Final exam questions

A client with Left ventricular heart failure and supraventicular tachycardia is prescribed digoxin 0.25mg daily. Which changes would the RN expect to find of this medication is therapeutic

Dieresis Decreased edema Decrease pulse rate

A client has been given a prescription for a furosemide 40mg every day in conjunction with digoxin. Which concern would prompt the nurse to ask HCP about k+ supplements

Digoxin toxicity occurs rapidly in the presence of hypokalemia

Antilipemics

HMG-CoA reductase inhibitors- atorvastatin (Lipitor) Cholesterol absorption- ezetimibe ( zetia)

anesthetic

Local-lidocaine General- propofol

Diuretic

Loop- furosemide Thiazide- hydrochlorothiazide Potassium sparing-aldactone

Nitroimidazoles

Metronidazole (Flagyl)

The nurse is preparing to initiate antibiotic therapy for a client who developed an incision infection. Which task would the RN ensure has been done before starting the first dose of IV antibiotics?

Wound culture

Organic nitrates

nitroglycerin

Penicillins

• Natural penicillin (Penicillin G) Penicillinase-resistant (naficillin, unipen) Amino penicillin (amoxicillin) Extended spectrum (zosyn)

Which information would the nurse include when teaching a client with CAD about aspirin therapy

Take aspirin with food Report ringing in the ears Monitor and report excessive bleeding and bruising Avoid otc pain medications that contain aspirin

Which information would the RN include when teaching a client about antacid tablet

They interfere with the absorption of other medications

NSAIDs

nonsteroidal anti-inflammatory drugs Salicylate- aspirin Propionic acid derivative- ibuprofen Acetic acid derivative- Ketoralac (Toradol)

Bronchodilator

SYMPATHOMIMETIC beta agonists- albuterol

Decongestants

Anticholinergic-Atrovent Corticosteroids- Flonase

Sulfanamides

Bactrim, sulfamethoxazole

Antimalarials

Chloroquine (Aralen)

Cardiac glycosides

Digoxin (Lanoxin)

Proton pump inhibitor

Protonix (Pantoprazole)

Leukotrine receptor antagonist

Singulair

Erectile agents

Viagra (sildenafil)

Cephalosporins

- 1st gen: cephalexin - 2nd gen: cefuroxime - 3rd gen: ceftazdime - 4th gen: cefepime

Insulin lispro onset of action

0.25 hours Peak-0.5- 1.5 hours Duration- 3-4 hours

insulin glargine

1-1.5 hours onset No peak action Duration of 20-24 hours

When should antacids be given

1-2 hours after meals and at bedtime Can be taken every 1-2 hours without adverse effects Liquid antacids have a faster onset of action

antiarrhythmic

2- metropolol, propranolol, sotalol 3- amiodarone 4- diltiazem

Calcium Channel Blockers

Diltiazem (Cardizem)

Parasympathetic

Anticholinergics- atropine & scopolamine

Antiemetic

Antidopaminergic- compazine Serotonin blockers- zofran

CNS depressants

Barbiturates- Luminol Benzodiazepines- lorazepam (Ativan)

Osteoporosis agent

Biphosphanates- fosamax * alendronate

A client is receiving hydrochlorothiazide. Which physiological alteration will the RN monitor to best determine the effectiveness of the clients therapy

Blood pressure

Metropolol is prescribed for a client with hypertension. The RN will monitor the client or what adverse effects

Bradycardia

Metropolol is prescribed for a client with hypertension. The RN monitors the client for which adverse effect

Bradycardia

Skeletal muscle relaxant

Cyclobenzaprine (Flexeril)

Antiprotozoal

Flagyl (metronidazole)

Aminoglycosides

Gentamicin

Which food would the RN instruct a client taking diltiazem to avoid?

Grapefruit juice

Antihistamine

H1 blockers- 1st gen (Benadryl) & 2nd gen (Claritin)

Which mechanism of action explains how hydrochlorothiazide increases UOP

Increase the excretion of sodium

Digoxin is prescribed for a client. Which therapeutic effect of a digoxin would the nurse expect

Increased contractile force of the myocardium

Anticoagulant

Injectable- heparin LMWH-Enoxapain Oral- warfarin Selective Xa inhibitor- xarelto Direct acting thrombin- Pradaxa Antiplatlets- aspirin &plavix Thrombolytics- tPA

A HCP prescribes losartan for a client. Which is an important nursing action

Monitor the clients blood glucose

Which side effect would the RN assess for in a child receiving prednisone?

Mood changes

Expectorant

Mucinex

A client with TB is started on rifampin. The RN evaluates that the teaching about Rifampin is effective when the client makes which statement?

My sweat will turn orange from this medication.

Narcotic Antagonist

Naloxone (Narcan)

Antacids

Non systematic- maalox & tums

CNS stimulants

Ritalin

Which medication requires the RN to monitor the client for signs of hyperkalemia

Spironolactone Potassium sparing diuretic

A clients serum lithium level is 0.2. What interpretation is correct

Sub therapeutic level

Oral hypoglycemic

Sulfonylureas- glipizide Biguanides- metformin DPP-4 inhibitor- januvia SGLT2 INHIBITOR- INVOKANA

antihypertensive

Sympatholytics- catapres ACE inhibitor- Captopril ARB-Cozaar

Tetracycline

Tetracycline

Trimethoprim/Sulfamethoxazole consideration

UOP of at least 150.ml a day should be maintained to prevent crystalluria. Taking with OJ provides no advantage- can produce an alkaline rash which creates alkaline urine that supports bacteria growth. -take 1 hour before meals.

Glycopeptides

Vancomycin Vancocin

Sympathomimetics

Vasoactive adrenergics- epinephrine, norepinephrine (levophed), dobutrex, dopamine(inotropin), sudafed

Thyroid drugs

levothyroxine

Antifungals

Systemic- amphotrecin b (fungizone) Superficial- nystatin (mycostatin)

Antiviral

Acyclovir (Zovirax) Oseltamivir (tamiflu)

Glucocorticoids

Prednisone

Indulins

Rapid- lispro Short- humulin Intermediate- NPH long acting- lantus (100 u) Long acting- toujea (300 u)

Which describes the purpose of restricting sodium for a client with hypertension

To prevent reabsorption of water in the distal tubules

Which issue related to antibiotic use is an increased risk for the older adult

Toxicity

A client develops thrombophlebitis in the right calf. Bed rest is prescribed and an IV infusion of heparin is initiated. Which drug action will the nurse include when describing the purpose of this medication to the client

It prevents extension of the clot

The RN is teaching the parents of a child prescribed a high dose of oral prednisone for asthma. Which information is critical for the RN to include when teaching about this medication?

It should be stopped gradually Prevents adrenal insufficiency or adrenal crisis

Antimania

Lithium

A client who had a femoropopliteal bypass graft is receiving clopidogrel post op. Which instruction will the nurse teach the client related to this med

Report any occurrence of multiple bruises

A client is prescribed monoamine oxidase inhibitor. Which foods would the nurse teach the client to avoid

Aged cheese Ripped avocado Delicatessen meats

Sympatholytics

Alpha blockers- phentolamine (regitine) Beta blockers- selective (metropolol) & non selective (propranolol)

Which adverse effect of morphine indicates the need for halo one administeration

Respiratory depression

Which action would the nurse perform when administering fluticasone proportionate to a client with asthma

Rinsing the oral cavity with water after use

Which ophthalmic solution is contraindicated for clients with glaucoma

Atropine

Antiparkinsonians

Dopaminergic- levodopa/cardidopa Central anticholinergic- benztropine(congentin)

Trimethoprim/Sulfamethoxazole is prescribed for a client with cystitis. Which instruction would the nurse include when providing medication teaching?

Drink 8-10 glasses of water daily

histamine 2 antagonist drugs

Pepcid

Fluoroquinolones

Levofloxacin (Levaquin)

A client has an INR of 4.6 what action will the RN take regarding his warfarin

Notify HCP of the lab results Normal INR is 2 to 3

NPH

Onset of 1.5 hours Peak 4-12 hours Duration 18 to 24 hours

Antitussives

Opiod antitussive-codeine Non opiod antitussive- benzonatate

Analgesic

Opioid agonists- morphine Opioid with non opiod- oxycodone+acetaminophen =Percocet Non opiod- acetaminophen (Tylenol)

What does rifampin cause

Orange body fluids

What test needs to be done with warfarin

PT INR

RN teaches dietary guidelines to a client who will be receiving a MAOI. The client compiled a list of foods to avoid. what foods are on this list

Pepperoni pizza Bologna sandwich High Tyramine foods

A client is admitted to the hospital with a diagnosis of DVT and IV Heparin sodium is prescribed. If the client experiences excessive bleeding, which medication will the nurse be prepared to administer

Protamine sulfate

Why are the elderly at an increase risk for toxicity with antibiotic

Reduced metabolism and excretion of meds

Which action by a client taking alendronate requires correction?

Taking medication twice a week Taking before rising Taking medication with breakfast Taking medication before bedtime Taking medication with apple juice- take with water to avoid esophagitis

Antidepressant

Tricyclics-Elavil SSRIs-Prozac SNRIs- Effexor ER MAO inhibitors- parnate

therapeutic range of lithium

0.5 to 1.5

Antipsychotics

1st gen-haldol 2nd gen- risperdol

Regular insulin

0.5 hours for onset Peak of 1-5 hours Duration of 6 to 10 hours

Parasympathomimetic

Acetylcholinesterase inhibitor- donepezil (aricept)

A HCP prescribes enoxaparin 30 mg subcutaneous daily. Which measure would the nurse take when administering this medication

Administer in the abdomen

Which lifestyle advice does the RN give to a client when oral digoxin therapy is initiated

Bran can decrease digoxin absorption Digoxin should not be taken with hawthorn supplements Ginseng may cause a dangerous increase in digoxin levels in the blood Meds that lower K+ or mg+ can cause digoxin toxicity

Laxative

Bulk forming - Metamucil Osmotic- miralax Stool softener- colace

The RN is administering 40 mg of furosemide intravenous. Which sensation reported by the client would the RN consider when determining that it is being administered too quickly

Buzzing ears

Macrolides

Erythromycin

Anticonvulsant

Hydantonins- phenytoin (Dilantin) Gabapentin (neurontin)

A client is taking furosemide. At each clinic visit, the RN will assess for which adverse effect

Hyperflexia

A client is receiving furosemide to relieve edema. The RN will monitor the client for which adverse effect

Hypokalemia

Which client statement indicates that the teaching about furosemide is understood

I need to change my position slowly I should eat more food that is high in potassium

The RN provides discharge medication education to a client who has a prescription for warfarin. Which client statement indicates to the nurse that the teaching was effective

I will avoid taking aspirin and NSAIDs

A client prescribed met Forman extended release to control type 2 diabetes. Which statement made by this client indicates the need for further education?

I will stop taking metformin for 24 hours before and after having a test involving dye. (Lactic acidosis)

When a client with a venous thrombosis is receiving warfarin, which test result would the nurse use to determine whether the daily dose of warfarin is therapeutic?

INR 2-3

The RN is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. What insulin would the RN conclude has the fastest onset of action?

Insulin lispro

Antitubercular

Isoniazid (INH) Rifampin (rifadin)

Which side effect would the nurse assess for after Epi is administered to an infant with severe bronchospasms

Tachycardia

A client is prescribed albuterol to relieve severe asthma. Which adverse effect will the RN instruct the client to anticipate

Tremors Palpitations