Patho/Pharm Exam 3 (SI questions)

A client reports frequent use of acetaminophen for relief of headaches and other discomforts. The nurse should evaluate which diagnostic data to determine if the client is at risk for toxicity? A. Liver enzymes B. Upper gastrointestinal x-ray results C. Electrocardiogram D. Chest x-ray

A

A patient with a history of asthma is experiencing an exacerbation. On assessment of lung sounds, the nurse hears wheezing throughout all lung fields. The nurse anticipates administering a medication from which drug class? A. Anticholinergic B. Beta 1 agonist C. Cholinergic D. Alpha 1 agonist

A

The nurse has given instructions for taking fentanyl to a client with a severe post-op pain. Which statement by the client indicates the teaching has been effective? A. "I should increase fluid intake." B. "I should maintain a low-fiber diet." C. "I should avoid all exercise to prevent lightheadedness." D. "I should avoid the use of stool softeners to prevent diarrhea."

A

aA patient is admitted with chest pain, n ECG is performed, and it is determined that the patient is having a myocardial infarction. What referred pain might the patient also describe, associated with MIs? A. Left arm pain, numbness, or tingling B. Midline abdominal pain C. Right shoulder pain D. Right upper quadrant pain

A

A patient experiencing an MI is sent for a cardiac categorization, and coronary disease if noted by the cardiologist. The patient is going to be discharged home with the recommendation of taking _______ mg of Aspirin per day to prevent future cardiac events. The nurse determines that it is necessary to contact the HCP under which conditions (SATA)? A. Patient takes Warfarin for a history of atrial fibrillation B. Patient has a history of End Stage Renal Disease C. Patient has a history of Myasthenia Gravis D. Patient was recently hospitalized for herpes zoster E. Patient has a history of duodenal ulcers

A, B, E

The nurse admits a client to the unit who reports taking high doses of aspirin to ease the pain of chronic headaches. The nurse should monitor for which side or adverse effects? (SATA) A. Black, tarry stools B. Bradycardia C. Bruising D. Hypertension E. Ringing in the ears

A, C, E

The nurse is caring for a client who underwent an open reduction internal fixation to the right hip. When administering opioid analgesics for pain, the nurse should instruct the client that which are side and adverse effects of opioid analgesics? (SATA) A. Sedation B. Diarrhea C. Constipation D. Increased pain level E. Respiratory depression

A, C, E

A patient with a history of gastric ulcers and liver failure is experiencing a mild headache, which medications should the patient avoid in the treatment of this headache (SATA)? A. Indomethacin B. Ketorolac C. Acetaminophen D. Naproxen E. Ibuprofen

All of the above

A client with suspected opioid overdose has received a dose of naloxone hydrochloride. The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 mm Hg to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing which piece of information? A. The client may become suicidal. B. These are signs of opioid withdrawal. C. These effects will last only a few moments. D. The client may otherwise sign out against medical advice.

B

During a routine office visit, the nurse documents the list of current medications of a client with a history of hypertension. Which statement by the client would cause the most concern? A. "I periodically take docusate for constipation" B. "I regularly take ibuprofen for chronic back pain" C. "I take metoclopramide for occasional nausea" D. "I am on warfarin for a history of atrial fibrillation"

B

The nurse is administering medications to a client with trigeminal neuralgia. The nurse expects that which medication will be prescribed for pain relief? A. Oxycodone plus aspirin B. Carbamazepine and gabapentin C. Acetaminophen and codeine sulfate D. Meperidine hydrochloride and hydroxyzine

B

Which of the following patients is not an ideal candidate for receiving ketorolac IVP to control post-operative pain? A. Patient with a Potassium level of 4.3 B. Patient with a Creatinine level of 2.66 C. Patient experiencing dizziness when she stand up too quickly E. Patient complaining of constipation after repeated morphine doses

B (NSAIDs are nephrotoxic-- especially ketorolac!)

A patient with myasthenia graves has overdosed on neostigmine ingested 3 hours prior to hospitalization. The patient presents with excessive respiratory secretions, nausea, diarrhea, and skeletal muscle weakness with rapidly worsening dyspnea. Which of the following interventions will the nurse anticipate implementing to address the patient's deteriorating respiratory status? A. administer atropine IVP B. prepare for intubation and mechanical ventilation C. administer activated charcoal D. placing the patient in Trendelenburg positon

B (atropine isn't going to help muscle weakness)

A client with chronic kidney disease is admitted with pneumonia and pleurisy. The client's laboratory results are shown below. Which prescription will the nurse question? [Hemoglobin- 9.0 g/dL Platelets- 267,000/mm3 WBC- 14,5000/mm3 Creatinine- 2.8 mg/dL] A. Acetaminophen 500mg PO Q6H PRN for mild pain B. Epoetin alfa 15,000 units, SQ once weekly C. Ketorolac 15mg IVP Q6H PRN for moderate pain D. Levofloxacin 500mg IV once daily

C

The nurse administers the prescribed dose of hydromorphone 2 mg to a client who is 2 days postoperative from a colostomy. Which assessment finding is most important for the nurse to follow-up? A. Client had one episode of emesis consisting of green fluid B. Client has had no bowel movement for the past 2 days C. Client falls asleep in the middle of a conversation with the RN D. Client reports experiencing pruritus

C

The nurse is caring for a client who has been taking hydrocodone for the last 3 months. Which side or adverse effects of this medication should the nurse assess for? A. Tachycardia and hypertension B. Diarrhea and abdominal cramping C. Psychological and physical dependence D. Increased respiratory rate and bronchospasm

C

The nurse is caring for a client with chronic back pain. Codeine has been prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication? A. Monitor apical heart rate B. Monitor radial pulse C. Monitor bowel activity D. Monitor peripheral pulses

C

Anticholinergic drugs should be avoided with which client? A. Client with overactive bladder B. Client with shortness of breath and wheezing C. Client with C. diff colitis D. Client who needs pupils dilated for a retinal exam

C (We want that person to get the infection out)

Four patients call a triage nurse for advice, which patient should be advised to chew 325 mg of aspirin STAT? A. Patient who is 20 weeks pregnant who is concerned about developing preeclampsia B. Patient with sickle cell anemia experiencing 10/10 pain from sickle cell crisis C. Patient reporting new onset of chest pain and dyspnea at rest E. Patient taking Clopidogrel for a history of coronary artery disease with stents

C (patient having an MI and NEEDS to get an antiplatelet med in their bloodstream ASAP to prevent worsening)

Which of the following patients should be seen first for the nurse concerned about early signs of salicylism? A. Patient complaining of generalized muscle pain B. Patient with elevated liver enzymes C. Patient stating he hears a constant ringing E. Patient complaining of chest pain

C (tinnitus is an early sign)

A client began taking amitriptyline approximately 4 weeks ago. The client reports to the clinic for a follow-up evaluation. The nurse determines that the client is experiencing a side or adverse effect related to the use of this medication if which is noted? A. Decreased rigidity B. Decreased akinesia C. A blood pressure of 118/74 mm Hg D. Client complaints of urinary retention

D

A client is taking morphine sulfate for acute pain. The client stands, is immediately "lightheaded," sits back in bed, and calls for the nurse. What is the nurse's priority action? A. Administer 0.5mg of IVP Naloxone B. Apply a gait belt and walk with the client C. Keep the client on strict bedrest D. Assess client for orthostatic hypotension

D

A client is taking morphine sulfate for acute pain. Which statement will best assist the client worried about nausea and vomiting while taking this medication? A. "Nausea and vomiting rarely occur with this medications." B. "Nausea and vomiting rarely occur when you are up and walking" C. "Take the medication on an empty stomach" D. "Tolerance to nausea can develop quickly and persistent nausea is rare"

D

A client with cancer is receiving a continuous intravenous infusion of morphine sulfate. The nurse monitoring the client for adverse effects would become most concerned about which vital sign? A. Temperature of 99.1°F (37.3°C) B. Blood pressure of 110/70 mm Hg C. Apical heart rate of 90 beats/minute D. Respirations of 10 breaths/minute

D

A patient receives atropine. Which potential side effect do we expect to see? A. diarrhea B. polyuria C. excessive salivation D. hypertension

D

A patient recently experiencing an ischemic stroke, and now had difficulty controlling oral secretions. Which medication would be indicated for this patient? A. Diphenoxylate and atropine B. Ipratropium C. Oxybutynin D. Scopalamine

D

Cholinergic drugs have which of the therapeutic effects? A. Decreased GI motility B. Urinary retention C. Tachycardia D. Miosis

D