Nursing pharmacology test 1
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 Many combination over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, some of which the client might not have. All drugs have potential adverse effects, so the client should use only those drugs required to treat existing symptoms and only in the recommended amounts.
A nurse is reviewing a client's prescriptions prior to administering gentamicin to the client to treat a systemic infection. The nurse should clarify the use of gentamicin with the provider if the client is taking which of the following drugs? A. Ethacrynic acid B. Diphenhydramine C. Acetaminophen D. Levothyroxine
a Ethacrynic acid Concurrent use increases the client's risk for hearing loss. Others: - Amphotericin B (antifungal) increases risk for nephrotoxicity. - NSAIDs (ex: ibuprofen) inc risk of nephrotoxicity. - Vancomycin (antimicrobial) increases risk of ototoxicity. Drugs that do not specifically interact w/gentamicin: - Diphenhydramine - Acetaminophen - Levothyroxine
A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply.) A. Clients can achieve desired effects with the use of lower dosages. B. Taking the two drugs together can reduce the effects of one or both drugs. C. Taking the two drugs together can potentiate the effects of one or both drugs. D. The two drugs can produce an action neither would have produced alone. E. Both drugs have similar actions.
a, e
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 Rationale: Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.
A nurse in a provider's office receives a call from a client who was recently hospitalized and treated with imipenem IV for a bacterial infection and reports an inability to eat due to mouth pain. The nurse should identify that the client might be experiencing which of the following as an adverse effect of this drug? A. Malabsorption B. Superinfection C. Anorexia D. Dental caries
b superinfection Rationale: Imipenem, a carbapenem, can cause the superinfection Candida albicans in the mouth, throat, or vagina. It can also cause glossitis, an inflammation or infection of the tongue. Clients taking the drug should report any mouth pain or vaginal discharge and itching because they might require treatment with an antifungal drug. - Unlikely to cause malabsorption, but can cause gastroenteritis, abdominal pain, and vomiting; unlikely to cause anorexia or dental caries.
A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? A. Liquid suspension B. Immediate-release capsule C. Extended-release tablet D. Powder form
c
A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? A. After the client has a definitive diagnosis B. On the day of discharge C. When the client's family members are present D. As soon as possible
d
A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following? A. Reduced drug absorption B. Drug dependence C. Altered drug distribution D. Drug toxicity
d
A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply.) A. Restlessness B. Bradycardia C. Insomnia D. Muscle pain E. Anxiety
a, c, e
A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? A. Tolerance to the drug B. Drug interaction C. Drug toxicity D. Dependence on the drug
c
A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? A. Fever B. Bruising C. Polyuria D. Palpitations
d rationale Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.
A nurse is caring for a client who is about to begin taking nitrofurantoin to treat a urinary tract infection. The nurse should tell the client to report which of the following adverse effects of the drug? A. Constipation B. Dark brown urine C. Cough D. Tremors
c Rationale: Nitrofurantoin, a urinary tract antiseptic, can cause cough, shortness of breath, chest pain, and fever. These adverse effects can indicate an acute allergic reaction and require immediate discontinuation of drug therapy.- Can also cause diarrhea and peripheral neuropathy.- Dark colored urine is harmless effect.
A nurse is caring for a client whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). The nurse should recognize that which of the following medications will likely be administered to this client? A. Trimethoprim/sulfamethoxazole B. Tetracycline C. Cephalexin D. Vancomycin
d vancomycin
A nurse is caring for a client who has a prescription for rifampin to treat tuberculosis. The nurse should expect the provider to prescribe which of the following drugs to the client to prevent possible resistance to rifampin? A. Gentamicin B. Vancomycin C. Isoniazid D. Metronidazole
c Rationale: Isoniazid is used to treat tuberculosis and reduces the possibility of resistance to rifampin when combined with the drug. Drug resistance can develop quickly if the client only takes rifampin.- Gentamicin, vancomycin, and metronidazole are not used to treat TB.
A nurse is caring for a client who is about to begin taking itraconazole to treat a fungal infection. The nurse should instruct the client to report which of the following adverse effects of the drug? A. Tingling in the hands and feet B. Joint pain C. Swelling of hands or feet D. Excessive sweating
c Rationale: Itraconazole, an azole antifungal drug, can cause edema, which can also indicate heart dysfunction, and should be monitored closely. It can also cause a temporary decrease in sexual hormone synthesis, resulting in gynecomastia, reduced libido, low sperm counts, and menstrual irregularities. + skin rashes, photosensitivity, dry mouth, headaches, tingling in hands and feet.
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 rationale Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.
A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? A. Ipratropium B. Beclomethasone C. Acetylcysteine D. Azelastine
c Acetylcysteine
A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A. Adverse effect B. Paradoxical effect C. Therapeutic effect D. Toxicity
a
A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? A. Therapeutic effect B. Adverse reaction C. Contraindication D. Precaution
a
A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A. Pharmacologic action B. Chemical stability C. Route D. Adverse effects
a
A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? A. They have similar mechanisms of actions. B. They have the same half-life. C. They are administered by the same route. D. They have similar availability.
a
A nurse is caring for a client who is taking warfarin and has a new prescription for trimethoprim/sulfamethoxazole to treat a urinary tract infection. The nurse should clarify the prescriptions with the provider because taking these two drugs concurrently can increase the client's risk for which of the following? A. Bleeding B. Thrombosis C. ECG changes D. Ototoxicity
a bleeding Rationale: Trimethoprim/sulfamethoxazole, a sulfonamide combination, can increase the effects of warfarin and increase the client's risk for bleeding. The nurse should request another prescription to treat the infection, or, if the client decides to take the drug, ask the provider to prescribe a lower warfarin dose and monitor prothrombin time carefully. The client should report any sign of bleeding, such as easy or unexplained bruising. Other options and rationales: - Thrombosis: rifampin decreases warfarin levels and inc risk of thrombosis - ECG changes: erythromycin - Ototoxicity: erythromycin+ gentamicin
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 theophylline rationale Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.
A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? A. Adverse effects B. Contraindications C. Implementation D. Black box warning
b
A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? A. Adverse effects B. Indications C. Pharmacokinetics D. Nursing implications
b
A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? A. To determine drug-food interactions B. To determine if dosage modification is indicated C. To determine how the drug is absorbed D. To determine availability
b
A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? A. Contraindications B. Precautions C. Paradoxical effects D. Adverse effects
b
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 Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.
A nurse in a provider's office receives a call from a client who is taking tetracycline orally to treat a chlamydia infection and reports severe blood-tinged diarrhea. The nurse should suspect the client is experiencing which of the following? A. Hemorrhoids B. Clostridium difficile-associated diarrhea C. Diverticular disease D. Small bowel obstruction
b Rationale: Severe diarrhea, often containing mucus and blood, can indicate Clostridium difficile-associated diarrhea. Treatment includes stopping drug therapy and replacing fluids and electrolytes. Clients should immediately report severe diarrhea and blood in the stools.
hen reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways? A. It begins with a lower-case letter. B. It is listed in parentheses along with the trade name. C. There are both letters and numbers in the name. D. The chemical name is listed in parentheses before the generic name.
a
A nurse in a provider's office receives a call from a client who has been taking penicillin V three times daily and reports abdominal cramping with bloody diarrhea for several days. Which of the following instructions should the nurse give the client? A. "Bring in a stool sample for testing." B. "Take the drug only twice daily." C. "Use an over-the-counter anti-diarrheal medication." D. "Return to the clinic for blood work."
a - The nurse cannot make changes to client's prescription, the client should not self-treat diarrhea, and blood work is not indicated for these symptoms.
A nurse is caring for a client who is about to begin taking metronidazole to treat an anaerobic intra-abdominal bacterial infection. The nurse should recognize that cautious use of the drug is indicated if the client also has which of the following conditions? Seizure disorder Hearing loss Asthma Anemia
a Rationale: Metronidazole, an antiparasitic drug, can cause ataxia, vertigo, and seizures. It requires cautious use with clients who have a history of seizure activity, liver or renal failure, or heart failure.- Hearing loss: vancomycin- Asthma: amoxicillin- Anemia: Amphotericin B
A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler 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 rationale Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.
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 nonsteroidal 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 rationale Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone.
A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (Select all that apply.) A. Low blood pressure B. Wheezing C. Bradycardia D. Peripheral edema C. Difficulty swallowing
a, b, e
A nurse is preparing to administer amphotericin B IV to a client who has a systemic fungal infection. Which of the following drugs should the nurse prepare to administer prior to the infusion to prevent or minimize adverse reactions? (Select all that apply.) A. Aspirin B. Hydrocortisone C. Acetaminophen D. Diphenhydramine E. Ibuprofen
c, d Rationale: Infusion reactions to amphotericin B IV, such as fever, chills, nausea, and headache, start 1 to 2 hr after the infusion begins and subside within 4 hr. The nurse can help prevent these effects by administering acetaminophen prior to the infusion. The nurse can help prevent adverse reactions by administering diphenhydramine prior to the infusion.- Aspirin inc risk of renal injury.- Hydrocortisone decreases client's resistance to infection.- Ibuprofen inc risk of renal injury.
A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? A. Maternal bleeding B. Maternal blood clots C. Gestational diabetes mellitus D. Fetal malformation
d
A nurse is caring for a client who has a gynecologic infection and a history of alcohol use disorder. The nurse should identify that which of the following drugs can cause a reaction similar to disulfiram if the client drinks alcohol while taking it? (Select all that apply.) A. Nitrofurantoin B. Amoxicillin C. Aztreonam D. Cefotetan E. Metronidazole
d, e Cefotetan + Metronidazole Rationale: Cefotetan, a second-generation cephalosporin, can cause a reaction similar to what disulfiram causes when clients consume alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension. Metronidazole, an antiparasitic drug, can cause a reaction similar to what disulfiram causes when clients consume alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension. Does not: - Nitrofurantoin (urinary tract antiseptic) can cause diarrhea, N/V. - Amoxicillin (penicillin) can cause diarrhea, N/V. - Aztreonam (a monobactum) can cause a superinfection with Candida albicans
A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A. "This will increase the effects of normal cellular functions." B. "This prevents cells in your body from performing certain actions." C. "This prevents hormones in your body from attaching to cell receptor sites." D. "This minimizes the risk that the medications you take will become toxic."
a
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 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
A nurse in a provider's office receives a call from a client who is taking ciprofloxacin to treat a respiratory tract infection and reports dyspepsia. Which of the following instructions should the nurse give the client? A. Take an antacid at least 2 hr after taking the drug. B. Take the drug with a cup of coffee. C. Take an iron supplement with the drug. D. Take the drug with 240 mL (8 oz) of milk.
a Rationale: The nurse should recommend that the client take an antacid to relieve the dyspepsia at least 2 hr after taking ciprofloxacin, a fluoroquinolone. This is because antacids decrease the absorption of the drug. - Avoid caffeine b/c it can increase CNS effects. - Avoid taking supplemental iron b/c iron dec absorption of drug. - Avoid taking drug w/milk or other dairy products b/c calcium decreases absorption.
A nurse is preparing to administer phenylephrine to a client. The nurse should identify that that which of the following manifestations is an adverse effect of this drug? A. Headache B. Sleepiness C. Hypotension D. Constipation
a rationale Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.
A nurse is caring for a client who is about to begin taking isoniazid to treat tuberculosis. The nurse should instruct the client to report which of the following adverse effects of the drug? (Select all that apply.) A. Jaundice B. Numbness of the hands C. Dizziness D. Hearing loss E. Oral ulcers
a, b, c Rationale: Isoniazid, an antimycobacterial drug, can cause liver toxicity, especially in clients who abuse alcohol. The nurse should monitor liver enzymes during therapy and instruct the client to report indications of liver damage, such as jaundice, abdominal pain, and fatigue. The nurse should instruct the client to report numbness, pain, or tingling in the hands or feet. Administering pyridoxine (vitamin B6) can help minimize these effects. Isoniazid can cause dizziness, ataxia, and seizures. The nurse should instruct the client to report these CNS effects. - Also: visual disturbances and dry mouth.
A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all that apply.) A. They do not require the supervision of a nurse. B. They can interact with other drugs. C. They should be included in the client's drug history assessment. D. They are less effective than prescription drugs. E. They do not cause toxicity.
a, b, c,
A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (Select all that apply.) A. The newborn's weight B. How much breast milk the newborn consumes each day C. Whether or not the benefits to the client outweigh the risks to the newborn D. The properties of the drug E. The route of administration of the drug
a, b, c, d
A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (Select all that apply.) A. Impaired cognitive level B. Language barrier C. Discomfort D. Repetition of teaching E. Unreadiness to learn
a, b, c, e
A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (Select all that apply.) A. Periodic laboratory tests are essential to measure serum drug levels. B. Monitoring for indications of toxicity is important. C. Taking the drug with an inducing agent will increase the possibility of toxicity. D. Taking the smallest effective dose is crucial. E. Increasing fluid intake is recommended to avoid toxicity.
a, b, d
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 rationale Because it is possible to alter pseudoephedrine and epinephrine into methamphetamine, a commonly abused drug, the law restricts the drugs' purchase.
A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? A. Reduced antitussive effect of dextromethorphan B. Potentiation of depression of CNS actions C. Increased renal reabsorption of the dextromethorphan D. Delayed analgesic effect of the opioid
b rationale Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.
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 rationle diphenhydramine is a first gen antihistiamine
A nurse is caring for a client who is about to begin receiving acyclovir IV to treat a viral infection. The nurse should recognize that cautious use of the drug is essential if the client also has which of the following conditions? A. Heart failure B. Dehydration C. Asthma D. Tinnitus
b Rationale: Acyclovir, an antiviral drug, can cause renal toxicity, especially in clients who are dehydrated. Hydration during and after IV infusion of the drug can help prevent crystalluria. Drugs to use cautiously for other options: - HF: metronidazole (antiparasitic) - Asthma: amoxicillin - Tinnitus: vancomycin (antimicrobial)
A nurse is caring for a client who has a new diagnosis of bacterial meningitis. The nurse should expect the provider to prescribe a drug from which of the following classifications of antibiotics? A. First generation cephalosporins B. Third generation cephalosporins C. Monobactams D. Macrolides
b Rationale: Later generation cephalosporins are used to treat infections that cross the blood-brain barrier, and third-generation are specifically prescribed to treat bacterial meningitis.- First gen: treat infections of skin, bone, and joints.- Monobactams: used to treat infections of abdomen, respiratory system, female reproductive tract.- Macrolides: treat severe infections, such as whooping cough, diphtheria, and chlamydia.
A nurse is caring for a client who has streptococcal pharyngitis and an allergy to penicillin. The nurse should recognize that which of the following drugs can be safely administered to this client? A. Nafcillin B. Azithromycin C. Cephalexin D. Amoxicillin/clavulanic acid
b azithromycin Rationale: Azithromycin, a macrolide, is an acceptable alternative to penicillin for patients who have bacterial infections and are allergic to penicillin. The medication is effective against many gram-positive and gram-negative bacteria and is used for streptococcal pharyngitis. - Nafcillin and amoxicillin/clavulanic acid are penicillins and are contraindicated for those w/a penicillin allergy. Vancomuycin and clindamycin are safer alternatives. - A small percentage of clients who are allergic to penicillin have a cross sensitivity to cephalosporins. Cephalexin is a cephalosporin and is an inappropriate choice for the client.
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, c rationale Muscle tremors is incorrect. Muscle tremors can occur with beta2 agonists, not with inhaled anticholinergics such as ipratropium.Urinary retention is correct. Urinary retention can occur with ipratropium, an inhaled anticholinergic. Dry mouth is correct. Ipratropium can dry oral secretions.Insomnia is incorrect. Methylxanthines, not inhaled anticholinergics such as ipratropium, can cause insomnia.
A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons? A. The IV form crosses the blood-brain barrier. B. The oral form has a decreased half-life. C. The oral form has decreased bioavailability because of the first-pass effect. D. The oral form has an increased rate of excretion.
c
A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? A. "Itching is an expected adverse effect of amoxicillin." B. "Itching can indicate amoxicillin toxicity." C. "Itching can indicate a hypersensitivity to amoxicillin." D. "Itching can result from dry skin, which is often caused by amoxicillin."
c
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
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
A nurse is caring for a client who has a new prescription for acyclovir to treat a herpes simplex infection. Which of the following laboratory values should the nurse monitor for this client? A. Prothrombin time B. Hct C. BUN D. Aspartate aminotransferase
c Rationale: Acyclovir, an antiviral drug, can cause renal toxicity due to drug accumulation in renal tubules. The nurse should monitor the client's urine output, BUN, and creatinine levels, and increase fluid intake to hydrate and flush the kidneys.Others:- Cefotetan (2nd gen cephalosporin) for PTT- Amphotericin B for Hct- Ketoconazole for AST
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 an alteration in which of the following? A. Bowel function B. Peripheral pulses C. Urine output D. Level of consciousness
c Rationale: Gentamicin, an aminoglycoside, can cause nephrotoxicity. The nurse should monitor the client's BUN and creatinine levels and for an increased output of diluted urine. It is also essential to monitor serum gentamicin levels and maintain a therapeutic range.- Can also cause N/V, hypotension, hypertension, vertigo, and skeletal muscle weakness.
A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? A. Blood pressure B. Apical heart rate C. Respirations D. Level of consciousness
c rationale codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.
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 rationale:It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.
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
c rationle Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.
A nurse in a provider's office receives a call from a client who is taking amoxicillin to treat a respiratory infection and reports a rash and wheezing. Which of the following instructions should the nurse give the client? A. Wait 1 hr and contact the provider if there is no improvement. B. Skip today's dose of amoxicillin and resume taking the drug tomorrow. C. Call emergency services immediately. D. Take an NSAID to reduce skin and airway inflammation.
c Rationale: Amoxicillin can cause a severe anaphylactic reaction. A client who has difficulty breathing should call emergency services and seek immediate care. The client will need to be treated with epinephrine and an antihistamine, such as diphenhydramine, to treat an anaphylactic reaction.
A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? A. "Drug absorption occurs in the stomach." B. "You should expect immediate absorption of the drug." C. "You should allow the tablet to dissolve in your mouth." D. "Do not crush or chew the tablet."
d
A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching? A. "Adverse effects are the intended effects of the medication." B. "Adverse effects indicate a severe allergy to the medication." C. "Decrease your medication dose if adverse effects occur." D. "Contact your provider if adverse effects occur."
d
When administering oral erythromycin to a client who has acute diphtheria, a nurse should monitor for which of the following adverse effects? A. Hypothermia B. Blurred vision C. Constipation D. Cardiac dysrhythmias
d Cardiac dysrhythmias, as the drug can cause ECG changes, such as a prolonged QT interval. Report palpitations, fainting, and dizziness.Other effects include fever, hearing loss, and diarrhea.
A nurse is caring for a client who is taking ciprofloxacin to treat a urinary tract infection. The client also takes prednisolone to treat rheumatoid arthritis. Recognizing the adverse effects of ciprofloxacin, the nurse should instruct the client to report which of the following adverse effects? A. Tachycardia B. Hair loss C. Insomnia D. Tendon pain
d Rationale: Ciprofloxacin, a fluoroquinolone, can cause tendon rupture, most often of the Achilles tendon. This adverse effect is especially common for older adults or clients who take glucocorticoids, such as prednisolone. The nurse should tell the client to report tendon pain and stop taking the drug. - Can also cause photosensitivity and vertigo, malaise.
A nurse is administering cefotetan IV to a client to treat an intra-abdominal infection. The nurse notes that the IV insertion site is warm, edematous, and painful to the touch. Which of the following actions should the nurse take? A. Decrease the rate of the cefotetan infusion. B. Administer diphenhydramine to the client. C. Request a prescription for another antibiotic. D. Stop the cefotetan infusion.
d Rationale: The nurse should stop the infusion, remove the IV catheter, assess for tissue damage, and treat the client accordingly. The nurse should then initiate IV access via another site, continuing cefotetan therapy according to prescribed parameters.- Because the client could have thrombophlebitis, slowing the infusion will not alleviate the potential tissue damage or risk of embolus, and the IV site should be changed. To prevent thrombophlebitis, the nurse should dilute cefotetan, a second-generation cephalosporin, and infuse it slowly over 20 to 30 min.- The edematous, painful, and warm IV insertion site does not indicate an allergic reaction. The nurse should administer an antihistamine, such as diphenhydramine, if the client has hives, a rash, or other indications of an allergy to cephalosporins.- Switching the client to another antibiotic is essential when the current drug is ineffective or the client has an intolerable reaction to it.
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 rationale Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.
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 rationale Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.
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 rationale Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid and inhaled long-acting beta2 agonist (LABA) combination medication.
A nurse is providing teaching for a client who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. Which of the following instructions should the nurse include? A. Increase the rifampin dose. B. Increase the oral contraceptive dose. C. Allow 2 hr between taking the two drugs. D. Use a non-hormonal form of contraception.
d Rationale: Rifampin, an antimycobacterial drug, can increase the metabolism of oral contraceptives, reducing their effectiveness. Clients who are taking oral contraceptives and rifampin should use additional, non-hormonal contraceptive methods to prevent an unwanted pregnancy. -Taking additional oral contraceptives would increase the risk of serious adverse effects from the oral contraceptives and is not recommended.
A nurse is caring for a client who has a new prescription for aztreonam to treat a respiratory tract infection. Which of the following findings in the client's medical record should the nurse recognize as requiring cautious use for this prescription and report to the provider? A. Glaucoma B. Closed-head injury C. Heart failure D. Renal impairment
d Rationale: Aztreonam, a monobactam, requires cautious use with clients who have renal dysfunction because it is excreted in the urine. Renal impairment could affect the excretion of aztreonam, allowing the level of the drug to accumulate. The nurse should report this finding to the provider, so the provider can prescribe a lower dose for the client or prescribe a different antimicrobial drug. - Contraindicated in those with a viral infection, used cautiously in older adults. - Metronidazole is an antimicrobial drug that req's cautious use in those with HF.
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 rationale: Zileuton, a leukotriene modifier, can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.
