NUR 3420- Pharmacology Exam 3-ATI Questions

A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include? A) "Avoid taking non-steroidal anti-inflammatory drugs." B) "Rinse your mouth after taking the medication to prevent a yeast infection C) "Stop taking the medication if you become nauseous" D) "Change position slowly when standing up."

A) "Avoid taking non-steroidal anti-inflammatory drugs."

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is and adverse effect of this drug? A) Headache B) Sleepiness C) Hypotension D) Constipation

A) Headache

For which of the following reasons should a client attach a spacer to a metered-dose inhaler? A) To increase the amount of drug delivered to the lungs B) To increase the amount of the drug delivered to the oropharynx C) To increase the amount of drug delivered on exhalation D) To increase the speed of drug delivery into the mouth

A) To increase the amount of drug delivered to the lungs

A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications? A) Uncontrolled bleeding B)Myocardial Infarction C) Respiratory Depression D) Decreased renal perfusion

A) Uncontrolled bleeding Rationale: Aspirin is a salicylate (anti-platelet) that irreversibly binds to and inhibits platelet activation. Because the lifespan of a platelet is 7-10 days, this is the average span of time needed after discontinuing anti-platelet therapy with aspirin before its effects are no longer present and the chance of an uncontrolled bleeding event is decreased.

A nurse is teaching a client who has a prescription for pramlintide therapy to treat type 1 diabetes mellitus. Which of the following instructions should the nurse include? A) Mix pramlintide with insulin in the syringe B) Administer pramlintide before meals C) Take pramlintide once daily at bedtime D) Inject pramlintide into the upper arm

B) Administer Pramlintide before meals Rationale: The nurse should instruct the client to inject pramlintide, an amylin mimetic, 20 min before any meal that contains at least 30 g of carbohydrates.

A nurse is administering epoetin intravenously to a client who has renal failure. Which of the following actions should the nurse take? A) Shake the vial before using B) Administer via bolus of 1 to 3 min C) Dilute the drug first with D5W D) Save the used vial for the next dose

B) Administer via IV bolus over 1 to 3 min Rationale: Instructions for administering the drug include administering it via IV bolus over 1 to 3 min.

A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply) A) Thyroid-stimulating hormone (TSH) B) Alainine aminotransferase (ALT) C) LDL D) CBC E) Creatinine Clearance

B) Alanine aminotransferase (ALT)- (Pioglitazone can cause liver injury. The nurse should monitor ALT at the start of therapy and then every 3 to 6 months thereafter. The nurse should tell the client to report jaundice, dark-colored urine, or abdominal pain.) C) LDL (Pioglitazone can cause elevations in both high-density lipoproteins, which is a beneficial effect, and LDLs, which is a detrimental effect. The nurse should monitor the client's plasma lipid levels at baseline and periodically throughout drug therapy)

A nurse should identify that clopidrogrel is contraindicated for clients who have which of the following conditions? A) Myocardial Infarction B) Peptic Ulcer Disease C) Pancreatitis D) Myasthenia Gravis

B) Peptic Ulcer Disease Rationale: Clients who have peptic ulcer disease should not take clopidogrel, because is can cause gastric bleeding.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? A) Reduced antitussive effects of dextromethorphan B) Potentiation of depression of CNS actions C) Increased renal reabsorption of the dextromethorphan D) Delayed analgesic effect of the opioid.

B) Potentiation of Depression of CNS actions

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? A) Suppresses the cough stimulus B) Reduces surface tension C) Reduces inflammation D) Dries mucous membranes

B) Reduces surface tension

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? A) Suppresses the cough stimulus B) Reduces Inflammation C) Thins and loosens mucus D) Dries secretions

C) Thins and loosens mucus

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following should the nurse expect to administer to the client? A) Ipratropium B) Beclomethasone C) Acetylcyteine D)Azelastine

C) Acetylcyteine

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? A) Start at a low dose and gradually increase it B) Take the drug as needed for nasal congestion C) Allow at least 2 weeks for the full therapeutic effect D) Use the drug prior to exercise

C) Allow at least 2 weeks for the full therapeutic effect

A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply). A) Blood amylase B) Creatinine Clearance C) Urine calcium D) Blood Glucose E) CBC

C) Urine Calcium ( Somatropin can cause hypercalciuria. The nurse should monitor the client's urine calcium and instruct the client to report flank pain, urinary frequency, or hematuria)

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings? A) joint pain B) Constipation C) Weight gain D) Dilated pupils

C) Weight gain Rationale: prioglitazone, a thiazolidinedione, can cause fluid retention. The nurse should monitor the client for weight gain and other indications of fluid retention or heart failure, including dyspnea, crackles, and wheezing.

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following adverse effect of this drug? A) Fever B) Bruising C) Polyuria D) Palpaitations

D) Palpaitations

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? A) Peptic Ulcer Disease B) A seizure disorder C) Anemia D) Coronary artery disease

D) Coronary Artery Disease

A nurse is caring for a client who is taking ferrous sulfate to treat iron-deficieny anemia and develops iron toxicity. Which of the following drugs should the nurse expect to use to treat this complication? A) Flumazenil B) Acetylycysteine C) Naloxone D) Deferoxamine

D) Deferoxamine Rationale: Indications of iron toxicity include nausea, vomiting, and diarrhea. iron toxicity can lead to acidosis and shock. A chelating agency, such as deferoxamine, binds to the iron to reduce toxicity.

A nurse us asessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug? A) Bacterial skin infections B) Diabetes Insipidus C) Immunosuppression D) Recent Myocardial Infarction

D) Recent myocardial infarction Rationale: Levothyroxine, a thyroid replacement hormone, can cause tachycardia, palpitations, and hypertension, especially when the client requires a dosage adjustment. Therefore, it is a contraindication for clients who have recently had a myocardial infarction.

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? A) Increases leukocyte activity B) Blocks muscarinic receptors C) Causes bronchodilation D) Reduces Inflammation

D) Reduces Inflammation

A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has a type 2 diabetes mellitus and who also has which of the following? A) Thyroid Disease B) Bronchitis C) Heart Failure D) Renal Impairment

D) Renal Impairment Rationale: Sitagliptin, a gliptin, requires cautious use with clients who have renal dysfunction and low creatinine and clearance because the kidneys eliminate the drug virtually intact. The provider should prescribe a lower dose for this client or prescribe a different hypoglycemic drug

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? A) Use a spacer to improve inhalation B) Take the drug at the onset of bronchospasm C) Rinse mouth to prevent an oral fungal infection D) Take the drug once a day in the evening

D) Take the drug once a day in the evening

A nurse is caring for a client who is taking clopidrogrel to prevent stent restenosis. The nurse should monitor the client for which of the following adverse reactions? A) Hperuricemia B) Hyponatremia C) Lymphocytopenia D) Thrombocytopenia

D) Thrombocytopenia Rationale: Clopidogrel, an anti-platelet drug can cause thrombotic thrombocytopenia purpura. The nurse should monitor the clients platelet count and also monitor for bruising, bleeding gums, and petechiae

A nurse should assess a client who has megaloblastic anemia for indications of which of the following vitamin deficiencies? A) Vitamin C B) Vitamin K C) Vitamin B12 D) Vitamin D

D) Vitamin B12 Rationale: Clients who have megaloblastic anemia have a deficiency of vitamin B12, folic acid, or both. Cyanocobalamin (vitamin B12) treats moderate vitamin B12, deficiencies. Clients who has a severe B12 deficiency should take cyanocoblamin and folic acid

A nurse in an emergency department is assessing a client who has been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer to the client? A) Filgastrim B) Deferoxamine C) Protamine D) Vitamin K

D) Vitamin K Rationale: Vitamin K reverses the effects of warfarin by promoting the synthesis of coagulation factors VI, IX, X, and prothrombin

A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take? A) Drink 16 oz of water B) Perform a fingerstick blood glucose check C) Take another glipizide tablet D) Lie down an d rest

Glipizide, a sulfonylurea, can cause hypoglycemia, which can cause manifest as diaphoresis, shakiness, hunger, and fatigue. The nurse should tell the client to check their blood glucose and, if it indicates hypoglycemia, to consume a snack of 15 to 20 g (0.5 to 0.7 oz) of carbohydrates, retest in 15 to 20 min, and repeat if their blood glucose level is still low.

A nurse administers pramlintide at 0800 to a client who has type 1 diabetes mellitus. At which of the following times should the nurse expect the drug to exert its peak action? A) 0820 B) 0900 C) 1030 D) 1100

A) 0820 Rationale: Pramlintide, an amylin mimetic, peaks 20 min after administration. The nurse should monitor the client for indications of hypoglycemia, such as diaphoresis and tremors.

A nurse is caring a client who has hemophilia A and is about to being taking desmopressin to prevent bleeding. The nurse should monitor for the client for which fo the following adverse reactions? A) Weight Loss B) Edema C) Polyuria D) Bradycardia

A) Edema Rationale: Desmopressin, an antidiuretic hormone, can cause fluid retention and edema. The nurse should monitor fluid intake and output for clients receiving this drug.

Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? A) Respiratory Depression B) Drug Abuse C) Drug tolerance D) Rebound Congestion

B) Drug Abuse

A nurse is caring for a client who is recently started alteplase therapy. The nurse should monitor the client for which of the following adverse effects? A) Bronchodilation B) Headache C) Edema E) Hypertension

B) Headache Rationale: Ateplase, a thrombolytic drug, can cause intracranial bleeding. The nurse should monitor the client for changes in level of consciousness, headache, one-sided weakness, and other indications of intracranial bleeding.

A nurse is a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness? A) Peripheral pulses B) Urine Output C) Skin Integrity D) Blood Glucose

B) Urine Output Rationale: Desmopressin, an antidiuretic hormone, treats diabetes insipidus. The nurse should monitor the client's fluid intake and urine output along with urine and serum osmolality and blood pressure.

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? A) Do not drink anything for 30 min after using the drug B) Wait 5 min between using the drug and another inhaled drug C) This drug is used to thin respiratory secretions D) Check pulse rate after inhaling the drug

B) Wait 5 minutes between using the drug and another inhaled drug

A nurse is caring for a client who is takin metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contract dye increases the client's risk for which of the following conditions? A) Hypokalemia B) Hyperglycemia C) Acute renal failure D) Acute pancreatitis

C) Acute renal failure Rationale: Metformin, a biguaniide, can interact with iodine-containing contrast dye and cause acute renal failure and lactic acidosis. The nurse should withhold metformin for 48 hr prior to and following the procedure. The nurse should also monitor the client for indications of acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation, an abdominal pain.

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? A) Take the drug as needed for acute asthma B) Follow a low-sodium diet C) Use an alternate-day dosing schedule D) Increase weight-bearing activity

D) Increase weight-bearing activity

A nurse is caring for a client who is about to begin factor VIII therapy to treat hemophilia A. When administering factor VIIII, which of the following actions should the nurse take? A) Administer the powdered form orally B) Premedicate with aspirin C) Administer it via rapid IV bolus D) Have emergency equipment ready

D) Have emergency equipment ready Rationale: Factor VIII can cause hypersensitive reaction and anaphylaxis. The nurse should monitor the client for hives, fever, wheezing, and difficulty breathing and have emergency equipment and drugs readily available.

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? A) Check apical pulse before taking the drug B)Take the drug only as needed before exercising C) Rinse mouth after using the drug D) Have laboratory tests performed at regular intervals

D) Have laboratory tests performed at regular intervals.

A nurse is caring for a client who is about to begin taking aspirin to recuse the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? A) Activating thromboxane A2 B) Blocking adenosine diphosphate receptor agonists C) Suppressing specific clotting factors D) Inhibiting cyclooxygenase action in platelets

D) Inhibiting cyclooxygenase action in platelets Rationale: Salicylates, such as aspirin, work by inhibiting platelet aggregation. They do this by blocking the action of cyclooxygenase on platelets. As a result, activation of thromboxane A2, does not occur.

A nurse is educating the parents of a child who has a new diagnosis of Prader-Willi Syndrome (PWS) and has been prescribed somatropin. Which of the following statements by a parents indicates understanding of the teaching? A) "We will use a different spot for injection each time we give the medication" B) "We'll give the shot in the thigh muscle rather than fatty tissue to decrease injection pain" C) "We'll watch our child for signs of low blood sugar while using somatropin" D) "We should stop the medication if our child loses weight"

A) "We will use a different spot for injection each time we give the medication" Rationale: To avoid atrophy of the tissue, administration of somatropin includes rotating the injection site each time. The nurse should identify this statement as an understanding of somatropin administration.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? A) Albuterol will increase the absorption of fluticasone B) Albuterol will decrease inflammation C) Albuterol will reduce nasal secretions D) Fluticasone will reduce the adverse effects of albuterol

A) Albuterol will increase the absorption of fluticasone

A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer? A) Ateplase B) Aspirin C) Clopidogrel D) Heparin

A) Ateplase Rationale: Ateplase is a thrombolytic drug, meaning it can dissolve existing thrombi, whereas anticoagulant/anti-platelet drugs do not. An acute ischemic cerebrovascular event is often caused by the occlusion of a cerebral vessel by a thrombus. Administration of alteplase should be within 3 hr of the original onset of symptoms for the drug to be effecitve.

A nurse is monitoring a client who is undergoing therapy with heparin. Which of the following findings should the nurse identify as a possible indication of hemorrhage? A) Rapid Pulse B)Yellowing of the sclera C) Elevated blood pressure D) Pale-Colored stools

A) Rapid Pulse Rationale: In the event of a moderate to severe hemorrhage, the volume of blood in the circulatory system decreases significantly, resulting in hypotension. Tachycardia is a compensatory mechanism of the heart that serves to combat the hypotension that results from the decreased volume of blood. Tachycardia can be detected by checking the client's pulse.

A nurse is teaching a client about the adverse effects of pseudophedrine. Which of the following should the nurse include? (Select all that apply) A) Restlessness B) Bradycardia C) Insomnia D) Muscle Pain E) Anxiety

A) Restlessness C) Insomnia E) Anxiety

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? A) Seizures B) Constipation C) Normal Sinus rhythm D) Somnolence

A) Seizures

When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs? A) Somatropin B) Hydrocortisone C) Glucagon D) Desmopressin

B) Hydrocortisone Rationale: Hydrocortisone, 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 propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug? A) Thyrotoxicosis B) Hypothyroidism C) Lactic acidosis D) Radiation sickness

B) Hypothyroidism Rationale: Propylthiouracil, an antithyroid drug, can cause hypothyroidism, which manifests as drowsiness, depression, weight gain, edema, and bradycardia. The nurse should request that the provider prescribe a lower dosage of the drug for the client.

A nurse is caring for a client who is about to begin taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness? A) Amylase level B) Reticulocyte Count C) C-reactive protein D) Creatinine Clearance

B) Reticulocyte County Rationale: A reticulocyte count measures the amount of immature RBCs, Folic Acid, also called folate, is essential for erythropoiesis. Clients who have a folic acid deficiency require a baseline reticulocyte count, as well as a serum folate, Hgb, Hct, and RBC county and periodic monitoring during folic acid therapy to determine effectiveness.

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects (Select All that apply) A) Muscle Tremors B) Urinary Retention C) Dry Mouth D) Insomnia E) Tachycardia

B) Urinary Retention C) Dry Mouth

A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs? A) Oral Contraceptives B) Calcium Supplements C) Beta Blockers D) Iron Supplements

C) Beta Blockers Rationale: Clients who take both insulin and beta blockers are at risk for falling to promptly recognize the symptoms of hypoglycemia because beta blockers mask symptoms such as tachycardia and tremors. Beta Blockers also increase hypoglycemic effects.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? A) Thins mucus B) Relaxes bronchial smooth muscle C) Decreases inflammation D) Increases the cough threshold

C) Decreases Inflammation

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective? A) PT B) WBC C) HgB D) Platelets

C) HgB Rationale: Epoetin, an erythropoietic growth factor, increases the production of RBCs for clients who have anemia due to chronic renal failure or chemotherapy. HgB and Hct should increase with effective therapy.

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? A) Decrease viscosity of nasal secretions B) Block H2 Receptors C) Prevent Histamine from binding to receptors D) Reduce nasal congestion

C) Prevention Histamine from binding to receptors

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is a priority to make? A) Blood Pressure B) Apical Heart Rate C) Respirations D) Level of consciousness

C) Respirations

A nurse is caring for a client who takes repaglinide 15-20 min before each meal to treat type 2 diabetes mellitus. The client asks, "if I skip a meal, what should I do?" Which of the following responses should the nurse make? A) Double the dose before the next meal. B) Take half the dose C) Skip the dose D) Take the usual dose

C) Skip the dose Rationale: to avoid a sudden and serious drop in blood glucose level, the client should skip the dose of rapglinide, a meglitinide, whenever skipping a meal. The nurse should also instruct the client to try to avoid skipping meals.

A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase? A) Protamine B) Desmopressin C) Ferrous Sulfate D) Heparin

D) Heparin Rationale: Heparin therapy should be initiated before alteplase therapy and continued for at least 48 to 72 hr after the fibrinolytic therapy to reduce the risk of additional clot formation

A nurse is caring for a client who is about to begin alteplase therapy to treat pulmonary embolism. Which of the following drugs should the nurse have available in the event of a severe adverse reaction? A)Vitamin K B) Aminocraproic acid C) Protamine D) Deferoxamine

B) Aminocaproic acid Rationale: Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops excessive fibrinolytic bleeding, a severe adverse effect of alteplase

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? A) Muscle Tremors B) Drowsiness C) Excitation D) Insomnia

B) Drowsiness

A nurse is teaching a client about self-administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following? A) Rapid Absorption B) Intradermal Injection C) Injection Pain D) Lipohypertrophy

D) Lipohypertrophy Rationale: Lipohyertrophy 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 2.5 cm (1 in.) apart, and avoid using the same spot within the same month

A nurse is teaching a client who has a prescription to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? A) Avoid drinking alcohol B) Sit or stand for 30 min after taking the drug C) Urinate every 4 hr. D) Take the drug 2 hr after a meal.

A) Avoid drinking alcohol Rationale: The nurse should instruct the client to avoid drinking alcohol. Alcohol also increases the drug's hypoglycemic effects.

A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130 mEQ.L. Which of the following action should the nurse take? A) Clarify the prescription with the provider B) Administer the drug with an analgesic C)Administer the required dose orally D) Assess factor IX levels

A) Clarify the prescription with the provider Rationale: Hyponatremia and fluid retention can occur with the administration of desmopressin, an antidiuretic hormone used in the the treatment of hemophilia A. The client's sodium level is below the expected range of 136 to 145 mEq/L. The nurse should notify the provider of the client's current sodium level and clarify the prescription prior to administration.

A nurse is caring for a client who has chronic stable angina. The nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the client's risk for myocardial infarction A) Clopidogrel B) Heparin C) Warfarin D) Alteplase

A) Clopidogrel Rationale: Clopidogrel is an anti-platelet medication that blocks the ADP receptors on platelets, preventing platelet aggregation. This effects is irreversible and lasts the lifespan of the platelets (7-10 days).

A nurse is teaching a client about ferrous sulfate to treat deficiency anemia. Which of the following instructions should the nurse include? A) Eat iron-enriched foods B) Spread the dosage across each day C) Take the drug on an empty stomach D) Report dark green or black stools. E) Increase dietary fiber intake

A) Eat iron-enriched foods Rationale: A client who has iron-deficiency anemia should increase iron intake by eating foods such as egg yolks, wheat germ, meat, and fish. B) Spread the dosage across each day Rationale: Spreading out the iron intake throughout the client's waking hours allows the bone marrow to maximize the production of RBCs C) Take the drug on a empty stomach Rationale: Food reduces the absorption of ferrous sulfate. The client should take the drug on an empty stomach to increase drug absorption. If GI effects are troublesome, they can take the drug with food. D) Increase dietary fiber intake is correct Rationale Ferrous sulfate can causes constipation. The client should increase fiber and fluid intake na exercise more often or more intensely

A nurse is teaching a client about acarbose therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? A) Eat more iron-rich foods B) Avoid drinking grapefruit juice C) Increase fiber intake D) Avoid drinking green tea.

A) Eat more iron-rich foods Rationale: Acarbose, an alpha-glucosidase inhibitor, can cause iron deficiency anemia. The nurse should instruct the client to increase their intake of iron-rich foods, such as red meat, spinach, and grains. The nurse should also monitor the client's CBC.

A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following adverse effects? A) Hypertension B) Muscle Pain C) Edema D) Dry Mouth

A) Hypertension Rationale: Epoetin an erythropoietic growth factor, can cause hypertension. The nurse should monitor the client's BP before and during therapy and inform the provider if it increases.

A nurse at a provider's office is assessing a client who has been taking hydrocortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the client's dosage? A) Hypotension B) Hyperglycemia C) Weight Gain D) Fat redistribution

A) Hypotension Rationale: Hypotension and fatigue are findings of adrenal insufficiency. During times of stress, the client might need a dosage increase to prevent adrenal insufficiency. The nurse should report the findings to the provider.

A nurse is providing teaching to a client who is about to begin exenatide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? (Select All that apply) A) Inject the drug subcutaneously B) Expect the peak effect in 2 hr C) Use the drug as a supplement to oral hypoglycemic D) Inject the drug 1 hr after the meal E) Discard used pens 10 days after the first use.

A) Inject the drug subcutaneously (The client should inject exenatide, an incretin mimetic, into the subcutaneous tissue of the thigh, upper arm, or abdomen) B) Expect the peak effect in 2 hr. (Levels of exenatide peak 2 hr after administration and then decrease gradually, with a half-life of 2.4 hr.) C) Use the drug as a supplement to an oral hypoglycemic (Exenatide supplements the action of an oral hypoglycemic, such as a sulfonylurea or metformin.)

A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect? A) lactic acidosis B) Anticholinergic effects C) Extrapyramidal effects D) Hypophosphatemia

A) Lactic Acidosis Rationale: Metformin, a biguanide , can cause lactic acidosis, which is a life-threatening complication that manifests as muscle aches, sleepiness, malaise, and hyperventilation. the client should top taking the drug and seek medical care immediately

A nurse is providing teaching to a client about taking fludrocortisone to treat adrenocortical insufficiency. Which of the following instructions should the nurse include? (Select All that apply) A) Obtain weight measurement daily B) Report weakness or palpitations C) Have blood pressure checked regularly D) Eat more iron-rich foods. E) Avoid drinking grapefruit juice

A) Obtain weight measurement daily (Fludrocortisone, a mineralocorticoid, can cause fluid and electrolyte imbalances, such as hypernatremia. Tracking weight on a daily basis can help identify weight gain and edema; reporting it can expedite any essential interventions) B) Report weakness or palpitations (Fludrocortisone can cause hypokalemia. The nurse should monitor the client's potassium levels and tell the client to report muscle weakness or palpitations) C) Have 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)

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? A) Over-the-counter cold products can also contain guaifenesin B) Blood Glucose levels are increased C) Rebound congestion is likely D) Drug tolerance is likely

A) Over-the-counter cold products can also contain guaifenesin

A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to report which of the following adverse effects effects?n (select all that apply) A) Sore throat B) Joint Pain C) Insomnia D) Bradycardia E)Rash

A) Sore throat (Proylthiouracil, an anthithyriod drug, can cause agranulocytosis. The nurse should monitor the client's CDC and instruct the client to report fever or sore throat) B) Joint pain (Propylthiouracil can cause arthralgia and myalgia. The nurse should instruct the client to report these effects and take over-the-counter anaglesics for pain relief.) D) Bradycardia (Propylthiouracil can cause hypothroidism, which manifests as bradycardia, drowsiness, and weight gain. The nurse should instruct the client to report these effects.) E) Rash (Proplythiouracil can cause urticaria or a skin rash. The nurse should instruct the client to report these effects)

A nurse is monitoring a client following ferrous sulfate administration. The nurse should monitor the client for which of the following adverse effects? A) Phlebitis B) Dark, orange-colored stools C) Constipation D) Injection Site pain

C) Constipation Rationale: Oral iron supplementation is associated with constipation. The nurse should encourage the client to consume adequate amounts of fiber and fluids in their diet to minimize this effect.

A nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma-derived factor IX. The nurse should explain that recombinant factor IX partial eliminants the risk for which of the following? A) HIV B) Cytomegalovirus C) Creutzfeldt-jakob disease D) Anaphylaxis

C) Creutzfeldt-jakob disease Rationale: Recombinant factor IX is safer than the plasma-derived formulation because it practically eliminates the risk for Creutzdelft-Jakob disease, a transmitted infection, from human sources.

A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects? A) Dusky Nail Beds B) Petechiae C) Enlarged spleen D) Swollen Calf

C) Enlarged Spleen Rationale: with long-tern use filgrastim, a leukopoietic growth factor, can cause an enlarged spleen, The nurse should tell the client to monitor and report abdominal pain or fullness

A nurse is providing teaching to a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the nurse A) Take levothyroxine with food to increase absorption B) Take levothyroxine with an antacid to reduce gastrointestinal effects C) Expect life-long therapy with the drug D) Carry a carbohydrate snack at all times

C) Expect a life-long therapy with the drug Rationale: Therapy with levothyroxine, a thyroid replacement hormone, usually continues for life because there are no other therapies that can restore thyroid function

A nurse is teaching a client who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug? A) Sleep modifications B) Fluid modifications C) Driving Modifications D) Dietary Modifications

D) Dietary Modifications Rationale: Warfarin is an anticoagulant drug that functions by inhibiting the action of vitamin K. Mange foods, such as green, leafy vegetables are rich in vitamin K. The client should maintain a consistent intake of vitamin K to avoid excesses or deficits and ensures the therapeutic effects of warfarin are consistent.

Which of the following drugs should a nurse have available for a client who is experiencing insulin toxicity? A) Naloxone B) Diphenhydramine C) Acetylcyteine D) Glucagon

D) Glucagon Rationale: Glucagon, a hyperglycemic that can be given subcutaneously, IM or IV, is used to treat severe hypoglycemia from insulin toxicity in clients who are unconscious and for whom IV glucose is not readily available. If the client does not respond to glucagon, the nurse should administer a glucose solution IV.