Med/Serg Pharm

A client experiences a blood clot in one leg, and the provider has ordered a thrombolytic medication. The client learns that the medication is expensive and asks the nurse if it is necessary. Which response by the nurse is correct? a. "The drug will decrease the likelihood of permanent tissue damage." b. "This medication also acts to prevent future blood clots from forming." c. "You could take aspirin instead of this drug to achieve the same effect." d. "Your body will break down the clot, so the drug is not necessary."

a. "The drug will decrease the likelihood of permanent tissue damage." Thrombolytics medications are given primarily to prevent permanent tissue damage caused by compromised blood flow to the affected area. Thrombolytics do not prevent clots from forming.Aspirin prevent, but does not dissolve, clots. Although the body will breakdown the clot, the drugis needed to prevent tissue damage due to active ischemia.

A nurse is admitting a client to an acute care facility for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following is the priority nursing action? a. Administer a supplemental dose of hydrocortisone. b. Insert an indwelling urinary catheter. c. Instruct the client about coughing and deep breathing. d. Collect additional information from the client about the Addison's disease.

a. Administer a supplemental dose of hydrocortisone. Acute adrenal Insufficiency (adrenal crisis) is the greatest risk to a client who has Addison's disease who is taking a glucocorticoid and undergoing surgery. To prevent acute adrenal insufficiency supplemental doses of hydrocortisone are administered during time of increased stressed.

A client who has recently had a myocardial infartion (MI) will being taking clopidogreal to prevent a second MI. Which medication will the nurse expect the provider to order as adjunctive therapy for this client? a. Aspirin b. Ticagrelor c. Warfarin d. Enoxaparin sodium

a. Aspirin Aspirin is often used with clopidogrel to inhibit platelet aggregation to increase the effectiveness of this drug. Enoxaparin is used to prevent venous thrombosis. Tigagrelor is similar to clopidogrel and is not used along with clopidogrel. Warfarin is used to prevent thrombosis.

The nurse is caring for a client who is receiving alteplase tPa after developing a blood clot. The nurse notes a heart rate of 110 beats per minutes and blood pressure of 90/60 mm HG. The nurse will perform which action? a. Assess the client for bleeding. b. Ask the client about itching or shortness of breath. c. Recheck the client's vital signs in 15 minutes. d. Evaluate the client's urine output and fluid intake.

a. Assess the client for bleeding. Tachycardia and hypotension indicate bleeding. The nurse should assess the client for bleeding. These signs do not indicate anaphylaxis. They may indicate dehydration, but bleeding is more likely than fluid volume deficit. The nurse should continue to evaluate vital signs, but it is imperative that nurse assess the client to explore a potential cause.

A nurse is caring for a client who is about to begin methotrexate therapy for rheumatoid arthritis. The nurse should include which of the following information? Select all that apply a. Avoid people who are sick b. Report bruising or petechiae c. Periodic lab tests are essential. d. The drugs effects are immediate. e. Avoid drinking alcohol.

a. Avoid people who are sick. Methotrexate causes bone marrow suppression and increases the risk for infection. Clients taking the medication should avoid large crowds and people who are sick. b. Report bruising or petechiae. Methotrexate an cause thrombocytopenia. Client's should report bruising or petechiae because this indicates a low platelet count. Nurses should monitor lab values for a decrease in platelets and red and white blood cells. c. Periodic lab tests are essential. Periodic labs tests help the provider monitor for kidney and liver damage. It is important to assess for jaundice and abdominal pain because these symptoms can indicate liver damage. e. Avoid drinking alcohol. Alchohol ingestion can increase the risk of liver damage. Clients taking methotrexate should avoid drinking alcohol.

A nurse is caring for a client who is about to begin insulin glargine (Lantus) therapy. The nurse should recognize the need for additional precautions because the client take which of the following types of drugs? a. Beta Blockers b. Iron supplments c. Oral contraceptives d. Calcium supplements

a. Beta Blockers Clients who take insulin and also take beta blockers are at risk for failing to promptly recognize the symptoms of hypoglycemia because they mask symptoms such as tachycardia and tremors. They also increase hypoglycemic effects.

A nurse should expect which of the following adverse effects for a client who is taking betaxolol eye drops to treat glaucoma? a. Bradycardia b. Discoloration of the iris c. Hypetension d. Constricted pupils

a. Bradycardia Betaxolol and timolol can cause bradycardia because of the blockade of cardiac beta1 receptors. Clients should check their pulse rate regularly and report any sustained decreases.

A nurse is caring for a client who is beginning raloxifene therapy to prevent osteoporosis. The nurse should tell the client to monitor for which of the following as an indication of a serious adverse reaction to the drug? a. Calf pain b. Blisters on mucous membranes c. Loss of hair d. Numbness of the fingertips.

a. Calf pain Raloxifene can increase the risk of deep-vein thrombosis, which can lead to pulmonary embolism or cerebral vascular accident. Clients should avoid longer periods of inactivity, and report any pain, redness, or swelling of the calf.

A nurse is talking to a client about beginning sumatriptan therapy to treat migraine headaches. The nurse should advise the client to watch for which of the following adverse effects? a. Chest pain b. Insomnia c. Polyuria d. Joint pain

a. Chest pain Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

Which of the following instructions should a nurse include when advising a client about instilling pilocarpine for managing open-angle glaucoma? a. Do not touch the tip of the dropper. b. Remove contact lenses prior to instilling the drops. c. Rub eyes gently after instilling the drops. d. Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops. e. Wash hands after instilling the drops.

a. Do not touch the tip of the dropper. Do not touch the tip of the dropper is correct. The tip of the dropper should remain sterile. It is important the clients avoid touch the dropper's tip or touch it to the eye area. b. Remove contact lenses prior to instilling the drops. Remove contact lenses prior to instilling the drops is correct. Clients should remove contact lenses before instilling eye drops because they can cause further irritation if left in place. d. Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops. Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops is correct. Applying gentle pressure to the nasolacrimal duct for 1 to 2 minutes after instillation helps keep the rug from entering the system circulation.

A client is brought to the emergency department with severe wheezing, dyspnea, and peripheral edema. The nurse assesses a respiratory rate of 30 breaths per minute, a heart rate of 88 beats per minute, and a blood pressure of 88/54 mm Hg. Which medication does the nurse expect to be given initially? a. Epinephrine b. Diphenhydramine c. Albuterol d. Dopamine

a. Epinephrine The Client has signs of anaphylactic shock, and the first medication given will be epinephrine because it treats both bronchoconstriction and hypotension. Albuterol may be given later to help with respiratory distress. Diphenhydramine is an antihistamine to treat tissue-induced swelling. Dopamine will be given if hypotension persists.

A nurse is caring for a client who is about to begin taking radioactive iodine-131 to treat Grave's disease. Which of the following instructions should the nurse include when talking with the client about this drug? a. Expect full effects in 2-3 months. b. Restrict fluid intake after taking the drug. c. Expect a bitter, acid-like taste. d. Take the drug once daily for 5 days.

a. Expect full effects in 2-3 months. The full therapeutic effects of radioactive iodine-131, an antithyroid drug, take 2-3 months and with successful treatment, hypothyroidism can result.

A nurse is caring for a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the health care professional include when talking with the client about taking the drug? a. Expect lifelong therapy with the drug. b. Take levothyroxine with an antacid to reduce GI effects. c. Take levothyroxine with food to increase absorption. d. Carry a carbohydrate snack at all times.

a. Expect lifelong therapy with the drug. Therapy with levothyroxine, a thyroid replacement hormone, usually continues for life because their are no other therapies that can restore thyroid function.

Which of following findings should alert a nurse that a client with multiple scelerosis is developing a potentially serious adverse reaction to the interferon? a. Fatigue b. Blue-green skin discoloration c. Twitching eyelids d. Tinnitus

a. Fatigue Because of the potential for bone marrow suppression and decreased platelet count, patients should report unexplained bruising, bleeding or fatigue.

A nurse is caring for a client who is about to receive gentamicin to treat a systemic infection. The nurse should question the use of the drug for a client who is taking which of the drugs? a. Furosemide b. Levothyroxine c. Acetominophen d. Diphenhydramine

a. Furosemide Gentamicin, a aminoglycoside, and furosemide, a diuretic, are ototoxicity drugs. Concurrent use multiplies the client's the risk for hearing loss.

A nurse is providing teaching to a client who is taking raloxifene, a selective estrogen receptor modulator, to prevent postmenopausal osteoporosis. The nurse should advise the client that which fo the following are adverse effects of this medication? Select all that apply a. Hot flashes b. Difficulty swallowing c. Shortness of breath d. Swelling or redness in calf e. Lump in breast

a. Hot flashes Raloxifene may cause hot flashes or increase existing hot flashes. c. Shortness of breath Raloxifene increases the risk for pulmonary embolism, which may cause shortness of breath. d. Swelling or redness in calf Raloxifene increases the risk for thrombophlebitis, which may cause swelling or redness in the calf.

When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, the primary care provider should choose which of the following drugs? a. HydroCortisone b. Somatropin c. Desmopressin d. Glucagon

a. HydroCortisone Hyrdrocortisone, a glucocorticoid, provides replacement therapy for acute and chronic adrenocortical insufficiency such as Addison's disease. Hydrocortisone is identical to cortisol, the primary glucocorticoid the adrenal cortex generates.

A nurse is caring for a client who is taking naloxone to treat a morphine overdose. The nurse should monitor for which of the following adverse effects? a. Increased pain b. Tachycardia c. Bradypnea d. Hypotension

a. Increased pain Naloxone reverses the analgesic effect of opioids and can cause increased pain and discomfort.

A nurse is caring for a client who is receiving hydromorphone to relieve severe pain. The nurse should monitor for which of the following adverse effects? (Select all that apply) a. Nausea and vomiting b. Respiratory depression c. Orthostatic hypotension d. Diarrhea e. Sedation

a. Nausea and vomiting Hydromorphone can cause nausea and vomiting. Clients may need to be medicated with an antiemetic when receiving Hydromorphone. b. Respiratory depression Hydromorphone can cause sever respiratory depression. Nurse should withhold the drug for respiratory rates below 12/min. c. Orthostatic hypotension Hydromorphone can cause hypotension and postural hypotension. Clients taking the drug should change positions slowly. e. Sedation Hydromorphone can cause sedation, dizziness, and lightheaded ness. Clients taking the drug should avoid activities that require alertness.

While talking with a client and their family about taking memantine for Alzheimer's disease, the nurse should include which of the following instructions? a. Notify the health care professional before taking an over-the-counter antacid. b. Watch for signs of liver impariment, such as jaundice or abdominal pain. c. Increase fluids to improve renal secretion. d. Report memory loss or confusion.

a. Notify the health care professional before taking an over-the-counter antacid. Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity.

A nurse is reviewing the medical record of a client who has a newly diagnosed seizure diroder. The client is to begin taking both valproic acid and phenytoin. The nurse should recognize that which of the following can occur asa result of a drug reaction between valproic acid and phenytoin? a. Phenytoin toxicity b. Hypertension c. Peptic ulcer disease d. Hyperammonemia

a. Phenytoin toxicity Valprioc acid can cause an increase in phenytoin blood levels, causing phenytoin toxicity. The primary care provider should monitor drum photo in levels and reduce dosage if levels begin to exceed the therapeutic range.

A nurse is caring for a client who is about to begin taking estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain to the client that the drug combnation includes which of the following therapeutic effects? Select all that apply a. Prevents osteoporosis b. Reduces the risk of thromboembolism. c. Reduces the risk of ovarian cancer d. Reduces the risk of breast cancer. e. Relieves hot flashe

a. Prevents osteoporosis Drug therapy with an estrogen and progesterone combination or estrogen alone increases bone density and prevents osteoporosis. c. Reduces the risk of ovarian cancer Drug therapy with an estrogen and progesterone combination reduces the risk of ovarian cancer. Estrogen alone without progesterone can increase the risks of endometrial and ovarian cancer. e. Relieves hot flashes Drug therapy with an estrogen and progesterone combination or estrogen alone reduces hot flashes, sweating and sleep disturbances.

A client who is taking clopidogrel and aspirin is preparing for orthopedic surgery. The nurse will consult with the surgeon and provide which instruction to the client? a. Stop taking both medications 7 days prior to surgery. b. Continue both medications to prevent thromboembolic events during surgery. c. Continue taking aspirin and stop taking clopidogrel 2 weeks prior to surgery. d. Continue taking clopidogrel and stop taking aspirin 5 days prior to surgery.

a. Stop taking both medications 7 days prior to surgery. Because both drugs can prolong bleeding time, clients should discontinue the drugs 7 days prior to surgery.

A nurse should advise clients to take acetaminophen for which of the following? Select all that apply a. To reduce fever b. To decrease inflammation c. To alleviate anxiety d. To relieve mild pain e. To promote sedation

a. To reduce fever Acetaminophen reduces fever. It is important, however,to monitor clients taking the drug for hepatotoxicity. d. To relieve mild pain Acetaminophen relieves mild to moderate pain. It is import to monitor client who might have high does for early signs of toxicity, including sweating, nausea and abdominal discomfort.

A nurse should question the use of levothyroxine in client who has a history of a. a myocardial infarction. b. diabetes insipidus. c. immunosuppression. d. bacterial skin infections.

a. a myocardial infarction. Levothyroxine, a thyroid replacement hormone, can cause tachycardia, palpitations and hypertension, and it is contraindicated in clients who recently had a myocardial infarction.

A nurse is talking about self-administering methotrexate to a client who has rheumatoid arthritis. The nurse should the client to a. drink 2 to 3 L of water per day to promote the drug's excretion. b. take it with food to reduce gastric irritation. c. use a nonsteriodal anti inflammatory drug (NSAID) to reduce toxicity d. take it in the morning to prevent insomnia.

a. drink 2 to 3 L of water per day to promote the drug's excretion. Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage.

An older client has urge urinary incontinence related to an overactive bladder. Which medication does the nurse expect the healthcare provider to order? a. tolterodine b. bethanechol c. tamsulosin d. phenazopyridine

a. tolterodine Detrol tolterodine is an anticholigergic used to decrease bladder spasms in 'overactive'bladder.

The nurse is providing teaching for a client who will begin using tobramycin ointment 0.5 inches 3 times daily. The client currently uses pilocarpine HCl drops to treat glaucoma. Which statement by the client indicates a need for further teaching? a. "I should not stop the medications without consulting my provider." b. "I should put the ointment on first and then instill the eyedrops." c. "I should apply the third dose of tobramycin at bedtime each day." d. "I should instill the drops in the conjunctival sac of the lower eyelid."

b. "I should put the ointment on first and then instill the eyedrops." Clients using both drops and ointments should instill the drops prior to applying the ointment. Ointments should be applied at bedtime if possible. Drops should be instilled into the conjunctival sac of the lower lid. Clients should always consult with their provider before discontinuing any medication.

During a code blue, the nurse selects the following concentration of epinephrine from the code cart for a client who is in VFib: a. 1:1,000 b. 1:10,000

b. 1:10,000 Epinephrine is available in two primary concentrations: 1:1,000 and 1: 10,000. The 1:10,000 concentration is used when giving a single IV dose of epinephrine in a cardiac arrest. The 1:1,000 concentration (a higher concentration) is typically used for anaphylactic cases, not given directly into the vascular system and given IM.

The nurse is preparing to administer a first does of clopidogrel to a client. As part of the history, the nurse learns that the client has a previous history of peptic ulcers, diabetes and hypertension. The nurse understands it will be necessary to notify the provider and obtain an order for a. Increased antihypertensive medications b. A proton pump inhibitor c. Nonsteriodal antiinflammatory medications d. Frequent serum glucose monitoring

b. A proton pump inhibitor Clients with a previous history of peptic ulcers are at increased risk for gastric bleeding and should take a PPI or histamine.

A nurse is caring for a client who is about to being using transdermal nitroglycerin to treat angina pectorals. When talking to the client about the drug, the nurse should include which of the following instructions? Select all that apply a. Apply a new patch at the onset of anginal pain. b. Apply a new patch each morning. c. Apply the patch to dry skin and cover the area with plastic wrap. d. Remove the patches for 10-12 hours daily. e. Apply the patch to a hairless area and rotate sites.

b. Apply a new patch each morning. theraputic preventive effects of transdermal nitroglycerin patches being 30-60 min after application and last up to 14 hours. Because angina pain is more likely to occur with activity, more clients require this protection during waking hours. d. Remove the patches for 10-12 hours daily. Removing the patches for 10-12 hrs helps prevent tolerance to the drug. For most clients, sleeping hours are the best time to go 'patch free' as angina pain is more likely to occur with activity. e. Apply the patch to a hairless area and rotate sites. Hair can interfere with the adhesion of the patch. Rotating sites helps prevent skin irritation.

A patient who is intubated develops bradycardia because of vagal stimulation. Which medication will the nurse anticipate administering to treat this symptom? a. Metoclopramide b. Atropine sulfate c. Bethanechol d. Benztropine

b. Atropine sulfate Atropine, an antiCholinergic drug, increases heart rate and is used to treat symptomatic bradycardia.

A nurse should question the use of conjugated equine estrogen by a client who has a history of which of the following? a. Rheumatoid arthritis b. Blood clots c. Peptic Ulcer Disease d. Osteoporosis

b. Blood clots Clients who have a history of thromboembolic disease may not use estrogen replacement because of the risks of mycardial infarction, pulmonary embolism and cerebrovascular accident.

A nurse is caring for an older adult client who is about to begin taking prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse effects? a. Breast cancer b. Bone loss c. Hepatitis d. Pulmonary embolism

b. Bone loss Prednisone, a glucocorticoid, can cause osteoporosis, especially long term use. Clients taking the drug should increase weight bearing excercises and report back pain.

A client has hypocalcemia caused by parathyroid hormone deficiency. Which medication will the nurse anticipate giving to this client? a. Calcitonin b. Calcitriol c. Calcium d. Vitamin D

b. Calcitriol Calcitriol increases serum calcium levels by helping the body use more of the calcium found in foods, increasing calcium secretion from the bones and regulating the body's production of parathyroid hormone.

A nurse should include which of the following instructions when talking with a client about taking levodopa/carbidopa to treat Parkinson's disease? a. Take the drug at bedtime to avoid daytime drowsiness. b. Change position slowly to prevent orthostatic hypotension. c. Eat a protein snack to increase absorption. d. Expect eye twitching to develop with long-term therapy.

b. Change position slowly to prevent orthostatic hypotension. Levodopa/carbidopa can cause orthostatic hypotension.

A nurse is caring for a client who is about to begin taking tramadol to treat moderate acute pain from a shoulder injury. When talking with the client about the drug, the nurse should include which of the following instructions? Select all that apply a. Reduce exercise level temporarily. b. Change positions gradually. c. Take the drug with food. d. Increase fiber and fluid intake. e. Avoid driving after taking the drug.

b. Change positions gradually. Tramadol can cause sedation and dizziness. Clients should use caution when changing positions or ambulating while taking this drug. c. Take the drug with food. Tramadol can cause nausea and vomiting. Clients should take the drug with food or milk and lie down if feeling nauseated. d. Increase fiber and fluid intake. Tramadol can cause constipation and dry mouth. e. Avoid driving after taking the drug. Tramadol can cause sedation and drowsiness. Clients should avoid driving or other activities that require alertness.

A nurse is caring for a client who is about to begin taking celecoxib to treat rheumatoid arthritis. The nurse should tell the client to report which of the following adverse reactions? a. Tinnitus b. Chest pain c. Diaphoresis d. Constipation

b. Chest pain Celecoxib, a COX-2 inhibitor, can cause cardiovascular or cerebrovascular events. Clients should report chest pain, shortness of breath, headache, numbness, weakness or confusion.

A nurse is caring for a client who is about to begin taking cephalexin to treat bacterial meningitis. The nurse should explain to the client the need to monitor which of the following laboratory tests? a. Aspartate aminotransferase b. Creatinine c. Prothrombin time d. Potassium

b. Creatinine Cephalexin, a first generation cephalosporin, is excreted by the kidneys. The nurse should evaluate renal function prior to and during treatment with the drug. Clients who have renal insufficiency should receive a reduced dose of the drug or another drug that does not affect renal function, such as ceftriaxon

A client who is taking digoxin develops ECG changes and other manifestations that indicate severe digoxin toxicity. Which of the following drugs should the nurse have available to treat this complication? a. Acetylcysteine b. Digibind c. Deferoxamine d. Flumazenil

b. Digibind Digiband binds to digoxin and blocks its action. The nurse should prepare this antidote IV to clients who have severe digoxin toxicity.

A nurse is caring for a client who has benign prostatic hypertrophy (BPH) and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? a. Angle-closure glaucoma for which he takes pilocarpine b. Erectile dysfunction for which he takes sildenafil c. Diabetes mellitus for which he takes glyburide d. A seizure disorder for which he takes carbamazepine

b. Erectile dysfunction for which he takes sildenafil Drugs that lowers bood pressure, such as sildenafil, can worsen hypotension in combination with tamsulosin. Clients taking sildenafil should not take tamsulosin.

Which of the following drugs should a provider prescribe for a client who has streptococcal pharyngitis and is allergic to penicillin? a. Cephalexin b. Erythromycin c. Amoxicillin/clavulanic acid d. Naficillin

b. Erythromycin Erythromycin, a macrolide, is an acceptable alternative to penicillin for clients who have bacterial infections and are allergic to penicillin. The drug is effective against most gram-positive bacteria, including streptococci, and some gram-negative bacteria.

A nurse is talking with a client who is to begin talking valproic acid to treat a seizure disorder. The nurse should advise the client to monitor for which fo the following adverse effects? a. Gum irritation b. Jaundice c. Hirsutism d. Depression

b. Jaundice Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these symptoms and health care professionals should monitor liver function studies prior to treatment and periodically during therapy.

A nurse is preparing to administer alendronate to a client who has osteoporosis. The nurse should recognize which of the following as an adverse effect of alendronate? a. Venous thromboemboli b. Joint pain c. Ventricular dysrhythmias d. Breast cancer

b. Joint pain Alendronate can cause joint and muscle pain. Clients may treat joint pain with analgesics. Other adverse effects include nausea, visual disturbances and esophagitis.

A nurse is talking to a client about self injecting regular insulin (Humulin). the nurse should tell the client to rotate injection sites to prevent which of the following? a. Rapid absoption b. Lipohypertrophy c. Injection pain d. Intradermal injection

b. Lipohypertrophy Lipohypertrophy, also called lipodystrophy, is a proliferation of fat at the sites of repeated insulin injections. It affects skin sensitivity and appearance. To prevent it, the client should rotate injection sites, keeping them at least 1 inch apart, and avoid using the same spot within the same month.

A client with angina has been given 0.4 mg of nitroglycerin SL. The client reports continued chest pain 5 minutes later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. The nurse will take which action? a. Administer 0.4 mg of nitroglycerin SL. b. Notify the provider of the client's vital signs. c. Administer 0.3 mg of nitroglycerin SL. d. Give nitroglycerin by translingual spray.

b. Notify the provider of the client's vital signs. Nitroglycerin should be held if the client has a systolic blood pressure less than 90 mm Hg. The nurse should notify the provider.

A nurse should advise a client who has which of the following to stop taking ibuprofen to treat an occasional headache or muscle strain? a. Hyperthyroidism b. Peptic ulcer disease c. Penicillin allergy d. Dysmenorrhea

b. Peptic ulcer disease Ibuprofen, an NSAID, is inappropriate for clients who have peptic ulcer disease. Nurses should monitor clients who are taking ibuprofen for gastric bleeding, and test or treat clients who have H. Pylori prior to long term or repeated treatment with NSAIDs.

The nurse is caring for a client who is about to begin taking finasteride to treat benign prostatic hypertrophy. The nurse should explain to the client the need to monitor which of the following laboratory tests? a. ALT b. Prostate-specific antigen (PSA) c. BUN d. Creatine phosphokinase (CPK)

b. Prostate-specific antigen (PSA) Increases in PSA can indicate prostate cancer. PSA levels should decrease with finasteride therapy.

A client who has Parkinson's disease is being treated with the anticholinergic medication benztropine. The nurse will tell the client that this drug will have which effect? a. Helping the client to walk faster b. Reducing some of the tremors c. Improving mental function d. Minimizing symptoms of bradykinesia

b. Reducing some of the tremors Benztropine is given to reduce rigidity and some of the tremors. It does not enhance walking or reduce bradykinesia or improve mental function.

A nurse is caring for a client who is taking repaglinide 15 to 30 minutes before each meal to treat type 2 diabetes mellitus. The client asks the nurse what to do if they skip a meal. Which of the following is the appropriate response? a. Take half the dose. b. Skip the dose. c. Double the dose before the next meal. d. Take the usual dose.

b. Skip the dose. To avoid a sudden and serious drop in blood glucose level, the client should skip the dose of repaglinide whenever a meal is skipped. The client should try to avoid skipping meals.

A nurse is caring for a client who is taking bethanechol for urinary retention. When advising the client about taking the drug, which of the following instruction should the nurse include? a. Take the drug with food. b. Stay close to a bathroom after taking the drug. c. Increase weight-bearing activities. d. Decrease fluid intake.

b. Stay close to a bathroom after taking the drug. Bethanechol can cause rapid relief of urinary retention or diarrhea, with fecal inconticence.

The nurse is reviewing the labs of a client who was put on levothyroxine for hypothyroidism. The nurse anticipates the following trend in lab values since starting this new medication: a. T4 decreasing b. TSH decreasing c. TRH Increasing d. TSH increasing

b. TSH decreasing Thyroid stimulating hormone (TSH) is elevated in untreated hypothyroidism. Levothyroxine is a synthetic thyroid hormone (T4) used to treat hypothyroidism. Once thyroid levels are normalized with levothyroxine the pituitary decreases the amount of TSH it produces and TSH levels decrease.

The nurse is providing discharge instructions to a client who has a new prescription for Prednisone. Which of the following must the nurse include in the teaching? a. Increase the dose gradually according to the prescription. b. Taper the dose gradually according to the prescription. c. Take the prescription every other day. d. Discontinue the prescription once your symptoms have resolved.

b. Taper the dose gradually according to the prescription. Tapering corticosteroids avoids adrenal insufficiency

A nurse is caring for a client who is about to begin gentamicin therapy to treat an infection. The nurse should monitor the client for which of the following? a. Bowel function b. Urine output c. Peripheral pulses d. Level of consciousness

b. Urine output Gentamicin, an aminoglycoside, can cause nephrotoxicity. The nurse should monitor BUN and creatinine.

The nurse is caring for a client who is receiving desmopressin. Which assessments are important while caring for this client? a. Lung sounds and serum magnesium. b. Urine output and serum sodium. c. Blood pressure and serum potassium. d. Heart rate and serum calcium.

b. Urine output and serum sodium. Desmopressin is an antidiuretic hormone, used for the treatment of diabetes insipidus, effects urine output and serum sodium levels.

The nurse is caring for a client who has increased intraocular pressure. The provider has ordered a cholinergic agonist. The nurse will perform a thorough health history to make sure the patient does not have a history of which condition? a. Hypertension b. Diabetes c. Asthma d. Renal Disease

c. Asthma Cholinergic agonists can worsen conditions such as asthma and chronic bronchitis because they can cause airway constriction.

A primary care provider is prescribing drug therapy for a client whose sputum culture results inficate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered? a. Trimethoprim/sulfamethoxazole b. Vancomycin c. Tetracycline d. Cephalexin

b. Vancomycin Vancomycin, a potentially toxic antibiotic, is used primarily for serious infections either in clients who are allergic to penicillin or in those whose infectiing bacteria are resistant to penicillin, such as MRSA.

A nurse is caring for a client who is about to receive alteplase to treat acute myocardial infarction. The nurse should understand that the drug is more effective when the client receives it a. 24 hr after clot formation. b. Within 3 hr of symptom onset. c. Prior to clot formation. d. after initiation of anticoagulation.

b. Within 3 hr of symptom onset. Alteplase, a thrombolytic drug, is most effective in treating acute myocardial infarction if the client receives it as soon as possible after the onset of symptoms.

A client has a new prescription for brimonidine ophthalmic, one drop three times a day. The client wears soft contact lenses and wants to know if the drops can be administered with the lenses in place. Which of the following should the nurse tell the client? a. "Go ahead and put the drop in your eye with the contact lens in place." b. "Take the contact lens out of your eye, then instill the eye drop, and immediately reinsert the contact lens." c. "Take the contact lens our of your eye, then instill the eye drop, and wait at least 15 minutes before putting the contact lens back in place." d. "You will need to discontinue the use of contact lenses while using brimonidine eye drops."

c. "Take the contact lens our of your eye, then instill the eye drop, and wait at least 15 minutes before putting the contact lens back in place." The client can continue to wear contacts but when instilling brimonidine, contacts should be removed, the medicaton should be administered and wait at least 15 minutes before putting the contacts back in the eye.

A client who is taking metformin to treat type 2 diabetes mellitus plans to undergo a CT scan using iodine-containing contrast dye. The nurse should recognize that an interaction between metformin and the IV contrast can increase the client's risk for which of the following? a. Acute pancreatitis b. Hyperglycemia c. Acute renal failure d. Hypokalemia

c. Acute renal failure Metformin, a biguanide, can interact with iodine-containing contrast dye, causing acute renal failure and lactic acidosis. The nurse should withhold metformin for 48 hr prior to and following the procedure (CT scan). The nurse should also monitor the client for indications for acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation and abdominal pain.

A nurse should question the use of acetaminophen for clients who have which of the following? a. Diabetes mellitus b. Asthma c. Alcohol use disorder d. Heart failure

c. Alcohol use disorder Acetaminophen can cause liver toxicity. Clients who have a history of alcohol use disorder should not take the drug.

The nurse is performing a medication history on a client who has glaucoma. The client cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications? a. Cholinesterase inhibitors b. Cholinergic agonists c. Alpha-adrenergic agonists d. Beta-adrenergic blockers

c. Alpha-adrenergic agonists Alpha-adrenergic agonists cause mydriasis, which increases sensitivity to light. Beta-adrenergic blockers cause miosis, which impairs vision in the dark. Cholinergic agonists and cholinesterase inhibitors may cause myopia and will impair vision in the dark.

A nurse should question the use of timolol for a client who has which of the following disorders? a. Seizure disorder b. Rheumatoid arthritis c. Asthma d. Diabetes Mellitus

c. Asthma Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. Clients who have asthma or any disorder that compromises respiratory function should not use the drug.

A nurse is caring for a client who is taking warfarin and is about to begin taking trimethoprim/sulfamethoxazole to treat a urinary tract infection. The nurse should question the drug regimen because taking these two drugs concurrently can increase the client's risk for which of the following? a. Thrombosis b. Ototoxicity c. Bleeding d. ECG changes

c. Bleeding Trimethoprim/sulfamethoxazole, a sulfonimide combination, can increase the effects of warfarin and increase the client's risk for bleeding.

A client who is taking amoxicillin to treat a respiratory infection contacts the nurse to report a rash and wheezing. Which of the following instruction should the nurse provide? a. Skip today's dose aof amoxicillin and resume taking the drug tomorrow. b. Take an NSAID to reduce the skin and airway inflammation. c. Call emergency services immediately. d. Wait1 hr and contact the provider if there is no improvement.

c. Call emergency services immediately. Amoxicillin can cause a severe anaphylactic reaction. A client who has breathing difficulties should call emergency services or seek immediate care.

A nurse is caring for a client who is about to begin taking echothiophate to treat glaucoma. The nurse should monitor the client for the development of which of the following adverse effects? a. Tachycardia b. Urinary retention c. Cataracts d. Farsigntedness

c. Cataracts Echothiophate, a cholinesterase inhibitor, can cause cataracts, or opacity of the lens of the eye. Clients should report any changes in vision, such as cloudiness or halos around lights.

A nurse is caring for a client who is taking alendronate to treat postmenopausal osteoporosis. The nurse should explain to the client that alendronate increases bone mass by which of the following actions? a. Promotes intestinal absorption of calcium and phosphorus b. Reduces action of osteoblasts. c. Decreases activity of osteoclasts d. Increases calcium excretion

c. Decreases activity of osteoclasts Osteoclasts are cells that cause bone resorption or bone loss. Alendronate reduce the activity of osteoclasts, reducing bone loss and increasing bone mass.

A client who has received heparin after previous surgeries will be given enoxaparin sodium after knee-replacement surgery. The client asks how this drug is different from heparin. The nurse will explain that enoxaparin a. May be taken orally instead of subcutaneously. b. Increases the risk of hemorrhage. c. Decreases the need for laboratory tests. d. Has a shorter half-life than heparin.

c. Decreases the need for laboratory tests. Enoxaparin is a low molecular weigh heparin, which produces more stable responses at lower doses, thus reducing the need for frequent lab monitoring. It has a longer half-life than heparin. It decreases the risk of hemorrhage because it is more stable at lower doses. It is given subcutaneously.

A nurse administers oxybutynin to a client to treat neurogenic bladder. Which of the following assessment findings should the nurse recognize as an adverse effect? a. Urinary incontinence b. Bradycardia c. Distended bladder d. Diaphoresis

c. Distended bladder Oxybutynin can cause urinary retention and bladder distention.

When talking with a client about taking amiodarone to treat atrial fibrillation, which of the following should the nurse tell the client to avoid? a. NSAIDs b. Foods high in vitamin K c. Grapefruit juice d. Milk

c. Grapefruit juice Grapefruit juice, particularly in large amounts, can cause toxicity of potassium channel blockers, such as amiodarone.

A nurse is talking to a client who is about to being taking valproic acid for a newly diagnosed seizure disorder. The nurse should tell the client to watch for the following adverse effects? Select all that apply a. Hirsutism b. Ataxia c. Headache d. Drowsiness e. Rash

c. Headache Valproic acid can cause headache, along with other central nervous system adverse effects, such as sleep disturbances. d. Drowsiness Clients takin valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these effects can indicate the need for a reduction in dose. e. Rash Skin rash is a side effect of valproic acid.

A nurse is assessing a client who takes vasopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor? a. Hypercalcemia b. Hypovolemia c. Hypertension d. Hypoglycemia

c. Hypertension Cardiac effects, such as hypertension and angina, are serious adverse effects of vasopressin for which the nurse should monitor.

A client who take carvedilol for hypertension is about to begin taking an oral antidiabetic drug to manage newly diagnosed type 2 diabetes mellitus. The nurse should make sure the primary care provider is aware that the client is at increased risk for which of the following if the client takes both drugs. a. Hypotension b. Bradycardia c. Hypoglycemia d. Hyperglycemia

c. Hypoglycemia Alpha/beta blockers, such as carvedilol, potentiate the hypoglycemic effects of insulin and oral hypoglycemic drugs.

A nurse is caring for a client who is about to begin warfarin. The nurse should caution the client about taking which of the following over-the-counter drugs? a. Dimenhydrinate b. Calcium carbonate c. Ibuprofen d. Diphenhydramine

c. Ibuprofen NSAIDs, such as ibuprofen and especially aspirin, can increase the risk of bleeding by clients taking warfarin, an anticoagulant.

The nurse is performing a health history on a client who has multiple sclerosis. The client reports epidodes of muscle spasticity and recurrence of mucle weakness and diplopia. The nurse will expect the client to be taking which medication? a. Cyclophosphamide (Cytoxan) b. Cyclobenzaprine (Flexiril) c. Interferon-B d. Adrenocorticotropic hormone (ACTH)

c. Interferon-B This patient is showing signs of remission and exacerbation of MS symptoms. Interferon is used to treat this phase. ACTH is used for acute attacks. Cyclophosphamide is used for chronic, progressive symptoms. Cyclobenzaprine is a centrally acting muscle relaxant that is used for muscle spasms to decrease pain and increase range of motion.

Which of the following is a therapeutic action of raloxifene? a. Stimulates secretion of parathyroid hormone. b. Blocks the effects of estrogen on endometrial tissue c. Mimics the effects of estrogen on bone tissue. d. Stimulates menstruation

c. Mimics the effects of estrogen on bone tissue. Raloxifene mimics the effects of estrogen on bone tissue, minimizing or stopping bone loss.

For which of the following should a nurse monitor a client who is taking donepezil for Alzheimer's disease? a. Double vision b. Confusion c. Nausea d. Dry mouth

c. Nausea The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking the drug with food can help minimize adverse effects.

A client has been receiving intravenous heparin. When laboratory tests are drawn the nurse cannot stop the bleeding at the puncture site. The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform? a. Request an order for vitamin K. b. Suggest the client receive a subcutaneous heparin. c. Obtain an order for protamine sulfate. d. Ask for an order for oral warfarin.

c. Obtain an order for protamine sulfate. Protamine sulfate is given as an antidote to heparin when the client's clotting times are elevated. Oral warfarin will not stop the anticoagulant effects of heparin. Vitamin K is used as an antidote for warfarin. Administering heparin by another route is not indicated when there is a need to reverse the effects of heparin.

A nurse is caring for a client who is about to begin using betaxolol eye drops to treat open-angle glaucoma. The nurse should advise the client to expect which of the following reactions? a. Eyelid twitching b. Diaphoresis c. Ocular stinging d. Nasal discharge

c. Ocular stinging Betaxolol, a beta-adrenergic blocker, can cause short term, mild stinging and burning of the eye. Clients should expect transient eye discomfort, but should not rub their eyes. Severe or continuous irritation should be reported.

A client who is taking glipizide to treat type 2 diabetes mellitus contacts the nurse to report feeling shaky, hungry, and fatigued. The nurse should tell the client to which of the following? a. Take another glipizide tablet b. Lie down and rest c. Perform a finger stick blood glucose check. d. Drink 16 oz of water

c. Perform a finger stick blood glucose check. Glipizide, a sulfonylurea, can cause hypoglycemia, which can manifest as diaphoresis, shakiness, hunger, and fatigue. The nurse should tell the client to check the blood glucose level and if it indicates hypoglycemia, consume a snack of 15 to 20 g of carbohydrates, retest in 15 to 20 minutes and repeat if blood glucose is still low.

A client who is taking tetracycline orally to treat a chlamydia infection contacts the nurse to report severe blood-tinged diarrhea. Recognzing adverse effects of tetracycline, the nurse should suspect which of the following? a. Hemorrhoids b. Small bowel obstruction c. Pseudomembranous enterocolitis d. Diverticular disease

c. Pseudomembranous enterocolitis Severe diarrhea, often containing mucus and blood, can indicate pseudomembranous colitis. Treatment includes stopping drug therapy and replacing fluids and electrolytes. Clients should report severe diarrhea and blood in stools promptly.

A nurse should tell a client who is taking etanercept for rheumatoid arthritis to report which of the following? a. Diarrhea b. Tinnitus c. Skin rash d. Dysphagia

c. Skin rash Etanercept can cause serious skin infections, such as Stevens-Johnson syndrome and toxic epidermal necroylsis. Client should report any skin rashes or blisters immediately.de6

To determine the effectiveness of desmopressin, a nurse should monitor a client's a. Skin integrity b. Blood glucose c. Urine output d. Peripheral pulses

c. Urine output Desmopressin, an antidiuretic hormone, is used to treat diabetes insipidus. The nurse should monitor the client's fluid intake, urine output, urine & serum osmolality and blood pressure.

A nurse is caring for a client who is about to being taking verapamil to treat atrial fibrillation. The nurse should tell the client to avoid grapefruit juice while taking verapamil because it can cause a. dehydration b. tachycardia c. hypotension d. diarrhea

c. hypotension Large amounts of grapefruit juice increase blood levels of verapamil by inhibiting its metabolism. The excess amount of the drug can intensify otherwise therapeutic effects like hypotension.

A nurse is caring for a client who is about to begin taking simvastatin to treat hypercholesterolemia. The nurse should tell the client to report the following indications of a serious adverse reaction that could warrant stopping drug therapy? a. Bronchoconstriction b. Lip numbness c. muscle pain d. Somnolence

c. muscle pain Simvastatin, an HMG-CoA reductase inhibitor (statin), can cause myopathy or pain in muscles and joints that can progress to rhabdomyolysis. With this rare but serious adverse effect, muscle protein breaks down and its excretion can cause kidney damage.

The nurse assumes care of a client who has myasthenia gravis and notes that a dose of neostigmine due 1 hour prior was not given. The nurse will anticipate the client to exhibit which symptoms? a. excessive salivation b. muscle spasms c. muscle weakness d. Respiratory paralysis

c. muscle weakness Neostigmine must be given on time to prevent myasthenic crisis, which is characterized by generalized, severe muscle weakness. The other symptoms are characteristic of cholinergic crisis, caused by too much medication.

The nurse is administering timolol eye drops to a client who has glaucoma. To prevent bradycardia, the nurse will perform which action? a. Prepare to administer an alpha-adrenergic agonist. b. Wait 5 minutes between drops. c. Have the patient sit up after instilling the drops. d. Apply pressure to the lacrimal ducts.

d. Apply pressure to the lacrimal ducts. Bradycardia is a systemic side effect of timolol. Applying pressure to the lacrimal ducts prevents the medication from being systemically absorbed and causing systemic side effects such as bradycardia.

Because of the potential for adverse effects, which of the following should a nurse recommend for clients who begin taking carbamazepine? a. Have serum glucose levels checked regularly. b. Discontinue the drug immediately if diarrhea occurs. c. Take the drug on an empty stomach. d. Begin taking the drug at a low dosage.

d. Begin taking the drug at a low dosage. Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, an iminostilbene that treats seizure disorders.Dosages should be low to minimize or prevent these adverse effects.

A nurse should tell a client who is taking methotrexate to monitor for which of the following? a. Peripheral edema b. Rednessi n the calf c. Muscle pain d. Black, tarry stools

d. Black, tarry stools Methotrexate can cause gastric intestinal ulceration, which can lead to perforation and bleeding. The client should watch for blood in stools and report these symptoms to the healthcare provider immediately.

A nurse is caring for a client who is about to begin taking pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following laboratory tests require monitoring? a. C-reactive protein (CRP) b. CBC c. Thyroid function d. Creatine phosphokinase (CPK)

d. Creatine phosphokinase (CPK) CPK is an enzyme found in the heart, brain and skeletal muscles. Clients taking pramipexole can develop muscle weakness with a lack of energy, creating a situation that can be more problematic for clients than their original muscle dysfunction. Monitoring CPK can alert health care professionals to the possibility of skeletal muscle damage from the drug.

A nurse should understand that naloxone can reverse the effects of an excessive dosage of which of the following drugs? a. Acetaminophen b. Prednisone c. Aspirin d. Fentanyl

d. Fentanyl Naloxone, an opiod antagonist, reverses the effects of an overdose of fentanyl, an Opiod analgesic. Nurses should monitor respirations and reassess clients after the effects of naloxone have diminished (20-40 minutes) for recurrence of the adverse effects of fentanyl.

Which of the following drugs should a nurse have available for a client who is experiencing an insulin overdose? a. Naloxone b. Acetylcysteine c. Diphenhydramine d. Glucagon

d. Glucagon Glucagon, a hyperglycemic that can be given subcutaneously, IM or IV treats severe hypoglycemia from insulin overdose in clients who are unconscious. If the client does not respond to glucagon the nurse should administer a glucose solution IV.

When talking to a client about taking conjugated estrogen and medroxyprogesterone, the nurse should include which of the following instructions? a. Sit up for 30 min after taking the drug. b. Avoid drinking alchoholic beverages. c. Watch for rectal bleeding. d. Have blood pressure checked regularly.

d. Have blood pressure checked regularly. Using a combination of estrogen and progesterone for hormone replacement can cause hypertension. Clients taking this drug should have their blood pressure checked regularly.

When talking with a client about taking fludrocortisone to treat adrenal insufficiency, the nurse should tell the client to do which of the following to reduce the risk of adverse reactions? a. Eat more iron rich foods. b. Decrease intake of potassium rich foods. c. Avoid drinking grapefruit juice. d. Have your blood pressure checked regularly.

d. Have your blood pressure checked regularly. Fludrocortisone can cause fluid retention and hypertension. The nurse should monitor the client's fluid balance and blood pressure to expedite any essential interventions.

A nurse is talking to a client who is newly diagnosed with Parkinson's disease about how levodopa/carbidopa will help control her symptoms. With which of the following mechanisms is the drug effective in treating the disorder? a. Inhibits serotonin metabolism in the brain. b. Increases available acetylcholine in the brain. c. Inhibits norepinephrine metabolism in the brain. d. Increases available dopamine in the brain.

d. Increases available dopamine in the brain. Levodopa/carbidopa, a dopaminergic agent, can act by increasing dopamine in the extrapyramidal center of the brain, reducing involuntary motion.

A nurse should questions the use of etanercept for a client who has a history of diabetes mellitus because of which of the the following risks? a. Gout b. Kidney toxicity c. Deep vein thrombosis. d. Infection

d. Infection Etanercept increases the risks of developing a serious infection. Primary care providers should not prescribe etanercept for clients who have an existing infection and should use it cautiously with clients who have diabetes mellitus because the disease itself increases the infection risk.

The nurse is caring for a postoperative client. The nurse will anticipate administering which medication to this client to help prevent thrombus formation caused by slow venous blood flow? a. Alteplase b. Aspirin c. Clopidogrel d. Low-molecular-weight heparin

d. Low-molecular-weight heparin Low-molecular weight heparin is an anticoagulant, which is used to inhibit clot formation and is used prophlactically to prevent postoperative deep vein thrombosis. Alteplase is thrombolytic which is used to break down clots after they form. Thrombolytics are contraindicated in any client with recent surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent arterial thrombosis.

A client exhibits ptosis of both eyes, and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of ptosis. The nurse understand that this client most likely has which disorder? a. Multiple sclerosis b. Muscle spasms c. Cerebral palsy d. Myasthenia gravis

d. Myasthenia gravis Improvement of symptoms after administration of edrophonium is diagnostic for myasthenia gravis.

When talking with a client about using leuprolide to treat endometriosis, the nurse should include which of the following instructions? a. Take the drug with food to increase absorption. b. Wear suncreen and protective clothing c. Avoid drinking grapefruit juice. d. Perform weight-bearing exercises

d. Perform weight-bearing exercises Leuprolide suppresses estrogen and can cause bone loss. Nurses should tell clients to perform weight bearing activities and increase their intake of calcium and Vitamin D.

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1-5 hr after administration? a. Insulin lispro (Humalog) b. Insulin glargine (Lantus) c. NPH insulin (Humulin N) d. Regular Insulin (Humulin R)

d. Regular Insulin (Humulin R) Regular insulin has a peak effect around 1-5 hr following administration

Methotrexate is used to treat the following; a. Gout b. Parkinson's disease c. Pericarditis d. Rheumatoid Arthritis

d. Rheumatoid Arthritis Methotrexate, a disease modifying anti rheumatic drug, is used to prevent or slow joint deformity in rheumatoid arthritis.

While adminstering metronidazole for a urinary tract infection, the nurse finds the IV insertion site warm and reddened. Which of the following actions should the nurse take? a. Request a prescription for another antibiotic. b. Slow the metronidazole infusion. c. Administer diphenhydramine. d. Stop the infusion.

d. Stop the infusion. The nurse should stop the infusion, remove the IV catheter, assess for tissue damage and treat according. The nurse should initiate IV access via another site and continue the metronidazole therapy.

A client who is taking imipenem to treat a bacterial infection contacts the nurse to report an inability to eat because of mouth pain. Recognizing the adverse effects of imipenem, the nurse should suspect which of the following? a. Anorexia b. Dental cares c. Malabsorption d. Suprainfection

d. Suprainfection Imipenem, a carbapenem, can cause a suprainfection, candida albicans in the mouth, throat, or vagina. It can also cause gloss it is, and inflammation of the tongue. Clients should report any mouth pain or vaginal discharge and itching because they could need treatment with an antifungal drug.

When administering insulin glargine (Lantus) to a client the nurse understands the following about the action of this drug; a. The peak is 30-60 seconds. b. The peak is 10 minutes. c. The peak is 3-4 hours. d. There is no peak.

d. There is no peak. Insulin glargine (Lantus) has a basal/24 hour release and there is no peak.

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications should not be taken concurrently with sildenafil? a. luprolide acetate b. clopiderogrel c. finasteride d. nitroglycerin

d. nitroglycerin Concurrent use of nitrates and sildenafil is contraindicated because fatal hypotension can occur. The client should avoid taking a nitrate medication within 24 hrs of taking sildenafil.