Lilley Pharmacology Ch 10-29 Final Review

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The medication order for a 5-year-old child reads: "Give digoxin elixir, 15 mcg/kg, PO now." The child weighs 20 kg. How many milligrams will this child receive?

0.3 mg

The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?

0.75 mL

A patient who has had an accidental overdose of tricyclic antidepressants is to receive physostigmine (Antilirium), 1.5 mg IM stat. The medication is available in a vial that contains 2 mL, with a concentration of 1 mg/mL. How much medication will the nurse draw up into the syringe for this dose?

1.5 mL

The preoperative order for an adult patient reads: "Give scopolamine, 0.7 mg IM on call for surgery." The medication is available in vials of 0.4 mg/mL. How many milliliters will the nurse administer for this dose? (Round to tenths.)

1.8 mL

The order for enoxaparin (Lovenox) reads: Give 1 mg/kg subcut every 12 hours. The patient weighs 242 lb, and the medication is available in an injection form of 120 mg/0.8 mL. How many milligrams will this patient receive? How many milliliters will the nurse draw up for the injection? (Round to hundredths.)

110 mg; 0.73 mL

The order reads: "Infuse 1000 mL of normal saline over the next 8 hours." The IV tubing has a drop factor of 15 gtt/mL. Calculate the mL/hour rate, and calculate the drops/minute setting for the IV tubing with this gravity infusion.

125 mL/hr; 31 gtt/min

The medication order reads: niacin, 500 mg PO, every evening. The medication is available in 250-mg tablets. How many tablets will the patient receive per dose?

2 tablets

A patient is in the emergency department with new-onset rapid rate atrial fibrillation. The nurse is about to add a continuous infusion of diltiazem (Cardizem) at 5 mg/hr, but must first give a bolus of 0.25 mg/kg over 2 minutes. The patient weighs 220 pounds. The medication comes in a vial of 5 mg/mL. How many milligrams will the patient receive, and how many milliliters will the nurse draw up for this dose?

25 mg; 5 mL

The order reads, "Give metoprolol (Lopressor) 300 mg/day PO in 2 divided doses." The tablets are available in 50-mg strength. How many tablets will the patient receive per dose?

3 tablets per dose (150 mg per dose)

A child in the pediatric ICU has been receiving a dopamine infusion. This morning while on rounds, the nurse noted that the IV has infiltrated. After stopping the infusion, the nurse prepares to administer phentolamine (Regitine). The ordered dose is 0.2 mg/kg, to be injected into the area of extravasation. The child weighs 39 lb. How many milligrams will the nurse administer? (Round to tenths.)

3.5 mg

The order reads: Give mannitol 0.5 g/kg IV now, over 2 hours. The patient weighs 165 lb, and you have a 100 mL vial of 20% mannitol. How many grams will the patient receive? How many milliliters of mannitol will you prepare for this infusion?

37.5 g, 187.5 mL

A patient with a feeding tube will be receiving risperidone (Risperdal) 8 mg in 2 divided doses via the feeding tube. The medication is available in a 1 mg/mL solution. How many milliliters will the nurse administer for each dose?

4 mL per dose

The order reads: bromocriptine (Parlodel) 10 mg per day PO. The medication is available in 2.5-mg tablets. How many tablets will the nurse give per dose?

4 tablets

A child is to receive phenobarbital 2 mg/kg IV on call as a preoperative sedative. The child weighs 64 pounds. How many milligrams will the child receive for this dose?

58.2 mg

The order reads: Give hydralazine (Apresoline) 0.75 mg/kg/ day. The child weighs 16 pounds. How much hydralazine will be given? Round to hundredths.

6. 5.45 mg/kg/day

The medication order reads: "Atomoxetine (Strattera) 1.2 mg/kg/day in 2 divided doses." The child weighs 66 lbs. How much will be given with each dose?

7. 18 mg per dose

7 The nurse is preparing to administer valproic acid to a child. The order reads: "Give valproic acid, 15 mg/kg/day PO in three divided doses." The child weighs 33 pounds. How many milligrams will the child receive with each dose?

7. 75 mg per dose

The order reads: "Dopamine 3 mcg/kg/min IV." The solution available is 400 mg in 250 mL D5W, and the patient weighs 176 pounds. The nurse will set the IV infusion pump to run at how many mL/hour?

9 mL/hr

Which statement by the patient reflects the need for additional patient education about the calcium channel blocker diltiazem (Cardizem)?

a. "I can take this drug to stop an attack of angina."

An elderly patient has been discharged following treatment for a mild case of heart failure. He will be taking a loop diuretic. Which instruction(s) from the nurse are appropriate? (Select all that apply.)

a. "Take the diuretic at the same time each morning." c. "Be sure to stand up slowly because the medicine may make you feel dizzy if you stand up quickly." f. "Please call your doctor immediately if you notice muscle weakness or increased dizziness."

The surgical nurse is reviewing operative cases scheduled for the day. Which of these patients is more prone to complications from general anesthesia?

a. A 79-year-old woman who is about to have her gallbladder removed

The nurse is reviewing drug interactions with a male patient who has a prescription for isosorbide dinitrate (Isordil) as treatment for angina symptoms. Which substances listed below could potentially result in a drug interaction? (Select all that apply.)

a. A glass of wine c. tadalafil (Cialis), an erectile dysfunction drug e. carvedilol (Coreg), a beta blocker

A patient is recovering from general anesthesia. What is the nurse's main concern during the immediate postoperative period?

a. Airway

When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs? a. Alpha blockers such as doxazosin (Cardura) b. Diuretics such as furosemide (Lasix) c. ACE inhibitors such as captopril (Capoten) d. Vasodilators such as hydralazine (Apresoline)

a. Alpha blockers such as doxazosin (Cardura)

Which response would the nurse expect to find in a patient with a phenytoin (Dilantin) level of 35 mcg/mL?

a. Ataxia

The nurse is providing education about cholinergic blocking drug therapy to an elderly patient. Which is an important point to emphasize for this patient?

a. Avoid exposure to high temperatures.

The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect?

a. CNS depression

The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy?

a. Cardiovascular disease

When administering niacin, the nurse needs to monitor for which adverse effect?

a. Cutaneous flushing

The nurse administering a cholinergic-blocking drug to a patient who is experiencing drug-induced extrapyramidal effects would assess for which therapeutic effect?

a. Decreased muscle rigidity and tremors

When monitoring a patient who is receiving an intravenous infusion of nesiritide (Natrecor), the nurse will look for which adverse effect?

a. Dysrhythmia

A patient is experiencing withdrawal from opioids. The nurse expects to see which assessment finding most commonly associated with acute opioid withdrawal?

a. Elevated blood pressure

Which action by the nurse is most appropriate for the patient receiving an infusion of packed red blood cells?

a. Flush the IV line with normal saline before the blood is added to the infusion.

The nurse caring for a patient who is receiving beta1 agonist drug therapy needs to be aware that these drugs cause which effect?

a. Increased cardiac contractility

The nurse is monitoring a patient who is receiving an infusion of a beta-adrenergic agonist. Which adverse effects may occur with this infusion? (Select all that apply.)

a. Mild tremors c. Tachycardia d. Palpitations f. Nervousness

The nurse is administering an antiepileptic drug and will follow which guidelines? (Select all that apply.)

a. Monitor the patient for drowsiness. c. Give the medication at the same time every day. e. Notify the prescriber if the patient is unable to take the medication.

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

a. More constant levels for analgesia

The nurse is assessing a patient who has begun therapy with amantadine (Symmetrel) for Parkinson's disease. The nurse will look for which possible adverse effects? (Select all that apply.)

a. Nausea c. Dizziness d. Insomnia

A patient is taking entacapone (Comtan) as part of the therapy for Parkinson's disease. Which intervention by the nurse is appropriate at this time?

a. Notify the patient that this drug causes discoloration of the urine.

A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effects? (Select all that apply.)

a. Orthostatic hypotension c. Increased urine flow d. Headaches

The nurse is administering an intravenous infusion of a phosphodiesterase inhibitor to a patient who has heart failure. The nurse will evaluate the patient for which therapeutic effects? (Select all that apply.)

a. Positive inotropic effects b. Vasodilation e. Positive chronotropic effects

The nurse is giving medications to a patient. Which drug or drug class, when administered with lithium, increases the risk for lithium toxicity?

a. Thiazides

A patient took an accidental overdose of a cholinergic drug while at home. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. The nurse expects that which drug will be used to treat this patient?

a. atropine (generic)

When monitoring laboratory test results for patients receiving loop and thiazide diuretics, the nurse knows to look for

a. decreased serum levels of potassium.

A patient is taking pregabalin (Lyrica) but does not have a history of seizures. The nurse recognizes that this drug is also indicated for

a. postherpetic neuralgia.

A patient with Parkinson's disease will start taking entacapone (Comtan) along with the carbidopa-levodopa (Sinemet) he has been taking for a few years. The nurse recognizes that the advantage of taking entacapone is that

a. the entacapone can reduce on-off effects.

A patient has been given a prescription for transdermal scopolamine patches (Transderm-Scōp) for motion sickness for use during a vacation cruise. The nurse will include which instructions? (Select all that apply.)

b. "Apply the patch 3 to 4 hours before boarding the ship." d. "The patch needs to be placed on a nonhairy area just behind your ear." e. "Change the patch every 3 days." f. "Rotate the application sites."

Which statement needs to be included when the nurse provides patient education for a patient with heart failure who is taking daily doses of spironolactone (Aldactone)?

b. "Avoid foods that are high in potassium."

When the nurse is teaching a patient about taking an antidysrhythmic drug, which statements by the nurse are correct? (Select all that apply.)

b. "Do not chew sustained-release capsules." e. "You may take the medication with food if stomach upset occurs."

A 68-year-old man has been taking the nitrate isosorbide dinitrate (Isordil) for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a prescription for sildenafil (Viagra). Which response would the nurse most likely hear from the prescriber?

b. "Taking sildenafil with the nitrate may result in severe hypotension, so a contraindication exists."

A 56-year-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. Which would be the most appropriate response by the nurse? a. "Not to worry. Eventually, tolerance will develop." b. "The physician can work with you on changing the dose and/or drugs." c. "Sexual dysfunction happens with this therapy, and you will learn to accept it." d. "This is an unusual occurrence, but it is important to stay on your medications."

b. "The physician can work with you on changing the dose and/or drugs."

The nurse is teaching a patient about self administration of enoxaparin (Lovenox). Which statement should be included in this teaching session?

b. "This drug is given in the folds of your abdomen, but at least 2 inches away from your navel."

A patient is currently taking a statin. The nurse considers that the patient may have a higher risk of developing rhabdomyolysis when also taking which product?

b. A fibric acid derivative

A patient has a new prescription for an ACE inhibitor. During a review of the patient's list of current medications, which would cause concern for a possible interaction with this new prescription? (Select all that apply.)

b. A potassium supplement taken daily e. An NSAID taken as needed for headaches

A nurse administering niacin would implement which action to help to reduce adverse effects?

b. Administer a small dose of aspirin or an NSAID 30 minutes before the niacin dose.

The nurse is preparing to give medications. Which is the most appropriate nursing action for intravenous (IV) phenytoin (Dilantin)?

b. Administer in normal saline solutions.

A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.)

b. Administer the oral dose at the same time every day c. Assess carefully for excessive bruising or unusual bleeding d. Monitor laboratory results for a target INR of 2 to 3

The nurse is administering an IV solution that contains potassium chloride to a patient in the critical care unit who has a severely decreased serum potassium level. Which action(s) by the nurse are appropriate? (Select all that apply.)

b. Administer the potassium at a rate no faster than 20 mEq/hr. c. Monitor the patient's cardiac rhythm with a heart monitor. d. Use an infusion pump for the administration of IV potassium chloride.

The nurse is administering cholestyramine (Questran), a bile acid sequestrant. Which nursing intervention(s) is appropriate? (Select all that apply.)

b. Administering the drug with meals d. Instructing the patient to take a fiber supplement while taking this drug e. Increasing fluid intake f. Not administering this drug at the same time as other drugs

A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?

b. Administration of flumazenil

The nurse is preparing to administer a medication for sleep. Which intervention applies to the administration of a nonbenzodiazepine, such as zaleplon (Sonata)?

b. Because of their rapid onset, these drugs need to be taken just before bedtime

In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition?

b. Benzodiazepines

A patient who is taking disulfiram as part of an alcohol treatment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome?

b. Copious vomiting

When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect which effect?

b. Decreased heart rate

A patient experiencing ethanol withdrawal is beginning to show severe manifestations of delirium tremens. The nurse will plan to implement which interventions for this patient? (Select all that apply.)

b. Doses of an intravenous benzodiazepine c. Restraints if the patient becomes confused, agitated, or a threat to himself or others d. Thiamine supplementation f. Monitoring in the intensive care unit

When assessing for adverse effects of cholinergic blocking drug therapy, the nurse would expect to find that the patient complains of which drug effect?

b. Dry mouth

A patient has received a double dose of heparin during surgery and is bleeding through the incision site. While the surgeons are working to stop the bleeding at the incision site, the nurse will prepare to take what action at this time?

b. Give IV protamine sulfate as an antidote

The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients?

b. Hypotension

The nurse is reviewing the use of bethanechol (Urecholine) in a patient who is experiencing postoperative urinary retention. Which statement best describes the mechanism of action of bethanechol?

b. It causes increased bladder tone and motility.

A patient will be taking selegiline (Eldepryl), 10 mg daily, in addition to dopamine replacement therapy for Parkinson's disease. The nurse will implement which precautions regarding selegiline?

b. Monitor for dizziness.

The nurse is administering an NMBD to a patient during a surgical procedure. Number the following phases of muscle paralysis in the order in which the patient will experience them. (Number 1 is the first step.) a. Paralysis of intercostals and diaphragm muscles

b. Muscle weakness = 1 d. Paralysis of small rapidly moving muscles (fingers, eye) = 2 c. Paralysis of muscles of the limbs, neck, and trunk = 3 a. Paralysis of intercostals and diaphragm muscles = 4

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effect?

b. Nervousness

A patient has been admitted to the emergency department after a suspected overdose of benzodiazepines mixed with alcohol. The patient is lethargic and cannot speak. The nurse expects which immediate measures to be implemented? (Select all that apply.)

b. Prepare to administer flumazenil. c. Monitor the patient for convulsions. d. Prepare for potential respiratory arrest.

During a teaching session for a patient who is receiving inhaled salmeterol, the nurse emphasizes that the drug is indicated for which condition?

b. Prevention of bronchospasms

A patient is receiving dabigatran (Pradaxa), 150 mg twice daily, as part of treatment for atrial fibrillation. Which condition, if present, would be a concern if the patient were to receive this dose?

b. Renal impairment

During a patient's recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply.)

b. Tachypnea c. Tachycardia e. Muscle rigidity

A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information?

b. Take the medication before the headache worsens

The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.)

b. The patient should be instructed to use caution when standing up from a sitting position. c. The patient should not take any products that contain the herbal product St. John's wort. d. This medication should not be stopped abruptly. f. The patient should be told to check with the prescriber before taking any over-the-counter medications.

A patient with a rapid, irregular heart rhythm is being treated in the emergency department with adenosine. During administration of this drug, the nurse will be prepared to monitor the patient for which effect?

b. Transitory asystole

When a patient has experienced extravasation of a peripheral infusion of dopamine, the nurse will inject the alpha blocker phentolamine (Regitine) into the area of extravasation and expect which effect?

b. Vasodilation

The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication?

b. WBC count

The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which drug may raise a concern for interactions?

b. acetaminophen (Tylenol)

During treatment for withdrawal from opioids, the nurse expects which medication to be ordered?

b. clonidine (Catapres)

Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.) a. Diarrhea b. Constipation c. Pruritus d. Urinary frequency e. Nausea

b. constipation, c. pruritis, e. nausea

When teaching the patient about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the patient to watch for

b. flickering lights or halos around lights.

When assessing a patient who is about to receive an albumin infusion, the nurse knows that a contraindication for albumin would be

b. heart failure.

When giving intravenous cholinergic drugs, the nurse must watch for symptoms of a cholinergic crisis, such as: (Select all that apply.)

b. hypotension. d. syncope. e. dyspnea.

The nurse is giving a dose of bethanechol (Urecholine) to a postoperative patient. The nurse is aware that contraindications to bethanechol include:

b. peptic ulcer.

A patient is taking a beta blocker as part of the treatment plan for heart failure. The nurse knows that the purpose of the beta blocker for this patient is to

b. prevent stimulation of the heart by catecholamines.

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder?

b. severe asthma

The nurse is assessing a patient who has been taking quinidine and asks about adverse effects. An adverse effect associated with the use of this drug includes:

b. tinnitus.

The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply.)

c. "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." d. "Be sure to contact the physician right away if you notice expression of suicidal thoughts." e. "We will need to check your child's height and weight periodically to monitor physical growth."

A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moderate sedation. The patient asks, "I am afraid of feeling it when they shock me?" What is the nurse's best response?

c. "The medications you receive will reduce any pain and help you not to remember the procedure."

The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about the new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start treatment." Which reply from the nurse is appropriate?

c. "These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy."

A patient calls the family practice office to report that he has seen his pills in his stools when he has a bowel movement. How will the nurse respond?

c. "What you are seeing is the waxy matrix that contained the medication, but the drug has been absorbed."

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusion, what should the nurse do next?

c. Administer an opiate antagonist per standing orders

Which condition will alert the nurse to a potential caution or contraindication regarding the use of a dopaminergic drug for treatment of mild Parkinson's disease?

c. Angle-closure glaucoma

For a patient receiving a vasoactive drug such as intravenous dopamine, which action by the nurse is most appropriate?

c. Assess the intravenous site hourly for possible infiltration.

The nurse providing teaching for a patient who has a new prescription for beta1 blockers will keep in mind that these drugs may result in which effect?

c. Bradycardia

When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occurring when this drug is taken to treat hypertension?

c. Dry, nonproductive cough

A nurse with adequate knowledge about the administration of intravenous nitroglycerin will recognize that which statement is correct?

c. Intravenous nitroglycerin must be protected from exposure to light through use of special tubing.

Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the "statin" class?

c. It is important to report muscle pain immediately.

A patient is being assessed before a newly ordered antilipemic medication is given. Which condition would be a potential contraindication?

c. Liver cirrhosis

The nurse is presenting a seminar on substance abuse. Which drug is the most commonly used illicit drug in the United States?

c. Marijuana

A patient is receiving instructions regarding warfarin therapy and asks the nurse about what medications she can take for headaches. The nurse will tell her to avoid which type of medication?

c. NSAIDs

An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication?

c. Paradoxical

When assessing a patient who has been taking amiodarone for 6 months, the nurse monitors for which potential adverse effect?

c. Photophobia

When the nurse is checking the laboratory data for a patient taking spironolactone (Aldactone), which result would be a potential concern?

c. Serum potassium level of 5.8 mEq/L

After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern will the nurse assess for during the conversation with the patient?

c. Suicidal ideations

The nurse is assessing a patient for possible substance abuse. Which assessment finding indicates possible use of amphetamines

c. Talkativeness and euphoria

When administering beta blockers, the nurse will follow which guideline for administration and monitoring?

c. Tapering off the medication is necessary to prevent rebound hypertension.

Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply.)

c. The dose needs to be given about 1 hour before the patient's bedtime e. The patient needs to be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken

The nurse is reviewing the orders for a newly admitted patient and sees an order for edrophonium (Tensilon). The nurse expects that this drug is ordered for which reason?

c. To aid in the diagnosis of myasthenia gravis

A patient has a new prescription for transdermal nitroglycerin patches. The nurse teaches the patient that these patches are most appropriately used for which reason?

c. To prevent the occurrence of angina

Several patients have standard orders for acetaminophen as needed for pain. When the nurse reviews their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication?

c. a patient with severe hepatitis

During assessment of a patient who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as:

c. serum potassium level of 2.0 mEq/L.

When preparing an IV solution that contains potassium, the nurse knows that a contraindication to the potassium infusion would be

c. serum potassium level of 5.6 mEq/L.

During the assessment of a patient about to receive a cholinergic-blocking drug, the nurse will determine whether the patient is taking any drugs that may potentially interact with the anticholinergic, including:

c. tricyclic antidepressants, such as amitriptyline.

A patient with diabetes has a new prescription for a thiazide diuretic. Which statement will the nurse include when teaching the patient about the thiazide drug?

d. "Monitor your blood glucose level closely, because the thiazide diuretic may cause the levels to increase."

During a patient teaching session about antiparkinson drugs, the nurse will include which statement?

d. "Take care to change positions slowly to prevent falling due to a drop in blood pressure."

A patient is receiving dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. What will the nurse do next?

d. Assess the patient's vital signs and cardiac rhythm.

Before initiating therapy with a nonselective beta blocker, the nurse will assess the patient for a history of which condition?

d. Asthma

While assessing a patient with angina who is to start beta blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs are used?

d. Asthma

The nurse is giving a cholinergic-blocking drug and will assess the patient for which contraindications to these drugs?

d. Benign prostatic hyperplasia

A patient at a weight management clinic who was given a prescription for orlistat (Xenical) calls the clinic hotline complaining of a "terrible side effect." The nurse suspects that the patient is referring to which problem?

d. Fecal inccontinence

While monitoring a patient who is receiving an infusion of a crystalloid solution, the nurse will monitor for which potential problem?

d. Fluid overload

The nurse is preparing an infusion for a patient who has a deficiency in clotting factors. Which type of infusion is most appropriate?

d. Fresh frozen plasma

The nurse is developing a plan of care for a patient receiving an anorexiant. Which nursing diagnosis is most appropriate?

d. Imbalanced nutrition, less than body requirements

Which nursing diagnosis is possible for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery?

d. Impaired gas exchange due to the CNS depressant effect

The nurse is monitoring a patient who is receiving antithrombolytic therapy in the emergency department because of a possible MI. Which adverse effect would be of the greatest concern at this time?

d. Irregular heart rhythm

The nurse is reviewing the medications that have been ordered for a patient for whom a loop diuretic has just been prescribed. The loop diuretic may have a possible interaction with which of the following?

d. NSAIDs

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem?

d. Provide an environment that is restful, and reduce loud noises

The nurse is administering lidocaine and considers which condition, if present in the patient, a caution for the use of this drug?

d. Renal dysfunction

Patient teaching for a patient receiving an MAOI would include instructions to the patient to avoid which food product?

d. Swiss cheese

The nurse is assessing a patient who is receiving a milrinone infusion and checks the patient's cardiac rhythm on the heart monitor. What adverse cardiac effect is most likely to occur in a patient who is receiving intravenous milrinone?

d. Ventricular dysrhythmia

For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication

d. around the clock, with additional doses as needed for breakthrough pain.

The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition?

d. diazepam (Valium)

A patient who has recently had a myocardial infarction (MI) has started therapy with a beta blocker. The nurse explains that the main purpose of the beta blocker for this patient is to

d. protect the heart from circulating catecholamines.

The physician has requested "lidocaine with epinephrine." The nurse recognizes that the most important reason for adding epinephrine is that it

d. reduces bleeding in the surgical area


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