 weeks.

a nurse is caring for a client who is taking warfarin. which of the following laboratory values should the nurse recognize as an effective response to the medication? a. Hct 45% b. Hgb 15 g/dL c. aPTT 35 seconds d. INR 3.0

d. INR 3.0 warfarin is an anticoagulant that prevents thrombus formation in susceptible clients. the INR measures its effectiveness. for most clients taking warfarin, an INR of 3.0 indicates effective therapy.

a nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. which of the following results should the nurse report to the provider immediately? a. PT 18 seconds b. platelet count 160,000/mm^3 c. Hct 43% d. INR 5.5

d. INR 5.5 when using the urgent vs. non urgent approach to client care, the nurse should determine that the priority laboratory result is an INR of 5.5. a client who is taking warfarin for the treatment of arterial fibrillation is expected to have an INR in the range of 2-3. a level of 5.5 is considered a critical value and places the client at risk of bleeding; therefore, the nurse should report this result to the provider immediately.

a nurse is reviewing the laboratory data for a client who is receiving clozapine for schizophrenia. the nurse should identify which of the following findings as a potential adverse effect of the medication? a. fasting blood glucose 95 mg/dL b. triglycerides 135 mg/dL c. total cholesterol 175 mg/dL d. absolute neutrophil count 1,200 mm^3

d. absolute neutrophil count 1,200 mm^3 the nurse should identify that an absolute neutrophil count of 1,200 to 8,000/mm^3. an adverse effect of clozapine can include agranulocytosis, which is a life-threatening conditioning in which WBCs are severely decreased.

a nurse is caring for a client who has a dry nonproductive cough. which of the following types of medication should the nurse recommend? a. expectorant b. mucolytic c. bronchodilator d. antitussive

d. antitussive antitussives suppress the cough reflex

a nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. the client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. which of the following actions should the nurse take? a. choose an IV port for IV bolus injection of diphenhydramine as near as possible to the client's hanging IV bag b. flush the IV tubing with 2 mL 0.9% sodium chloride before and after administering diphenhydramine c. allow the IV infusion to keep running while administering the diphenhydramine via IV bolus d. aspirate to check for IV patency before administering the diphenhydramine

d. aspirate to check for IV patency before administering the diphenhydramine it is important to confirm IV patency prior to administering an IV bolus. some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

a nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medication's peak level is 7 mcg/mL. which of the following actions should the nurse take? a. administer half of the prescribed dosage at the client's next scheduled dose b. tell the client that the medication seems to be effective c. advise the client to drink more water throughout the day d. continue to administer the medication as prescribed

d. continue to administer the medication as prescribed the nurse should identify that a peak level of 7 mcg/mL for tobramycin is within the expected reference range of 5-10 mcg/mL. therefore, the nurse should continue to administer the scheduled medication as prescribed.

a nurse is administering oral hydroxyzine to a client. which of the following adverse effects should the nurse instruct the client to expect? a. diarrhea b. anxiety c. nausea and vomiting d. dry mouth

d. dry mouth hydroxyzine has anticholinergic properties. dry mouth is a common adverse effect of this medication. the nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.

a nurse is caring for a client who has a vitamin K deficiency. which of the following manifestations should the nurse expect? a. irregular bone formation b. abnormal movements c. blurred vision d. excessive bruising

d. excessive bruising the nurse should identify that excessive bruising can indicate bleeding under the skin. vitamin K is needed by clotting factors to coagulate the blood. therefore, a client who has a deficiency in vitamin K is at risk for excessive bruising and bleeding.

the nurse is providing teaching to a newly licensed nurse about caring for a client who has prescription for gemfibrozil. the nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests? a. platelet count b. electrolyte levels c. thyroid function d. liver function

d. liver function Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. it can cause liver toxicity; therefore, the nurse should monitor the client's liver function.

a nurse is administering a prescription for nifedipine to a client who is pregnancy. which of the following pieces of information related to nifedipine should the nurse monitor and document? a. hypoglycemia b. uterine ripening c. increased blood d. number of uterine contractions

d. number of uterine contractions a client who is going into preterm labor can have prescription for nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into myometrial cells, which can delay labor.

a hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg 3 times daily PO and gabapentin 1,800 mg 3 times daily PO to manage pain. the client tells the nurse "I'm having pain that keeps me from doing what I'd like most of the time." which of the following additions should the nurse anticipate to the client's medication regimen? a. oral meperidine b. parenteral naloxone c. parenteral diazepam d. oral oxycodone

d. oral oxycodone the client's current pain regimen consists of a nonopioid analgesic (naproxen) and an adjuvant medication for neuropathic pain (gabapentin). according to the WHO analgesic ladder for cancer pain management, the next addition to the pain regimen is an opioid for moderate pain. oxycodone is an oral opioid that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client's pain regimen.