Cardiovascular Eye Ear Medications

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine. The nurse is also reviewing instructions concerning taking levothyroxine with the client. There is a need for further teaching when the client makes which statement?

"I will take the pill with milk to keep from upsetting my stomach."

The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (9.95 mmol/L). The client is taking cholestyramine. Which statement made by the client indicates the need for further teaching?

"I'll continue my nicotinic acid from the health food store."

The client plans to give his lispro insulin injection at 0800 right before eating breakfast. The nurse knows that the client understood the education provided when the client states which time presents the greatest risk for hypoglycemia?

0930

The nurse is monitoring a client receiving spironolactone by mouth daily. Which data would indicate to the nurse that the client is experiencing a side effect related to the medication?

A potassium level of 5.2 mEq/L

Glimepiride is prescribed for a client with diabetes mellitus. The nurse reinforces instructions for the client and tells the client to avoid which while taking this medication?

Alcohol

A client is suspected of having myasthenia gravis, and the primary health care provider administers edrophonium to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

An increase in muscle strength

The nurse is caring for a client receiving digoxin. The nurse monitors the client for which early manifestation of digoxin toxicity?

Anorexia

A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin. The nurse is reinforcing dietary discharge teaching with the client. The nurse should plan to teach the client to avoid which food while taking this medication?

Broccoli

The nurse is collecting data from a client receiving pioglitazone 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1c (HbA1c)

Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

A client who has sustained an eye injury has been prescribed corticosteroid eye drops. The nurse should most carefully monitor for side effects of this medication if the client has which health problem listed on the medical record?

Diabetes mellitus

The nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?

Diabetes mellitus

A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a beta blocker, digoxin, and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which assessment data supports this diagnosis?

Double vision, loss of appetite, and nausea

The nurse is teaching a mother how to administer eardrops to an infant. The nurse determines the mother understands instructions if the mother demonstrates pulling the ear in which manner?

Down and back and directing the solution toward the wall of the canal

A client taking an aldosterone antagonist known as eplerenone for hypertension asks about side effects of this medication. The nurse tells the client that which sign/symptom is a side effect?

Elevated potassium level

The nurse in the emergency department is preparing to instill fluorescein into the eye of a client with the complaint of eye pain. Fluorescein dye is used to detect which conditions? Select all that apply.

Foreign object 4.Corneal abrasion 5.

A child with a right-to-left cardiac shunt is receiving propranolol. The health care provider visits the child and writes prescriptions in the child's record. The licensed practical nurse (LPN) reviews the prescriptions and notes that the child is placed on a nothing-by-mouth (NPO) status. The LPN consults with the registered nurse and prepares to monitor which parameter closely?

Glucose level

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol for dysrhythmia suppression. The nurse determines that the client needs further teaching about this medication when making which statement?

I can stop taking the prescribed digoxin after starting this new medication."

Potassium iodide is prescribed for a client. The nurse reinforces instructions to the client that the primary health care provider should be notified if the client experiences which symptom? Select all that apply.

A burning in the mouth A brassy taste in the mouth 5. Soreness of the gums and teeth

A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the client's room with the medication, the client's meal tray is untouched and the client says he has no appetite. Which action is the most appropriate?

Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the medication.

A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?

Monitor for signs of bleeding.

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment?

Monitoring blood pressure

The nurse is discharging a client from the hospital who was given a prescription for atorvastatin. The nurse should tell the client to report which adverse effect to the health care provider immediately?

Muscle pain and weakness

The nurse is reviewing laboratory results of a digoxin level for the client taking digoxin. The digoxin level is 2.5 ng/mL, which indicates digoxin toxicity. Which signs and symptoms should the nurse note? Select all that apply.

Nausea 2.Syncope Bradycardia

Clients who are given a prescription for sildenafil should be taught that a potentially fatal medication interaction can occur with which medication?

Nitroglycerin

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Refrigerate the insulin.

The health care provider has prescribed morphine sulfate intravenous push for a client with pulmonary edema. Which therapeutic effects should the nurse expect in this client? Select all that apply.

Relief of anxiety Reduction of oxygen consumption Improvement in efficacy of breathing

A client is scheduled for subtotal thyroidectomy. Potassium iodide is prescribed. The nurse understands that which outcome is the therapeutic effect of this medication?

Suppress thyroid hormone production.

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" Which action can the nurse suggest to assist the client in successfully adapting to this therapy?

Switching to a morning administration of the medication

A client is newly diagnosed with hypothyroidism. Levothyroxine is prescribed. The nurse should reinforce to the client which instructions about the medication?

Take on an empty stomach.

The nurse reinforces instructions to a client who is taking levothyroxine. Which instruction should the nurse give the client?

Take the medication on an empty stomach.

A client with angina pectoris who was given a first dose of newly prescribed nitroglycerin sublingual tablets complains of slight dizziness and headache. The nurse takes which action first?

Takes the client's blood pressure.

A client has received atropine sulfate intravenously during a surgical procedure. The nurse monitors the client for which side effect of the atropine sulfate in the postoperative period?

Urinary retention

A client is receiving digoxin daily. The nurse suspects digoxin toxicity after noting which signs and symptoms? Select all that apply.

Visual disturbances Nausea and vomiting Serum digoxin level of 2.3 ng/mL (2.93 nmol/L)

A client with angina pectoris has just been started on medication therapy with nitroglycerin. In planning care for this client, the nurse should place priority on measuring which data?

Vital signs

A client is being discharged from the hospital on warfarin for venous thromboembolism (VTE) prevention. Which instructions should the nurse reinforce in the client's teaching plan? Select all that apply.

Wear a Medic Alert bracelet. 2.Check urine and stool for blood. 3.Notify your dentist before an appointment.

A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which data would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

Tarry stools

The nurse is scheduled to administer a dose of digoxin to a client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. Which would be the nurse's next action?

The dose should be administered as prescribed.

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The primary health care provider prescribes levothyroxine. To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to reinforce which information?

The full therapeutic effect may take 1 to 3 weeks.

A child is being sent home on digoxin after being diagnosed with a congenital heart defect. The medication needs to be given once a day. Which should the nurse reinforce in the teaching plan for the family?

"Give the medication in the morning 20 to 30 minutes before a feeding."

The nurse is caring for a child with heart failure and provides instructions to the mother regarding the procedure for administration of the prescribed digoxin. Which statement by the mother indicates a need for further teaching?

"I can mix the medication with food."

A client reports to the clinic for follow-up after a 1-month treatment with acebutolol. The nurse determines that a therapeutic effect of the medication has occurred if which response is noted?

A blood pressure of 130/84 mm Hg

A client arrives at the health care clinic for follow-up care and evaluation of the effectiveness of prazosin. Which finding indicates a therapeutic effect related to the use of this medication?

Decrease in blood pressure

Lispro insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

"I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."

Prednisone 10 mg orally daily has been prescribed for a client. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates that further teaching is needed?

"I can take acetylsalicylic acid (aspirin) or my antihistamine if I need it."

A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client is seen by the health care provider, and Prinzmetal's angina is diagnosed. The nurse is instructing the client about diltiazem. Which client statement indicates a need for further teaching?

"I have to limit my coffee, but I can drink all the fruit juice I want."

A client is being discharged home, and the health care provider has prescribed spironolactone for the client. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching by the nurse?

"I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

A client receiving total parenteral nutrition (PN) has a history of heart failure. The health care provider has prescribed furosemide 40 mg orally daily to prevent fluid overload. The nurse is giving instructions about taking furosemide in relation to the client's health plan. Which statement by the client indicates a need for further teaching?

"I need to talk to my doctor about increasing my digoxin."

A pilocarpine ocular system is prescribed for the client with glaucoma. The nurse reinforces instructions to the client regarding the medication. Which statement by the client indicates an understanding of the use of this medication?

"I should check my eye each morning to make sure that the medication system is in place."

The nurse realizes that the client taking metformin needs further teaching when the client makes which statement?

"I should treat hypoglycemic episodes due to metformin with glucose tablets only."

Thrombolytic therapy was administered to a client following an acute inferior myocardial infarction. The nurse giving discharge instructions to the client evaluates a need for further teaching when the client makes which statement?

"I will apply pressure for 10 minutes for minor bleeding."

The nurse is reinforcing instructions to the client about insulin glargine. The nurse determines that the client understands the action of the medication if the client makes which statement?

"I will give myself this medication subcutaneously once each night before bed."

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids?

"I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress."

A client is taking nicotinic acid for hyperlipidemia, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions?

"Ibuprofen taken 30 minutes before the nicotinic acid should decrease the flushing."

The client has been prescribed nifedipine. The nurse is instructing the client about nifedipine. Which client statement indicates a need for further teaching?

"If I see empty tab shells in my stool, I need to report it to my doctor."

Which instruction should the nurse reinforce to the client with diabetes mellitus receiving acarbose? Select all that apply.

"Take the medication with each meal." "Side effects include abdominal bloating and flatus." 5. "Take some form of glucose if hypoglycemia occurs." 6. "Report symptoms such as shortness of breath or tiredness."

The nurse is reinforcing instructions to a client with essential hypertension about medication therapy with irbesartan. Which client statement would indicate a need for further teaching?

"The medication reduces my need for exercise."

Hypoglycemia from insulin overdose

Administer the full dose as prescribed.

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. Which action should the nurse plan?

Administer the next dose of warfarin sodium.

A hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

Adrenal suppression

A client receiving desmopressin begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likely experiencing which reaction?

Adverse medication effects

A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse should check the client for a potential hypoglycemic reaction at which time?

5:00 pm

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions to the client and should tell the client that which is the most likely time for a hypoglycemic reaction to occur?

6 to 14 hours after administration

A client informs the nurse that she has been taking acarbose as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The primary health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium. Which data would indicate that the client is experiencing a myasthenic crisis?

A temporary improvement in the condition

A client has been prescribed acarbose for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply.

Abdominal cramping is common. 4.Side effects include excessive flatulence. 5.The medication should be taken with each meal.

When discussing the rationale for levothyroxine with a client with hypothyroidism, the nurse should emphasize that the client can anticipate which primary expected outcome?

Achieving normal thyroid hormone levels

The nurse is preparing to administer digoxin to an adult client. The nurse checks which important item before administering the medication?

Apical pulse rate

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily?

Apple

A licensed practical nurse (LPN) is reviewing the medication list of the client with a history of glaucoma. The LPN should consult with the registered nurse if which medication is prescribed for the client?

Atropine sulfate

A client is being treated for heart failure and is receiving digoxin. The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, and respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse should expect which change in the client's vital signs?

Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

The nurse is planning to administer amlodipine to a client. The nurse should plan to check which before giving the medication?

Blood pressure and heart rate

Which finding indicates a side effect associated with the use of latanoprost eye drops?

Brown pigmentation of the iris

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse should plan to monitor the client for hypokalemia as a side effect of therapy if the client is receiving which medication?

Bumetanide

The nurse is collecting data from a client with hypertension being treated with diuretic therapy. The nurse should monitor the client for hypokalemia if the client is receiving which diuretic?

Bumetanide

The nurse is reinforcing dietary instructions to a client who is taking spironolactone. The nurse instructs the client to avoid which food in the daily diet?

Citrus fruits

A client is admitted with chest pain related to atrial fibrillation. Based on her blood glucose reading, metformin is prescribed for the client. As the nurse reviews the client's chart and prescriptions, which finding would require the nurse to verify the metformin prescription? Refer to chart.

Creatinine result

A client is being treated with atenolol for hypertension. The client tells the nurse, "I am very tired and weak since I began taking the medication." Based on the client's statement, the nurse determines that the client is experiencing which problem?

Common side effect

Vasopressin is prescribed for the client with diabetes insipidus. During data collection, the nurse is particularly cautious in checking the client for which preexisting condition?

Coronary artery disease

The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which disorder?

Graves' disease

The nurse notes that a client is being treated with nesiritide. The nurse should expect this client to be experiencing which disorder?

Heart failure

The nurse is preparing to administer digoxin, 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the nurse to check before administering the medication?

Heart rate

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon hydrochloride for emergency home use. The client asks the nurse about the purpose of the medication. The nurse tells the client that the purpose of the medication is to treat which aspect of diabetes?

Hypoglycemia from insulin overdose

A client who has begun taking fosinopril is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. Which suggestion would provide the best support for the client?

Inform the client that impaired taste is expected and generally disappears in 2 to 3 months.

The nurse is teaching a client, newly diagnosed with diabetes mellitus, to mix 24 units NPH and 12 units regular insulin in the same syringe. Which instructions should the nurse give to the client to take after wiping the vials with an alcohol wipe?

Inject 24 units of air into the NPH insulin vial.

The nurse needs to mix Regular insulin (clear) and NPH insulin (cloudy) in the same syringe. Arrange the actions in the order that they should be performed. All options must be used.

Inject air into the NPH insulin vial. Inject air into the regular insulin vial. Draw up the regular insulin into the syringe. Draw up the NPH insulin into the syringe.

The nurse is caring for a client who has been taking acetazolamide for glaucoma. The nurse reviews the assessment data documented in the client's medical record and determines that an adverse effect of the medication may be occurring if which result is noted?

Jaundice

A client is being discharged to home with a prescription for eye drops to be given in the left eye. The nurse has shown the client how to self-administer the drops. The nurse determines that the client needs further teaching if the client performs which actions during a return demonstration?

Lies supine, pulls up on the upper lid, and puts the drop in the upper lid

An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse is reviewing the medical record and needs to contact the primary health care provider if there is a history of which condition?

Liver disease

The nurse has a prescription to give a client a scheduled dose of digoxin. Before administering the medication, the nurse routinely screens for which signs/symptoms that could indicate early signs of digoxin toxicity?

Loss of appetite, nausea, and vomiting

The nurse is caring for a client with glaucoma who is receiving acetazolamide daily. Which sign/symptom indicates to the nurse that the client is experiencing an adverse effect related to the medication?

Low back pain and dysuria

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse tells the client that which is the best time to take the insulin?

Once daily at the same time each day

Lispro insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is reinforcing a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 15 to 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

A client is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory monitoring should the nurse plan to check during a continuous heparin infusion? Select all that apply.

Platelets Activated partial thromboplastin time (aPTT)

The nurse is preparing to administer furosemide to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to review before administering this medication?

Potassium level

The nurse is assisting in developing a plan of care for a client receiving warfarin sodium. The nurse selects which problem as the priority in caring for this client?

Potential for injury

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The licensed practical nurse (LPN) is concerned that the client received a bolus of medication when the tubing was removed from the IV pump during a gown change. The LPN immediately notifies the registered nurse or health care provider and then checks to see whether which medication is available in the medication supply area in case it is prescribed?

Protamine sulfate

The hospitalized client with angina continues to have chest pain after the initial administration of a sublingual nitroglycerin tablet. The nurse should take which action?

Provide a second sublingual dose in 5 minutes.

The nurse is preparing to administer eardrops to an infant. How should the nurse administer the eardrops?

Pull down and back on the ear, and direct the solution toward the wall of the canal.

The nurse is providing instructions to a mother regarding the administration of eardrops for her infant. The nurse observes the mother administer the drops and determines that the mother is performing the procedure correctly if the mother performs what action?

Pulls down and back on the earlobe and directs the solution toward the wall of the canal

The nurse is administering gentamicin sulfate ophthalmic ointment to a client. After instilling the ointment, the nurse reinforces instructions to the client to close the eye and perform which action?

Roll the eyeball in all directions.

The nurse is reinforcing instructions to a client regarding intranasal desmopressin acetate. The nurse should tell the client that the medication has which side effect?

Runny nose

The nurse is assisting in reinforcing a teaching plan for a client given a prescription for pioglitazone. The nurse plans to reinforce instructions to the client about which information related to this medication?

Signs of hypoglycemia

A client diagnosed with hyperthyroidism will be taking propylthiouracil. The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the primary health care provider?

Sore throat

The nurse reinforces dietary instructions to a client who will be taking warfarin sodium. The nurse tells the client to avoid which food item?

Spinach

A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When should the nurse plan on withholding the prescribed dose of the medication?

The child's pulse is less than 80 beats per minute.

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which should the nurse recognize as potential adverse effects? Select all that apply.

Tinnitus 3.Hypotension 4.Hypoka

The nursing student is asked about the medication latanoprost and how this medication helps glaucoma. The student responds correctly by identifying which as the medication's mechanism of action?

To facilitate the outflow of aqueous humor

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

To increase water reabsorption

Somatrem is administered to a client with pituitary dwarfism. Which is the expected therapeutic effect of this medication?

To stimulate linear growth

The nurse reinforces medication instructions to a client who is taking levothyroxine. The nurse instructs the client to notify the primary health care provider (PHCP) if which sign/symptom occurs?

Tremors

The nurse notes that a client in a long-term care facility is receiving a daily dose of furosemide. The nurse writes in the care plan to monitor which parameter on a daily basis?

Weight

The nurse has completed client teaching about heart failure and prescribed medications that include digoxin and furosemide. The nurse documents that the teaching goals have been met if the client states knowing to report which symptom?

Weight gain of 2 to 3 pounds in a few days

The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching?

Withdraws the NPH insulin first

A client who will undergo thyroidectomy at a later date has been started on medication therapy with potassium iodide As the licensed practical nurse (LPN) prepares to administer a scheduled dose, the client states that there is a burning sensation and a brassy taste in the mouth. Which action should the LPN take?

Withhold the medication and notify the RN.

Levothyroxine sodium is prescribed for a client with hypothyroidism. When should the nurse encourage the client to take the medication?

in the morning

Isosorbide mononitrate is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. Which action should the nurse suggest to the client?

Take the medication with food.

The home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

"I can take aspirin or my antihistamine if I need it."

A client is being discharged following treatment for left-sided heart failure. The nurse is reinforcing teaching the client the purpose, actions, adverse effects, and use of digoxin and hydrochlorothiazide prescribed for daily use. Which statement by the client indicates a need for further teaching?

"I should decrease my intake of foods high in potassium such as bananas."

The nurse reinforces instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium. Which statement by the client indicates an understanding of the nurse's instructions?

"I will report any episodes of palpitations, chest pain, or dyspnea."

A client with chronic atrial fibrillation is being started on amiodarone as maintenance therapy for dysrhythmia suppression. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching?

"I will stop taking the prescribed anticoagulant after starting this new medication."

The nurse is monitoring a client receiving glipizide. Which outcome indicates an ineffective response from the medication?

A glycosylated hemoglobin level of 12%

A client is taking ticlopidine hydrochloride. The nurse tells the client to avoid which substance while taking this medication?

Acetylsalicylic acid

Heparin sodium is prescribed for the client. Which laboratory result indicates that the heparin is prescribed at a therapeutic level?

Activated partial thromboplastin time (aPTT) of 55 seconds

The nurse prepares to administer digoxin to a 3-year-old with a diagnosis of heart failure and notes that the apical heart rate is 120 beats per minute. Which nursing action is appropriate?

Administer the digoxin.

The nurse is caring for a client with chronic heart failure who is taking digoxin 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which action should the nurse take based on this laboratory result?

Administer the dose of the medication as scheduled.

Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which prescription should the nurse anticipate during therapy with the prednisone?

An increased amount of daily NPH insulin

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states to monitor for which?

Anorexia, nausea, weakness, and fatigue

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is most important for the nurse to check before administering a second dose of the medication?

Blood pressure

A client has been given a prescription for gemfibrozil. The nurse plans to instruct the client to limit intake of which food while taking this medication?

Beef

The nurse reinforces instructions to a client who has been prescribed betaxolol eye drops for the treatment of glaucoma. The nurse instructs the client regarding the administration of the medication and about the importance of returning to the clinic for which assessment?

Blood pressure and apical pulse

The nurse is assisting in monitoring a client who received hydralazine hydrochloride to treat autonomic dysreflexia. Which finding accurately indicates that the medication is effective?

Blood pressure declines.

A client is diagnosed with pulmonary embolism and is to be treated with thrombolytic therapy. The nurse should report which priority data collection finding to the registered nurse before initiating this therapy?

Blood pressure of 198/110 mm Hg

The nurse is planning to administer hydrochlorothiazide to a client. Which are concerns related to the administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

Atenolol hydrochloride is prescribed for a hospitalized client. The nurse should perform which as a priority action before administering the medication?

Check the client's blood pressure.

A hospitalized client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Which appropriate actions should the nurse take? Select all that apply.

Check the client's pain level. 4. Check the client's blood pressure. 5. Administer a second nitroglycerin, 0.4 mg, sublingually.

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Diarrhea can occur secondary to metformin. The repaglinide is not taken if a meal is skipped. The repaglinide is taken 30 minutes before eating. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

The nurse is monitoring a client receiving desmopressin acetate for adverse effects to the medication. Which sign/symptom indicates the presence of an adverse effect?

Drowsiness

The nurse in the preoperative holding unit administers a dose of scopolamine to a client. The nurse monitors the client for which common side effect of the medication?

Dry mouth

A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?

Early morning

Fludrocortisone is prescribed for a client with Addison's disease. The primary health care provider needs to be notified if the client experiences which conditions? Select all that apply.

Edema Chest pain Muscle cramps

A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which is the most reliable indicator of hypoglycemia?

Low blood glucose level

A client with diabetes mellitus visits a healthcare clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 mg/dL to 200 mg/dL (10.2 mmol/L to 11.4 mmol/L). Which medication, added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

The nurse preparing a client for surgery reviews the client's medication record. The client is to receive nothing by mouth (NPO) after midnight. Which medication noted on the client's record should the nurse question?

Prednisone

The nurse is monitoring a client who is taking propranolol. Which data collection finding would indicate a potential serious complication associated with propranolol?

The development of audible expiratory wheezes

A client has a prescription for niacin. The nurse determines that the client understands the importance of this therapy if the client verbalizes the importance of which periodic monitoring?

The serum cholesterol level

A health care provider (HCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to do which?

Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.

The nurse is caring for a client who is taking metoprolol. The nurse measures the client's blood pressure (BP) and apical pulse immediately before administration. The client's BP is 122/78 mm Hg and the apical pulse is 58 beats per minute. Based on this data, which is the appropriate action?

Withhold the medication.

A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep vein thrombosis. The nurse is told that the client's activated partial thromboplastin time (aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30 seconds. The nurse identifies these results as characteristic of which description?

Within the therapeutic range

The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril orally daily. The nurse evaluates the need for further teaching when the client makes which statement?

"I can skip a dose once a week."

A client received a dose of regular insulin this morning at 7:00 am. At which time should the nurse likely anticipate the potential for a hypoglycemic reaction to occur?

10:00 am

A client is being discharged to home following recovery from an anterior myocardial infarction with recurrent angina. The client will be taking diltiazem, isosorbide dinitrate, and nitroglycerin sublingually as needed, and the nurse reinforces information to the client about the medications. Which statement by the client indicates a need for further teaching about the medications?

"I should notify my doctor immediately if I experience headaches with any of these medications."

Latanoprost drops are prescribed for the client with glaucoma. The client returns to the health care clinic for evaluation. Which finding noted in the client indicates a side effect associated with the use of these eye drops?

Brown pigmentation of the iris

Nifedipine has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further teaching?

"Nausea and drowsiness are expected, and if they occur, I don't really need to worry about it."

The nursing student is caring for a client scheduled for cataract surgery. The student reviews the preoperative prescriptions with the nursing instructor and notes that cyclopentolate eye drops are prescribed to be administered preoperatively. The unit nurse performed an admission health assessment on the client before surgery. Which condition contraindicates using cyclopentolate?

Glaucoma

A client with heart failure is being discharged to home and will be taking furosemide. The nurse determines that teaching has been effective if the client makes which statement?

"I will weigh myself every day."

A potassium-retaining diuretic is prescribed for a client with heart failure. Which foods should the nurse instruct the client to avoid?

Bananas

A client with heart failure who is taking furosemide and digoxin calls the nurse and complains of anorexia and nausea. The nurse should take which action?

Check the result of the potassium level drawn 3 hours ago.

The nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who lives at home alone and has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, which number of prefilled syringes should the nurse prepare for the client?

A 7-day supply

The nurse is monitoring a client receiving furosemide 40 mg orally daily. Which indicator should inform the nurse that a therapeutic effect has occurred?

A blood pressure of 128/80 mm Hg

A client who is taking hydrochlorothiazide has also been prescribed triamterene. The client asks the nurse why both medications are required. Which response is the most accurate to give to the client?

Triamterene is a potassium-retaining (sparing) diuretic, whereas hydrochlorothiazide is a potassium-excreting diuretic.

Cortisone acetate is prescribed for a client with adrenal insufficiency, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate a need for further teaching?

"I will stop the medication when I feel better."

The nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium. Which statement made by the client reflects the need for further teaching?

"I will take enteric-coated aspirin for my headaches because it is coated."

The nurse is caring for a client who has been taking diuretics on a long-term basis. The nurse reviews the medication record, knowing that which medications if prescribed for this client would place the client at risk for hypokalemia?

Bumetanide

A client diagnosed with diabetes insipidus is beginning medication therapy with lypressin. The nurse realizes the client understands instructions if the client comments the medicine will be taken in which manner?

Intranasally to promote water reabsorption

The nurse is reinforcing medication instructions to a client who has been prescribed simvastatin. Which is the action of simvastatin?

It inhibits hepatic synthesis of cholesterol.

The client with Cushing's syndrome had bilateral adrenalectomies and is now on corticosteroid therapy. The client also has a history of seizures. The nurse giving discharge instructions concerning corticosteroid therapy realizes there is a need for further teaching when the client makes which statement?

"I know my doctor can now decrease my dosage of phenytoin."

The nurse is reinforcing instructions to a client with glaucoma receiving acetazolamide daily. Which statement by the client indicates an understanding of the adverse effects related to the medication?

"I need to call the doctor if I notice dark urine and stools."

The nurse is reinforcing discharge teaching to the client who was given a prescription for nifedipine for blood pressure management. Which instructions should the nurse reinforce? Select all that apply.

"Take pulse rate each day." 4. "Weigh at the same time each day." 5. "Palpitations may occur early in therapy." 6. "Be careful when rising from sitting to standing."

A client taking an angiotensin-converting enzyme (ACE) inhibitor reviewed the medication information sheet and notes that the medication is used to treat hypertension. He states, "I have heart failure. Why am I taking this medicine?" The nurse responds by making which statement?

"The medication causes relaxation in your arteries and veins and decreases the heart's work."

Thyroid replacement therapy is prescribed for a client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which response by the nurse would be accurate?

"The medication will need to be continued for life."

A client with aldosteronism has been instructed on spironolactone treatment. Which client statement indicates that the client needs further teaching about the medication?

"This medication will decrease my blood glucose."

A client has been instructed by the primary health care provider to alternate the use of hydrogen peroxide and glycerin eardrops to loosen an impacted accumulation of earwax. The nurse gives the client which directions to accomplish this daily procedure safely and independently?

"Use the solutions at body temperature for 7 to 14 days."

A client is experiencing impotence after taking an antihypertensive medication. The client states, "I would sooner have a stroke than keep living with the side effects of this medication." The nurse should make which appropriate response to the client?

"You are concerned about the side effects of your medication?"

A client has self-administered his first injection of regular insulin at 7:30 am, before breakfast. This client should be instructed to closely monitor for signs of hypoglycemia at which time?

11:00 am

A client with myocardial infarction is a candidate for alteplase therapy. The nurse assisting in the care of this client is aware that it will be necessary to monitor for which adverse effect of this therapy?

Bleeding

The nurse is attending an in-service education session on the therapeutic use of calcium-channel blockers. The instructor of the session determines that teaching has been effective when the nurse correctly identifies that these medications are used for which disorders? Select all that apply.

Angina Hypertension 4.Dysrhythmias

The nurse is concerned that a client may experience systemic effects from a beta-blocker ophthalmic solution. The nurse realizes the client is able to self-administer the medication if the client instills the drops in which manner?

Applies digital pressure to the lacrimal sac for 1 to 2 minutes after instillation

The nurse is reviewing the health care provider's prescription sheet for the preoperative client, which states that the client must be on nothing by mouth (NPO) status after midnight. The nurse should clarify whether which medication should be given to the client rather than withheld?

Atenolol

A client recently began medication therapy with propranolol. The nurse should be most concerned after noting the presence of which effect in this client?

Audible expiratory wheezes

The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. The nurse reminds the client to do which?

Avoid taking products containing acetylsalicylic acid.

The nurse is caring for a client who is receiving hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameters?

Blood pressure

A client has a fasting blood glucose of 268 mg/dL at 7:30 am. The sliding scale prescriptions are blood glucose 151 to 200 mg/dL, administer 3 units Humalog insulin; 201 to 250, administer 6 units Humalog insulin; 251 to 300 mg/dL, administer 9 units Humalog insulin; over 300 mg/dL contact the primary health care provider. Therefore, at 7:30 am, how many units of Humalog should be administered?

Humalog 9 units

A client with a history of hypertension has been prescribed triamterene. The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which fruit?

Bananas

Metformin is prescribed for a client with type 2 diabetes mellitus. Which should the nurse tell the client is a common side effect of the medication?

Gastrointestinal (GI) disturbances

The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse should expect the primary health care provider to prescribe which? Select all that apply.

Calcitonin 3.Furosemide 4.Assist to ambulate PRN

A client returning to the medical nursing unit following cardiac catheterization has a stat prescription to receive a dose of procainamide. The licensed practical nurse assisting in caring for the client obtains which piece of equipment to adequately determine the client's response to this medication?

Cardiac monitor

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.

Insomnia Weight loss Mild heat intolerance

The nurse is reinforcing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which routes?

Intranasal

A client is diagnosed with hypothyroidism, and levothyroxine is prescribed. The nurse notes that the client is presently taking warfarin sodium and anticipates that the primary health care provider will alter which medication dosage?

Decrease the dosage of warfarin sodium.

A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin to induce labor. The LPN plans to notify the registered nurse immediately if which signs and symptoms are noted? Select all that apply.

Decreased blood pressure, increased pulse 4.Contractions greater than 1 minute in dura

A client has taken his first dose of lisinopril about 2 hours ago and begins to develop fullness in his face and hoarseness. Which action should the nurse take first?

Determine the client's ability to breathe effectively.

The nurse is preparing to administer an injection of regular insulin. The vial of the regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which action should the nurse take?

Discard the insulin and obtain another vial.

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse reinforces medication instructions to the client. The nurse determines that the client needs further teaching if the client states which action is necessary?

Discontinue the medication when symptoms subside.

A client with chronic glaucoma is being started on medication therapy with acetazolamide. The nurse reinforces instructions to the client that which symptom can occur early but subsides or disappears with continued treatment?

Diuresis

The nurse should anticipate the use of which medications in the treatment of the client with heart failure? Select all that apply.

Diuretics Cardiac glycosides 5. Phosphodiesterase (PDE) inhibitors 6. Angiotensin-converting enzyme (ACE) inhibitors

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which information?

Full therapeutic effect may take 1 to 3 weeks.

A client has arrived at the emergency department complaining of weakness, an irregular heartbeat, and lethargy. The nurse is attempting to discover what caused these symptoms. The nurse asks the client "Have you been prescribed any new medications?" The client tells the nurse "About 2 weeks ago I was prescribed a drug to make me pee, but I don't know the name." The nurse determines that the client is referring to which medication?

Furosemide

The nurse has reinforced instructions to a client regarding the method for instilling eye drops into the left eye. The nurse determines that the client needs further teaching if the client does which during a return demonstration?

Lies supine, pulls up on the upper lid, and puts the drop in the upper lid

A client who has just been diagnosed with glaucoma has been given a prescription for a miotic medication. When reinforcing instructions to the client about medication effects, the nurse plans to tell the client that the medication works in which manner?

Lowers intraocular pressure and enhances blood flow to the retina

A client is being discharged with a prescription for propranolol. When reinforcing instructions to the client about the medication, the nurse should include which information?

Medication should be withheld if the pulse rate drops below 60 beats per minute.

Potassium iodide is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How should the nurse respond?

Notify the primary health care provider.

The nurse is asked to assist in preparing a heparin sodium infusion for a client with a diagnosis of thrombophlebitis. Which items should the nurse have available for this procedure? Select all that apply.

Protamine sulfate 3. Intravenous tubing 4. Intravenous infusion controller 5. Intravenous insertion equipment

Warfarin sodium is prescribed for a client. The nurse expects that the primary health care provider will prescribe which laboratory tests to monitor for a therapeutic effect of the medication? Select all that apply.

Prothrombin time (PT) 4.International normalized ratio (INR)

A health care provider tells the nurse that a potassium-retaining diuretic is being prescribed for the client with heart failure. The nurse reviews the health care provider's prescriptions expecting that which medication will be prescribed?

Spironolactone

The nurse has a prescription to give a first dose of hydrochlorothiazide to an assigned client. The nurse should question the prescription if the client had a history of allergy to which item?

Sulfa drugs

The nurse assists with creating a plan of care for a client with hyperparathyroidism receiving calcitonin-human. Which outcome has the highest priority regarding this medication?

Reaching normal serum calcium levels