N3300 (Final) Exam 2

The nurse is seeing a 69-year-old client who is highly physically active and consumes a balanced diet that includes adequate fluid intake. Despite this, the client states experiencing occasional constipation in recent months. What remedy should be the nurse's first suggestion?

A bulk-forming (fiber) laxative

A client with symptomatic hyperthyroidism is prescribed propranolol. Which clinical manifestation would the nurse identify that indicates the medication is having the desired effect?

A heart rate of 72 beats/min

The nursing instructor is discussing common respiratory disorders with the nursing class. Which of the following might the instructor identify as a common sign or symptom?

Bronchospasm

A male client wishes to discontinue his antidepressant secondary to sexual dysfunction. What antidepressant medication may be ordered by his health care provider because it does not interfere with sexual function?

Bupropion

A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?

Diazepam

The nurse is providing care for a 51-year-old client who has been taking cimetidine for several months. When monitoring for adverse effects, the nurse should perform what assessment?

Inspect the client for gynecomastia.

A client with a history of peptic ulcer disease has responded well to treatment with a histamine-2 antagonist. What effect will this drug have?

Reduce the quantity of hydrochloric acid secreted.

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication?

SSRIs prevent serotonin from being reabsorbed

A 54-year-old client, who is preparing to go on an ocean cruise, asks for a medication to relieve the symptoms of seasickness. What medication would a health care provider most likely prescribe?

Scopolamine

What type of antihistamine is typically preferred for older adults?

Second-generation

A client has been administered flumazenil because of the toxic effects of benzodiazepines. The client should be observed for acute benzodiazepine withdrawal symptoms. Which sign or symptom is indicative of acute benzodiazepine withdrawal?

Seizures

A client has not had anything to eat or drink within the past 12 hours and has a fasting blood glucose level of 125 mg/dL. What does the nurse interpret these findings to indicate?

The client has an impaired fasting blood glucose level.

While reviewing a client record, the nurse sees that the client has a history of chronic insomnia. What assumption can the nurse have regarding the client?

The client has been experiencing dysfunctional sleep for more than 1 month.

Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property?

They do not cross the blood-brain barrier.

What is the major reason that monoamine oxidase inhibitors (MAOs) are rarely used in clinical practice today?

They may cause dangerous interactions with some foods and drugs.

A client, after presenting at the clinic with sneezing and coughing, is diagnosed with the common cold. Which type of microorganism causes the common cold?

Virus

A client reports taking antihistamines to treat nausea. The nurse correctly suspects that the nausea results from what trigger?

motion sickness.

A male client's health care provider orders ramelteon for his long-term insomnia. The client is concerned that he will become dependent on the drug and is hesitant to take it. What instructions will the nurse give to this client?

"Ramelteon does not cause physical dependence."

A client with type 1 diabetes has been prescribed 12 units of regular insulin and 34 units of NPH insulin in the morning. How should the nurse explain why two different types of insulin are required to control the client's blood glucose?

"The different onsets and peaks of the two types provide better overall glucose control."

A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?

A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 AM and 9:30 AM

A client is undergoing chemotherapy and is experiencing severe nausea. The nurse has administered ondansetron intravenously, with good results. What drug effect has this client experienced?

Blockage of receptors in the CTZ

What outcome would best indicate the nurse's teaching of a client newly diagnosed with diabetes was effective and that drug therapy is appropriate?

Blood glucose level is stable with no diabetic complications.

The nurse is caring for a 12-year-old child who has been hospitalized with depression, and the health care provider has elected to treat the child with a TCA. The nurse understands that what laboratory test will be routinely ordered by the provider?

Blood pressure, ECG, and plasma drug levels

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation

A client diagnosed with hypothyroidism admits knowing the term "thyroid gland" but not knowing its function. The nurse should explain the fact that thyroid hormone is responsible for which action?

Controlling the rate of cell metabolism throughout the body

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex

A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug?

Difficulty falling asleep at night

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug?

Dizziness

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

Guaifenesin

A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?

Perform a blood sugar analysis

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action?

Slows peristalsis by acting on the smooth muscles of the intestine

A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?

Smaller than the average prescribed dose

Which medications exert their effects by inhibiting reuptake of norepinephrine and serotonin?

Tricyclic antidepressants

Respiratory symptoms are treated with many types of drugs, including

anti-inflammatory agents.

The client reports using an over-the-counter (OTC) drug to treat insomnia. What classification of OTC medications is often used for this purpose?

antihistamines

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia

What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline?

orthostatic hypotension

When learning about thyroid hormones in pharmacology, the nursing students learn that when the thyroid gland is stimulated by thyroid-stimulating hormone (thyrotropin or TSH) from the anterior pituitary gland, thyroid hormones are:

released into the bloodstream

Before taking a flight across the country, a client with a history of motion sickness asks the health care provider for medication to control nausea. For which medication will the nurse anticipate providing teaching?

scopolamine

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to

stop taking the medication and come to the clinic as ordered by the health care provider

The nurse is providing education to a client who has been prescribed eszopiclone. What information should the nurse include?

the importance of taking the drug immediately before going to bed

The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to

high Fowler's position

A client, being evaluated for diabetes, asks how a blood glucose test is used to diagnosis this disease. What is the nurse's best response?

"A fasting blood sugar result of 126 mg/dL (6.99 mmol/L) or more on two separate occasions is diagnostic of diabetes."

A client has been taking amitriptyline for the treatment of depression for several months. The client has been experiencing significant anticholinergic effects and has now presented to the emergency department reporting recent nausea, vomiting, dizziness and malaise. What assessment question should the nurse prioritize?

"Are you still taking your medication consistently?"

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

The nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching?

"I should avoid beverages that contain caffeine."

A 59-year-old man with type 2 diabetes is prescribed metformin. When the client returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond?

"Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy.

A nurse is preparing to administer hydroxyzine to the nauseated client. Which is included in the teaching plan about the medication?

"This medication will help with the nausea by making you drowsy."

The nurse is preparing for discharge a client who has a prescription for sucralfate. When does the nurse instruct the client to take the medication?

1 hour before or 2 hours after meals and at bedtime

When would the nurse recommend that a traveler take an oral antiemetic to prevent motion sickness?

30 minutes prior to trip

A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period?

4 weeks

A nurse instructs a client taking an antidiarrheal agent to stop the drug and call the health care provider if the client does not experience relief within which time frame?

48 hours

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

The health care provider orders eszopiclone (Lunesta) for a male client as a treatment for intermittent insomnia. The client states that he feels the prescription works well as a sleep aid, but he is having difficulty with short-term memory loss. What is this client experiencing?

An adverse reaction

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response?

Antihistamines are not recommended for treating a cold

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

Asthma

A client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells?

Basophils

A client is admitted for assessment of inappropriately flamboyant and extroverted behavior coupled with risk-taking behaviors. The client reports having periods of major depression but has never sought help before. What mood disorder is most likely responsible for this client's behaviors?

Bipolar disorder type I

The nurse is preparing to administer a mixture of 12 units regular insulin and 45 units NPH insulin to a client with a blood sugar of 378 mg/dL. After the nurse draws the medication into the syringe, what is the nurse's next action?

Check the dosage with another nurse

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

Cigarette smoking

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

What is the priority nursing diagnosis for an 89-year-old client with frequent liquid stools?

Deficient fluid volume

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

Delayed growth and development

When teaching a patient on an MAO inhibitor, what would be important to include in the teaching?

Do not take OTC drugs.

A hospital client's current drug regimen includes antibiotics and proton pump inhibitors. When planning this client's care, the nurse should perform what action?

Ensure the client's meals are not spicy or highly acidic.

A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms?

Extreme tachycardia

Clients taking benzodiazepines, especially older adult clients, are at high risk for which effect?

Falls

The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2?

Fatal respiratory depression

A client has received a benzodiazepine for sedation before a diagnostic procedure. Which agent would the nurse expect the client to receive to reverse the sedative effects?

Flumazenil

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which intervention should the nurse perform if swallowing and gag reflexes are present in the patient?

Give oral fluids or candy

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

Glucagon

Which is the best indicator of overall diabetic control?

Glycosylated hemoglobin levels

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting?

Help the client rinse his mouth.

A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client?

Hip fractures

The nurse is assessing a client who has been receiving therapy with levothyroxine. What findings would suggest to the nurse that a client may be experiencing an adverse effect?

Hyperactivity and insomnia

A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively?

Increase fluid intake

The psychiatric nurse would recognize that venlafaxine's therapeutic effect is achieved by what means?

Increasing levels of both serotonin and norepinephrine

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid?

Increasing mass and water content of stool

The nurse is providing education to a client newly prescribed propylthiouracil. What information should the nurse provide about the drug's primary mode of action?

Inhibits production of thyroid hormone

A female client is prescribed metformin to decrease her blood glucose levels associated with diabetes mellitus type 2. Which statement accurately describes the action of metformin?

It decreases intestinal absorption of glucose and improves insulin sensitivity.

A client diagnosed with hyperthyroidism is unsure about the need for the prescribed propranolol, stating, "I looked this up online and it's for high blood pressure, not thyroid problems." What statement concerning beta-adrenergic blockers should the nurse use as a basis for the response?

It will block stimulation of the sympathetic nervous system.

The nurse is caring for a client with chronic obstructive pulmonary disease. The plan of care will focus on what client problem?

Lack of patent airway

The nurse admits a client with type 2 diabetes who takes metformin (Glucophage).The nursing diagnosis given is ineffective breathing pattern. What complication of the client's current drug therapy does the nurse believe the client is experiencing?

Lactic acidosis

A group of students are reviewing information about antidepressants that inhibit the activity of monoamine oxidase, leading to increase in epinephrine, norepinephrine, dopamine, and serotonin. The students demonstrate understanding when they identify which drug as acting in this manner?

Phenelzine

A client has refused a scheduled dose of metformin, stating that he/she is worried about inducing hypoglycemia because his/her blood glucose level is currently 66 mg/dL (3.66 mmol/L). The nurse should convey what teaching points to the client?

Metformin does not cause hypoglycemia.

A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?

Muscle twitching

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?

Nausea and vomiting

The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition?

Obesity

Medications are given post-operatively to prevent or treat severe nausea and vomiting associated with the surgery. What serotonin receptor antagonist would the nurse expect the surgeon to order?

Ondansetron

A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer?

Oral rehydration solutions

Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)?

PPIs suppress acid more strongly and for a longer time.

What is the most effective method used to monitor clients with asthma that they can use at home?

Peak-flow monitor

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is:

Polyethylene glycol-electrolyte solution (NuLYTELY)

A client with a diagnosis of asthma has been prescribed ipratropium 2 puffs QID. What is the most likely goal of this treatment?

Promoting long-term management of asthma symptoms

Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs?

Propylthiouracil

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

A client is to receive a tricyclic antidepressant. The nurse is reviewing the client's medical record. What would alert the nurse to a possible contraindication?

Recent myocardial infarction

The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?

Tachycardia

A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction?

Take an oral dose of some form of glucose as soon as possible.

Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status?

The adverse effects of benzodiazepines can persist for several days after stopping the drug.

A client diagnosed with type 2 diabetes several months ago has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance?

The client frequently checks blood glucose levels.

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?

The medications have fewer anticholinergic effects than alternatives.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?

They come into direct contact with nasal mucosa.

What is one of the benefits related to second generation antihistamine administration in older adults?

They do not impair thinking

A client reports nasal congestion, sneezing, watery drainage from the nose, and itching of the throat, eyes, and ears. The nurse recognizes that these are consistent with what disorder?

allergic rhinitis

The nurse is working in the medical station at a local amusement park. An adult is reporting dizziness and feelings of "seasickness" after going on several rides. This patient may benefit from:

an anticholinergic.

How does ondansetron achieve its therapeutic effect when prescribed for postoperative nausea?

antagonizes serotonin receptors

The nurse is providing health education for a client who has been prescribed a benzodiazepine. What adverse effect should the nurse discuss in the teaching?

dependence

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?

diphenhydramine

An older adult reports chronic abdominal pain and dark, tarry stools. The client has a history of chronic arthritis being treated with naproxen daily. What is the most likely cause of the presenting symptomology?

gastric ulcer

The nurse educator works at the diabetes clinic. When talking to a class of adolescent diabetics, the educator tells the students that the most recognized signs of diabetes are:

hyperglycemia and glycosuria.

A client who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by:

increasing the effects of the neurotransmitter GABA

A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed?

loperamide

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for

metabolic alkalosis.

A client exhibits severe tachycardia, fever, dehydration, and heart failure. The nurse recognizes that these signs are consistent with what thyroid-associated health condition?

thyroid storm

A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to:

try to identify and avoid factors that cause nervousness or insomnia.