Hesi Pharmacology
Butorphanol tartrate by intravenous push is prescribed for a client in labor. The nurse recognizes which assessment findings to be side or adverse effects of this medication? Select all that apply. 1.Tinnitus 2.Syncope 3.Bradycardia 4.Palpitations 5.Increased thirst 6.Nausea and vomiting
1. Tinnitus 2.Syncope 4.Palpitations 6.Nausea and vomiting The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to 3 hours before the anticipated deliver. Butorphanol tartrate is a medication that may be prescribed for pain relief. Bradycardia and increased thirst are not side or adverse effects.
A client who has had a prostatectomy is complaining of pain from bladder spasms. The nurse checks the primary health care provider's prescription sheet and expects to see which medication prescribed to treat the problem? 1.Oxybutynin 2.Hydromorphone 3.Morphine sulfate 4.Meperidine hydrochloride
1.Oxybutynin Bladder spasms after prostatectomy are treated with antispasmodic medications, such as oxybutynin. Opioid analgesics such as morphine sulfate, hydromorphone, and meperidine hydrochloride usually are not effective in treating pain caused by spasms.
The client with a traumatic brain injury (TBI) has begun excreting copious amounts of dilute urine through the Foley catheter. The client's urine output for the previous shift was 3000 mL. The nurse expects that the primary health care provider will prescribe which medication? 1.Mannitol 2.Desmopressin 3.Ethacrynic acid 4.Dexamethasone
2.Desmopressin A complication of TBI is diabetes insipidus, which can occur with insult to the hypothalamus, the antidiuretic hormone storage vesicles, or the posterior pituitary gland. Urine output that exceeds 9 L per day generally requires treatment with desmopressin. Dexamethasone is usually given to control cerebral edema secondary to brain tumors. Ethacrynic acid and mannitol are diuretics, which would be contraindicated.
A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1.Hypercalcemia 2.Peripheral neuritis 3.Small blood vessel spasm 4.Impaired peripheral circulation
2.Peripheral neuritis isoniazid is an antitubercular medication. A common side effect of isoniazid is peripheral neuritis, manifested by numbness, tingling, and paresthesias in the extremities. This can be minimized with pyridoxine (vitamin B6) intake. Options 1, 3, and 4 are not associated with the information in the question.
A client is prescribed fluphenazine daily. The nurse teaches the client to take which measure to minimize a common side/adverse effect of this medication? 1.Monitor the temperature daily. 2.Use hard sour candy or sugarless gum. 3.Eat snacks at midmorning and at bedtime. 4.Have the blood pressure checked once a week.
2.Use hard sour candy or sugarless gum. Fluphenazine is an antipsychotic. Dry mouth is a common side effect of this medication. Frequent mouth rinsing with water, sucking on hard candy, and chewing sugarless gum will alleviate this common side effect. Mild leukopenia may occur, but the temperature does not need to be taken daily. Weight gain is a common side effect, and frequent snacks would worsen the problem. Hypotension and hypertension are rare side effects of fluphenazine.
The nurse is analyzing the laboratory studies on a client receiving dantrolene to treat muscle spasms from an injury. Which laboratory test would identify an adverse effect associated with the administration of this medication? 1.Platelet count 2.Creatinine level 3.Liver function tests 4.Blood urea nitrogen level
3.Liver function tests Dose-related liver damage is the most serious adverse effect of dantrolene. To reduce the risk of liver damage, liver function tests should be performed before treatment and throughout the treatment interval. Dantrolene is administered at the lowest effective dosage for the shortest time.
A client with aldosteronism is being treated with spironolactone. Which finding indicates to the nurse that the medication is effective? 1.A decrease in body metabolism 2.A decrease in sodium excretion 3.A decrease in potassium excretion 4.A decrease in aldosterone production
4. A decrease in aldosterone production Aldactone antagonizes the effect of aldosterone and decreases circulating volume by inhibiting tubular reabsorption of sodium and water. Thus, it produces a decrease in blood pressure. It increases the excretion of sodium and plasma potassium . It has no effect on body metabolism.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? 1.Immediately before swimming 2.5 minutes before exposure to the sun 3.Immediately before exposure to the sun 4.At least 30 minutes before exposure to the sun
4.At least 30 minutes before exposure to the sun Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
A client has been taking a pyrazinamide for 1 month. The client asks the nurse whether the therapy is due to be terminated soon. The nurse determines that the medication probably will be continued based on a positive finding in which report? 1.Blood culture 2.Urine culture 3.Wound culture 4.Sputum culture
4.Sputum culture Pyrazinamide is an antituberculosis medication given with other antituberculosis medications, Pyrazinamide might not be discontinued if sputum cultures continue to be positive. The remaining options are not related directly to the use of this medication.
A home health nurse is visiting a client who has been started on therapy with clotrimazole. The nurse determines the effectiveness of the medication by noting a decrease in which problem? 1.Pain 2.Rash 3.Fever 4.Sneezing
2.Rash Clotrimazole is a topical antifungal agent used in the treatment of cutaneous fungal infections. It is not used for pain, fever, or sneezing.
Which supplies should the nurse obtain for the administration of ribavirin to a hospitalized child with respiratory syncytial virus (RSV)? 1.A mask and pair of goggles 2.Isolation gown and sterile gloves 3.An intravenous (IV) pole and hood 4.Intramuscular (IM) syringe and needle
1.A mask and pair of goggles Ribavirin is administered via hood, face mask, or oxygen tent and is not administered by the IV or IM route. Some caregivers experience headaches, burning nasal passages and eyes, and crystallization of soft contact lenses as a result of administration of ribavirin. Specific to this medication is the use of goggles. A mask may be worn. A gown is not necessary. The medication used for the prevention of RSV is palivizumab, a monoclonal antibody, which is given monthly in an IM injection to prevent hospitalization associated with RSV.
The nurse is teaching a client with hyperthyroidism about the prescribed medication, propylthiouracil. The nurse determines that teaching has been successful if the client states to report which symptom to the primary health care provider (PHCP)? 1.Fever 2.Fatigue 3.Excitability 4.Nervousness
1. Fever An adverse effect of propylthiouracil is agranulocytosis. The client should be alert for this adverse effect by noting the presence of fever or sore throat, which should be reported to the PHCP immediately. Excitability is not a side or adverse effect of this medication. Fatigue may be an occasional side effect of the medication but does not warrant PHCP notification.
A client with previously well-controlled diabetes mellitus has had fasting blood glucose levels ranging from 180 to 200 mg/dL. The client takes glyburide 5 mg orally daily. In reviewing the client's medication list, the home health care nurse suspects that which newly added medications could be contributing to the elevated blood glucose levels? 1.Prednisone 2.Ranitidine 3.Cimetidine 4.Ciprofloxacin
1. Prednisone Corticosteroids, thiazide diuretics, and lithium may decrease the effect of glyburide, thus causing hyperglycemia. The medications listed in the incorrect options increase the effect of glyburide, leading to hypoglycemia.
The nurse is providing education to a client who is being started on atenolol. Which statement by the client indicates that teaching has been effective? 1."I am taking this medication for hypertension." 2."It is to help manage my rheumatoid arthritis." 3."This medication will help my ulcerative colitis." 4."This medication will reverse my second-degree heart block."
1."I am taking this medication for hypertension." Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It is used to treat conditions such as hypertension and angina pectoris. It is not used to treat the conditions noted in the other options. In addition, its use is contraindicated in the client with heart block greater than first degree.
The nurse is caring for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client should the nurse note as an expected side effect of this combination medication? 1."I feel like my heart is racing." 2."I feel more bloated than usual." 3."My eyes have been watering lately." 4."I haven't had a bowel movement in 4 days."
1."I feel like my heart is racing." Albuterol/ipratropium is a combination agent—one is a β2-adrenergic agonist and the other is an anticholinergic medication, and in combination they produce an overall bronchodilation effect. Common side and adverse effects include headache, dizziness, dry mouth, tremors, nervousness, and tachycardia. Therefore, option 1 is correct. Options 2, 3, and 4 are not specifically associated with this medication.
The nurse is caring for a child with heart failure (HF). The nurse 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? 1."I will make sure to mix the medication with food." 2."I need to take my child's pulse before administering the medication." 3."If more than 1 dose is missed, I need to call the primary health care provider." 4."If my child vomits after being given the medication, I should not repeat the dose."
1."I will make sure to mix the medication with food." Medication should not be mixed with food because this method of administration would not ensure that the child received the prescribed dose. The parents need to be instructed that if the child vomits after the digoxin is administered, they are not to repeat the dose. In addition, the parents should be instructed that if a dose is missed and is not identified until 4 or more hours later, the dose should not be administered. If more than 1 dose is missed, the primary health care provider needs to be notified.
A client with chronic kidney disease (CKD) who is receiving an antihypertensive medication is experiencing frequent hypotensive episodes. The nurse reviews the client's medication record, knowing that which medication would have the greatest tendency to cause hypotension? 1.Methyldopa 2.Epoetin alfa 3.Levothyroxine 4.Calcium carbonate
1.Methyldopa Methyldopa is metabolized by the kidneys and requires careful dosage adjustment according to the client's renal function to prevent hypotension. Calcium carbonate is used in the treatment of calcium deficiency and does not cause hypotension when administered via the oral route. Parenteral administration of calcium may cause hypotension. Levothyroxine does not cause hypotension. Epoetin alfa is an erythropoietin and is more likely to cause hypertension than hypotension.
Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side and adverse effects of the medication should the nurse monitor? Select all that apply. 1.Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 4.Vitamin B6 deficiency 5.Ocular pain or blurred vision 6.Tingling and numbness of the fingers
1.Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 5.Ocular pain or blurred vision Rifabutin may be prescribed for a client with active MAC disease and tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side and adverse effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil count), red-orange-colored body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flu-like syndrome. Vitamin B6 deficiency and numbness and tingling in the extremities are associated with the use of isoniazid.
A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose? 1.On an empty stomach 2.At the same time each evening 3.Evenly spaced around the clock 4.As needed when the client complains of depression
2. At the same time every evening Sertraline is classified as an antidepressant. Sertraline generally is administered once every 24 hours. It may be administered in the morning or evening, but evening administration may be preferable because drowsiness is a side effect. The medication may be administered without food or with food if gastrointestinal distress occurs. Sertraline is not prescribed for use as needed.
A child with severe seborrheic dermatitis is receiving treatments of topical corticosteroid applied over an extensive area of the body, followed by the application of an occlusive dressing. The nurse should monitor the child closely, knowing that which systemic effect can occur as a result of this treatment? 1.Local infection 2.Growth retardation 3.Thinning of the skin 4.Adrenal hyperactivity
2. Growth retardation Topical corticosteroid can be absorbed in sufficient amounts to produce systemic toxicity. Principal concerns are growth retardation (in children) and adrenal suppression (in all age groups). Systemic toxicity is more likely under extreme conditions of use, such as with prolonged therapy in which extensive surfaces are treated with high doses of high-potency agents in conjunction with occlusive dressings.
The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which complication? 1. Diabetic ketoacidosis 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from overeating at meals 4. Hyperglycemia occurring on "sick days"
2. Hypoglycemia from insulin overdose Glucagon is used to treat hypoglycemia resulting from insulin overdose. The family of the client is instructed in how to administer the medication. In an unconscious client, consciousness usually returns within 20 minutes of glucagon injection. After the client has regained consciousness, oral carbohydrates should be given. The other options are incorrect.
A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. After diagnostic studies, diabetes insipidus is diagnosed. Desmopressin is prescribed. The client asks why this medication was prescribed. Which is a correct statement by the nurse? 1."It relieves the headaches." 2."It increases water reabsorption." 3."It stimulates the production of aldosterone." 4."It decreases the production of the antidiuretic hormone."
2. It increases water reabsorption Desmopressin is an antidiuretic hormone (ADH) used in the treatment of diabetes insipidus. It promotes renal conservation of water by acting on the collecting ducts of the kidney to increase the permeability to water, which results in increased water reabsorption. Desmopressin does not relieve headaches, stimulate aldosterone, or decrease production of ADH.
Ribavirin is prescribed for a hospitalized child with severe respiratory syncytial virus (RSV). The nurse prepares to administer this medication via which route? 1.Oral 2.Oxygen tent 3.Intramuscular 4.Subcutaneous
2. Oxygen tent Ribavirin is an antiviral respiratory medication used mainly for hospitalized children with severe RSV. Administration is via hood, face mask, or oxygen tent. Ribavirin is not administered orally, intramuscularly, or subcutaneously.
A nurse provides dietary instructions to a client who will be taking warfarin sodium. The nurse should tell the client to avoid which food item? 1.Grapes 2.Spinach 3.Watermelon 4.Cottage cheese
2. Spinach Warfarin sodium is an anticoagulant. Anticoagulant medications act by antagonizing the action of phytonadione, which is needed for clotting. When a client is taking an anticoagulant, foods high in phytonadione often are omitted from the diet. Phytonadione-rich foods include green leafy vegetables, fish, liver, coffee, and tea.
A topical corticosteroid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? 1."I should not rub the medication into the skin." 2."The medication will help relieve the inflammation." 3."I need to apply the medication in a thick layer to protect the skin." 4."I should protect the area by covering it with a diaper and plastic pants."
2. The medication will help relieve the inflammation A topical corticosteroid will relieve inflammation. The mother should be advised not to apply a tight-fitting diaper or plastic pants after applying the medication because these items will act as an occlusive dressing. The use of occlusive dressings (bandages or plastic wraps) over the affected site is avoided after application of the topical corticosteroid unless the health care provider specifically prescribes this wound coverage. The medication is gently rubbed into the skin after a thin layer is applied.
The nurse is providing discharge instructions to a client taking warfarin sodium. Which statement, based on primary health care provider (PHCP) permission, is appropriate to include in client teaching for this medication? 1."Alcohol can be consumed as long as it is in small amounts." 2."You need to check with your doctor about what can be taken for headaches." 3."It doesn't matter what time the daily dose is taken as long as it is taken each day." 4."It is all right to take over-the-counter medications as long as they do not contain vitamin K."
2."You need to check with your doctor about what can be taken for headaches." Warfarin sodium is an anticoagulant that prevents further extension of formed existing clots and also prevents new clot formation and secondary thromboembolic complications. Because the medication places the client at risk for bleeding, the client is instructed to avoid salicylates (acetylsalicylic acid, or aspirin) and alcohol. The medication should be taken exactly as prescribed and at the same time daily. The client needs to avoid all over-the-counter medications and needs to consult with the PHCP before taking any other medications because of the risk for medication interactions.
The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list? 1.Advise that sunscreen is not needed. 2.Drink 8 to 10 glasses of water per day. 3.Decrease the dosage when symptoms are improving to prevent an allergic response. 4.If the urine turns dark brown, call the primary health care provider (PHCP) immediately.
2.Drink 8 to 10 glasses of water per day. Each dose of trimethoprim-sulfamethoxazole should be administered with a full glass of water, and the client should maintain a high fluid intake to avoid crystalluria. The medication is more soluble in alkaline urine. The client should not be instructed to taper or discontinue the dose. Clients should be advised to use sunscreen since the skin becomes sensitive to the sun. Some forms of trimethoprim-sulfamethoxazole cause urine to turn dark brown or red. This does not indicate the need to notify the PHCP.
A client seen in the health care clinic for follow-up care is taking atorvastatin. The nurse should assess the client for which adverse effect of the medication? 1.Earache 2.Hearing loss 3.Photosensitivity 4.Lung congestion
3.Photosensitivity Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. Adverse effects include photosensitivity and the potential for developing cataracts. The symptoms in the remaining options are not side and adverse effects of this medication.
The nurse is describing the medication side and adverse effects to a client who is taking amitriptyline. Which information should the nurse incorporate in the discussion? 1.Consume a low-fiber diet. 2.Increase fluids and bulk in the diet. 3.Rest if the heart begins to beat rapidly. 4.Walk if you have difficulty urinating because this is a normal side effect.
2.Increase fluids and bulk in the diet. Amitriptyline causes constipation, and the client is instructed to increase fluid intake and bulk (high fiber) in the diet. If the heart begins to beat fast, the primary health care provider (PHCP) is notified, because this could indicate an adverse effect. Difficulty urinating is an adverse effect and indicates urinary retention; this should also be reported.
The nurse is preparing an intravenous (IV) infusion of phenytoin as prescribed by the primary health care provider for the client with seizures. Which solution should the nurse plan to use to dilute this medication? 1.Dextrose 5% 2.Normal saline solution 3.Lactated Ringer's solution 4.Dextrose 5% and half-normal saline (0.45%)
2.Normal saline solution IV infusion of phenytoin should be administered by injection into a large vein. The medication may be diluted in normal saline solution; however, dextrose solution should be avoided because of medication precipitation. The medication is administered as intermittent doses. Continuous IV infusions should not be used. Infusion rates of more than 50 mg/minute may cause hypotension or cardiac dysrhythmias, especially in older and debilitated clients.
thyroidectomy is taking a potassium iodide solution. The client complains to the nurse that she is experiencing a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client? 1.Dilute the medication in 8 oz of water. 2.Report the symptom to the primary health care provider (PHCP). 3.Continue to take the medication because the symptom is normal. 4.Take one half dose of the prescribed medication for the next 2 days.
2.Report the symptom to the primary health care provider (PHCP). The client should be instructed about symptoms of iodism that can occur with the administration of potassium iodide solution. These symptoms include a brassy taste, burning sensation in the mouth, and soreness of the gums and teeth. The client should be instructed to withhold the medication and notify the PHCP if these symptoms are noted.
The nurse notes that a client has been taking colchicine. The nurse assesses the client for which finding that is an indication for the use of this medication? 1.Double vision 2.Difficulty urinating 3.Migraine headaches 4.Joint inflammation and pain
4.Joint inflammation and pain Colchicine is classified as an antigout agent that interferes with the ability of the white blood cells to initiate and maintain an inflammatory response to monosodium urate crystals. The client should report a decrease in pain and inflammation in the affected joints and a decrease in the number of gout attacks. The other options are incorrect
Meperidine hydrochloride is prescribed for a client with pain. What should the nurse monitor for as a side or adverse effect of this medication? 1.Diarrhea 2.Bradycardia 3.Hypertension 4.Urinary retention
4.Urinary retention Side and adverse effects of meperidine include respiratory depression, orthostatic hypotension, tachycardia, drowsiness and mental clouding, constipation, and urinary retention; therefore, the remaining options are incorrect.
The nurse teaches a client newly diagnosed with type 1 diabetes about storing Humulin N insulin. Which statement indicates to the nurse that the client understood the discharge teaching? 1."I should keep the insulin in the cabinet during the day only." 2."I know I have to keep my insulin in the refrigerator at all times." 3."I can store the open insulin bottle in the kitchen cabinet for 1 month." 4."The best place for my insulin is on the window sill, but in the cupboard is just as good."
3. I can store thew open insulin bottle in the kitchen cabinet for 1 month An insulin vial in current use can be kept at room temperature for 1 month without significant loss of activity. Direct sunlight and heat must be avoided. Therefore, options 1, 2, and 4 are incorrect.
The nurse is reviewing medical record notes of a client with bladder cancer who is prescribed concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid). The nurse should include in the client's education which information about the anticipated therapeutic effect of leucovorin? 1. "It promotes medication excretion." 2. "It will promote protein synthesis." 3. "It will help to preserve normal cells." 4. "It speeds up the effect of the methotrexate."
3. It will help preserve normal cells The administration of leucovorin with methotrexate is known as leucovorin rescue. High concentrations of methotrexate cause harm and damage to normal cells. Leucovorin bypasses the metabolic block caused by methotrexate, thereby permitting normal cells to synthesize. Leucovorin rescue is potentially hazardous because failure to administer leucovorin in the right dose at the right time can be fatal.
A client is admitted to the hospital emergency department with an acute anterior wall myocardial infarction. The nurse discusses thrombolytic therapy with the client and spouse. The spouse is concerned about the dangers of this treatment. Which statement by the nurse is appropriate? 1."There is no reason to worry. We use this medication all the time." 2."I'm certain you made the correct decision to use this medication." 3."You have concerns about whether this treatment is the best option." 4."Your loved one is very ill. The primary health care provider has made the best decision for you."
3. You have concerns about whether this treatment is the best option Paraphrasing is restating the client's or family members' own words. This allows the client and family members to express their concerns and talk through the decisions that have been made. Option 1 offers false reassurance. In option 2, the nurse is expressing approval, which can be harmful to the client-nurse or family-nurse relationship. Option 4 represents a communication block that denies the family member's right to an opinion.
A client with chronic kidney disease is receiving epoetin alfa for the past 2 months. What should the nurse determine is an indicator that this therapy is effective? 1.A decrease in blood pressure 2.An increase in white blood cells 3.An increase in serum hematocrit 4.A decrease in serum creatinine level
3.An increase in serum hematocrit Epoetin alfa stimulates red blood cell production. Initial effects should be seen within 1 to 2 weeks, and the hematocrit reaches normal levels in 2 to 3 months.
Methylergonovine is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse should contact the primary health care provider who prescribed the medication if which condition is documented in the client's medical history? 1.Hypotension 2.Hypothyroidism 3.Diabetes mellitus 4.Peripheral vascular disease
4.Peripheral vascular disease Methylergonovine is an ergot alkaloid used to treat postpartum hemorrhage. Ergot alkaloids are contraindicated in clients with significant cardiovascular disease, peripheral vascular disease, hypertension, preeclampsia, or eclampsia. These conditions are worsened by the vasoconstrictive effects of the ergot alkaloids. Options 1, 2, and 3 are not contraindications related to the use of ergot alkaloids.
A client who has been chronically taking asprin for arthritis has been given a prescription for misoprostol. The nurse determines that the new medication is effective if the client. states relief from which problem? 1.Diarrhea 2.Bleeding 3.Joint aches 4.Epigastric pain
4. Epigastric pain A client who chronically uses aspirin is prone to gastric mucosal injury, which causes epigastric pain as a symptom. Misoprostol is a gastric protectant specifically given to prevent this occurrence. Diarrhea can be a side effect of the medication, but it is not an intended effect. Bleeding and joint aches are not relieved by Misoprostol.
A client taking an oral laxative wants to obtain a rapid effect from the medication. How should the nurse instruct the client to take the medication? 1.At bedtime 2.With breakfast 3.With the noon meal 4.On an empty stomach
4. On an empty stomach Most rapid results from an oral laxative occur when it is taken on an empty stomach. If taken at bedtime, the client will have a bowel movement in the morning. It will not have a rapid effect if taken with a meal.
The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction? 1."I need to change positions slowly." 2."I will monitor my blood pressure every week." 3."I will report signs and symptoms of infection immediately." 4."I can use salt substitutes freely and eat foods high in potassium."
4."I can use salt substitutes freely and eat foods high in potassium." The client taking an angiotensin-converting enzyme (ACE) inhibitor is instructed to take the medication exactly as prescribed, to monitor blood pressure weekly, and to continue with other lifestyle changes to control hypertension. The client should change positions slowly to avoid orthostatic hypotension and report fever, mouth sores, or sore throat (neutropenia) to the health care provider. In addition, salt substitutes and high-potassium foods should be avoided because they contain potassium and increase the risk for hyperkalemia.
Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy? 1.Nausea 2.Diarrhea 3.Headache 4.Sore throat
4.Sore throat Clients taking trimethoprim-sulfamethoxazole should be informed about early signs and symptoms of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the primary health care provider (PHCP) if these occur. The other options do not require PHCP notification.
The nurse is providing teaching for a client prescribed ciprofloxacin for a urinary tract infection. Which statement made by the client indicates that there is a need for further teaching? 1."I can take the ciprofloxacin with or without food." 2."I'll need to wear sunscreen and protective clothing while taking ciprofloxacin." 3."I'll need to contact my primary health care provider if I develop any white patches in my mouth." 4."If I develop any tendon pain while taking ciprofloxacin, exercise should help to decrease the pain."
4."If I develop any tendon pain while taking ciprofloxacin, exercise should help to decrease the pain." The primary health care provider should be contacted immediately if the client develops any tendon pain, swelling, or inflammation because of the risk of tendon rupture. Exercise is contraindicated until tendon rupture is ruled out. Fluorquinolones such as ciprofloxacin need to be discontinued at the first sign of any tendon pain, swelling, or inflammation. Ciprofloxacin can be taken with or without food, can cause photosensitivity, and can increase the risk for oral Candida infections.
The primary health care provider has prescribed coal tar treatments for a client with psoriasis, and the nurse provides information to the client about the treatments. Which statement made by the client indicates a need for further education about the treatments? 1."The medication has an unpleasant odor." 2."The medication can cause phototoxicity." 3."The medication can stain the skin and hair." 4."The medication always causes systemic toxicity."
4."The medication always causes systemic toxicity." Coal tar is used to treat psoriasis and other chronic disorders of the skin. Coal tar suppresses DNA synthesis, mitotic activity, and cell proliferation. Coal tar has an unpleasant odor, frequently stains the skin and hair, and can cause phototoxicity. Systemic toxicity does not occur.
Silver sulfadiazine is prescribed for a client with a partial-thickness burn, and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 1."The medication is an antibacterial." 2."The medication will help heal the burn." 3."The medication should be applied directly to the wound." 4."The medication is likely to cause stinging every time it is applied."
4."The medication is likely to cause stinging every time it is applied." Silver sulfadiazine is an antibacterial that has a broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in healing. It does not cause stinging when applied.
The nurse has given the client with atrial fibrillation instructions to take 1 aspirin daily. The client says to the nurse, "Why do I need to take this? I don't get any pain with my heart rhythm. "Which response by the nurse is the most appropriate? 1."This will keep you from experiencing chest pain." 2."This will most likely keep you from ever having a heart attack." 3."This will prevent any inflammation from occurring on the walls of your heart." 4."This will help prevent clot formation in your heart as a result of your heart's rhythm."
4."This will help prevent clot formation in your heart as a result of your heart's rhythm." Atrial fibrillation puts the client at risk for mural thrombi because of the sluggish blood flow through the atria that occurs as a result of loss of the atrial kick. In atrial fibrillation, the primary health care provider may prescribe a daily aspirin. This will prevent clot formation along the walls of the atria and resultant embolus. Aspirin will not prevent chest pain or keep a client from ever having a heart attack. Although aspirin does have anti-inflammatory properties, it cannot prevent any inflammation from occurring, as stated in option 3.
The adult client with hepatic encephalopathy has a serum ammonia level of 200 mcg/dL (120 mcmol/L) and receives treatment with lactulose. The nurse determines that the client had the best and most realistic response if the serum ammonia level changed to which value after medication administration? 1.5 mcg/dL (3 mcmol/L) 2.10 mcg/dL (6 mcmol/L) 3.15 mcg/dL (9 mcmol/L) 4.90 mcg/dL (54 mcmol/L)
4.90 mcg/dL (54 mcmol/L) The normal serum ammonia level is 10 to 80 mcg/dL (6 to 47 mcmol/L). In the client with hepatic encephalopathy, the ammonia level is not likely to drop below normal, nor is it likely to drop into the low-normal range. A level of 90 mcg/dL (54 mcmol/L) is slightly above normal and represents the most realistic response of the medication. The nurse should also monitor the client for signs and symptoms that indicate improvement in the condition.
A client has begun medication therapy with pancrelipase. Which finding indicates that the medication has been effective? 1.Relief of heartburn 2.Elimination of abdominal pain 3.Stabilization of blood glucose levels 4.A decrease in the amount of fat in the stools
4.A decrease in the amount of fat in the stools Pancrelipase is a pancreatic enzyme used as a digestive aid for clients with pancreatitis. It should reduce the amount of fatty stools (steatorrhea). Another recognized beneficial effect is improved nutritional status. It is not used to treat heartburn or abdominal pain and does not regulate blood glucose.
A client with a subarachnoid hemorrhage needs to have surgery delayed until a stable clinical condition is achieved. The nurse prepares to administer which medication as prescribed to prevent clot breakdown and dissolution? 1.Alteplase 2.Heparin sodium 3.Warfarin sodium 4.Aminocaproic acid
4.Aminocaproic acid Aminocaproic acid is an antifibrinolytic agent that prevents clot breakdown or dissolution. It is commonly prescribed after subarachnoid hemorrhage if surgery is delayed or contraindicated, to prevent further hemorrhage. Alteplase is a fibrinolytic that actively breaks down clots. Warfarin sodium and heparin sodium are anticoagulants that interfere with propagation or growth of a clot.
A client is scheduled for discharge and will be taking phenobarbital for an extended period. The nurse would place highest priority on teaching the client which point that directly relates to client safety? 1.Take the medication only with meals. 2.Take the medication at the same time each day. 3.Use a dose container to help prevent missed doses. 4.Avoid drinking alcohol while taking this medication.
4.Avoid drinking alcohol while taking this medication. Phenobarbital is an anticonvulsant and hypnotic agent. The client should avoid taking any other central nervous system depressants such as alcohol while taking this medication because of the synergistic effect that can occur when taken together. The medication may be given without regard to meals. Taking the medication at the same time each day enhances compliance and maintains more stable blood levels of the medication. Using a dose container or "pillbox" may be helpful for some clients.
