Pharm 1 Final Review

Nifedipine (Procardia) 30 mg p.o. is prescribed for a client. The nurse teaches the side effects and instructs the client to immediately report: A. Increased shortness of breath and orthopnea. B. Dizziness when changing positions. C. Weight loss of two pounds per week. D. Blood pressure 110/70-114/78 for two successive readings.

A. Increased shortness of breath and orthopnea.

Mr. Smith was diagnosed with scabies and was prescribed permethrin 5% cream (Elimite). Which is the best instruction by the nurse to ensure the client applies the cream appropriately? A."Leave the cream on the body for approximately 8-12 hours, preferrably at night, and rinse the cream off in the bath or shower in the morning." B. "After applying the cream, immediately rinse the cream off in the shower." C. "Apply the cream only to the affected areas on the skin, so it can be more effective." D. "Leave the cream on the body for 24 hours."

A."Leave the cream on the body for approximately 8-12 hours, preferrably at night, and rinse the cream off in the bath or shower in the morning." Permethrin is the preferred agent for scabies. The 5% cream (Elimite) is applied to the entire skin surface and allowed to remain for 8-12 hours before bathing.

What priority nursing intervention is essential for the client receiving alteplase (Activase), a thombolytic? A.Assess for signs and symptoms of increase bleeding, bruising, and repurfusion irregular heart rate (dysrhythmias). B. Administer vitamin K if bruising is observed. C. Monitor liver enzymes. D. Monitor blood pressure and stop the medication if blood pressure is 110/80 mmHg.

A.Assess for signs and symptoms of increase bleeding, bruising, and repurfusion irregular heart rate (dysrhythmias). Alteplase (Activase) can cause bleeding as well as reperfusion dysrhythmias. Alteplase does not directly affect liver enzymes. Vitamin K will not reverse the effects of Activase. Vital sign changes can alert the nurse to complications; however, a blood pressure of 110/80 mmHg is not, in itself, cause for alarm.

A patient arrives at the emergency department with severe 10/10 lower leg pain after a fall in a touch football game. Following routine triage, which of the following is the appropriate next step in assessment and treatment? A. Apply an elastic bandage to the leg. B. Apply heat to the painful area. C. Administer the ordered intravenous fentanyl. D. Elevate the leg.

Administer the ordered intravenous fentanyl. Following triage, an x-ray should be performed to rule out fracture and pain control measures should be implemented. Ice, not heat, should be applied to a recent sports injury. An elastic bandage may be applied once fracture has been excluded.

Miss. Batten is prescribed topical retinoids - tretinoin for her moderate acne. She returns to the office 1 week later, disappointed because she does not see improvement in her condition. You explain to the client that improvement may not be seen for up to how many weeks? A. 3 weeks. B. 8 weeks. C. 2 weeks. D. 2-1/2 weeks.

B. 8 weeks.

Some drugs may be completely metabolized by the liver circulation before ever reaching the general circulation. This effect is known as: A. Blood-brain barrier. B. First-pass effect. C. Hepatic microsomal enzyme system. D. Conjugation of drugs.

B. First-pass effect. Some oral drugs are rendered inactive by hepatic metabolic reactions, during the process known as the first-pass effect. An alternative route may need to be assessed.

A client who is experiencing acute asthma exacerbations after having a recent upper respiratory infection is prescribed a short-term beclomethasone inhaler. Which is the expected outcome for the use of steroids in clients with asthma? A. Prevent development of respiratory infections. B. Have an anti-inflammatory effect. C. Act as an expectorant. D. Promote bronchodilation.

B. Have an anti-inflammatory effect.

A client refuses a PRN medication of morphine sulfate PO; you document the reason for the refusal in the medication administration record and dispose of the medication according to facility policy. By documenting the client's refusal and reason for declining the medication, you are adhering to which of the "rights" of medication administration? A. Right dose. B. Right documentation. C. Right patient. D. Right medication.

B. Right documentation. By documenting the client's refusal of the medication within the medication administration record, the nurse is adhering to the safety measure of the Right documentation.

A client is taking warfarin 5 mg/day for atrial fibrillation. The client's international normalized ration (INR) is 3.8. The nurse would consider the INR to be what? A. Low INR range. B. Within normal range. C. Sub-therapeutic INR range. D. Elevated INR range.

D. Elevated INR range. Therapeutic INR range of a patient who is taking warfarin (Coumadin) is 2-3.

After a nurse provided instructions about timolol (Timoptic) to a client with a history of chronic heart disease, the client asks, "How can this eye drops affect my heart?" The nurse's best response includes which of the following information? A.Clients are at risk if timolol is given at the same time as the oral medications taken for cardiac disease. B. This medication does not have any effects on the cardiac system. C.If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents. D. Clients are only at risk if the prescribed ophthalmic medication is pulmonary-selective.

C.If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents. If systemic absorption occurs after the administration of timolol, the adverse effects such as decreased heart rate blood pressure may develop.

The nurse administers a medication to the wrong client. The appropriate nursing action is to: A. Document the error if the client has an adverse reaction. B. Monitor the client for an adverse reaction before reporting the incident. C.Report the error to the provider, document the medication in the client record, and complete an incident report. D. Notify the provider and document the error in the incident report only.

C.Report the error to the provider, document the medication in the client record, and complete an incident report. The nurse is responsible for documenting medication errors and completing an incident report for review by the facility's quality assurance personnel.

A patient's wife asks the nurse why her husband did not receive the clot busting medication alteplase (tPA) she has been reading about. Her husband is diagnosed with a hemorrhagic stroke. What should the nurse respond? A. You should discuss the treatment of your husband with your doctor. B. Not every is eligible for this drug. Has he had surgery lately? C.The medication you are talking about dissolves clots and could cause more bleeding in your husband's head. D. He didn't arrive within the time frame for that therapy.

C.The medication you are talking about dissolves clots and could cause more bleeding in your husband's head.

Mrs. Geonity is prescribed a medication, and the provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. She asks you what the rationale is for the dosage changes. How should you respond? A."Your generic drug does not work as efficiently, and the provider increased your dose." B. "Your insurance plan requires that we change the drug dose frequently." C. "Dosage varies based on the brand name." D. "Dosages determines whether the drug actions may be therapeutic or toxic."

D. "Dosages determines whether the drug actions may be therapeutic or toxic."

A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education? A. "Constipation and bloating may be a problem when taking this medication." B. "I'll continue to watch my diet and reduce my fats." C. "Increasing my physical activity may help reduce my cholesterol numbers." D."I'll continue taking my non-prescribed over-the-counter nicotinic acid (Niacin) that I purchased at the pharmacy."

D."I'll continue taking my non-prescribed over-the-counter nicotinic acid (Niacin) that I purchased at the pharmacy."

A nurse is administering IV furosemide (Lasix) to a patient admitted with congestive heart failure. After the infusion, which of the following symptom is NOT an expected use of the drug? A. Decreased pain. B. Increased urinary output. C. Decreased edema. D. Decreased blood pressure.

A. Decreased pain.

A client has a serum cholesterol level of 265 mg/dL, triglyceride level of 235 mg/dL, and LDL of 180 mg/dL. What do these serum levels indicate? A. Hyperlipidemia. B. Alipidemia. C. Hypolipidemia. D. Normolipidemia.

A. Hyperlipidemia.

The nurse evaluates that the client understood discharge teaching regarding warfarin (Coumadin) based on which statement? A. "I should use a soft toothbrush for dental hygiene." B. "I will double my dose if I forget to take it the day before." C. "I should decrease the dose if I start bruising easily." D. "I should keep taking ibuprofen for my arthritis."

A. "I should use a soft toothbrush for dental hygiene." This statement is accurate and will reduce the risk of bleeding. Ibuprofen will potentiate bleeding. The client should call the health care provider if experiencing excessive bruising.

Which statement indicates the client understands discharge instructions regarding cholestyramine (Questran)? A. "I will increase fluids and fiber in my diet." B. "I will have my blood pressure checked weekly." C. "I will take cholestyramine (Questran) at the same time as my other medications." D. "I will weigh myself weekly."

A. "I will increase fluids and fiber in my diet."

The nurse is caring for a client with chronic hypertension. The client is receiving a beta-adrenergic blocker daily. Which client manifestations would the nurse conclude are adverse effects of this medication? Select all the Apply. A. Bradycardia. B. Decreased serum triglycerides. C. Hypotension. D. Thrombocytopenia. E. Hypoglycemia.

A. Bradycardia. C. Hypotension. E. Hypoglycemia.

Which complication should the nurse assess for in the elderly client newly diagnosed with hypothyroidism who has been prescribed levothyroxine (Synthroid)? A. Cardiac dysrhythmias. B. Paralytic ileus. C. Respiratory depression. D. Thyroid storm.

A. Cardiac dysrhythmias.

A client has been treated for chronic open-angle glaucoma for 5 years asks the nurse, "How does glaucoma damage my eyesight." The nurse's reply should be based on the knowledge that open-angle glaucoma: A. Causes increased intraocular pressure and damage to the optic nerve. B. Leads to detatchment of the retina. C. Is caused by decreased blood flow to the retina. D. Results from chronic eye inflammation.

A. Causes increased intraocular pressure and damage to the optic nerve. In open-angle glaucoma, there is an obstruction to the outflow of aqueous humor, leading to increased intraocular pressure. The increased intraocular pressure eventually causes destruction of the retina's nerve fibers. This nerve destruction causes painless vision loss. The exact cause of gluacoma is unknown. Glaucoma does not lead to retinal detachment.

The nurse would question an order for cholestyramine (Questran) if the client has which condition? A. Decrease Gastric Motility. B. Renal Disease. C. Hepatic Disease. D. Glaucoma.

A. Decrease Gastric Motility. Cholestyramine (Questran) binds with bile in the intestinal tract to form an insoluble complex. It can also bind to other substances and lead to intestinal obstruction.

The nurse is caring for the client diagnosed with Type 2 Diabetes. The client is complaining of a headache, jitteriness, agitation, and nervousness. Which interventions should the nurse implement? Select all the apply. A. Determine when the last antidiabetic medication was administered. B. Assess the client's vital signs. C. Administer prescribed insulin via the sliding scale protocol. D. Check the client's blood glucose level. E. Give the client a glass of orange juice if the client is hypoglycemic.

A. Determine when the last antidiabetic medication was administered. B. Assess the client's vital signs. D. Check the client's blood glucose level. E. Give the client a glass of orange juice if the client is hypoglycemic.

The nurse is providing discharge instructions for a client prescribed the thiazide diuretic hydrocholorthiazide (Diuril). Which instruction should the nurse include? A. Eat bananas or oranges regularly. B. Weigh monthly and report the weight to the healthcare provider. C. Try to sleep in an upright position. D. Drink at least 8-10 glasses of water a day.

A. Eat bananas or oranges regularly. Loop and thiazide diuretics cause the body to excrete potassium in the urine. The client should attempt to replace the potassium by eating potassium-rich foods such as bananas and orange juice.

The nurse is administering the combination medication hydrochlorothiazide and metoprolol to a client diagnosed with chronic hypertension. Which interventions should the nurse implement? Select all the apply. A. Encourage the client to eat potassium-rich foods. B. Monitor the client's oral intake and urinary output. C. Teach the client how to prevent orthostatic hypotension. D. Do not administer if the client's BP is less than 90/60 mmHg. E. Do not administer if the client's apical pulse is less than 60 bpm.

A. Encourage the client to eat potassium-rich foods. B. Monitor the client's oral intake and urinary output. C. Teach the client how to prevent orthostatic hypotension. D. Do not administer if the client's BP is less than 90/60 mmHg. E. Do not administer if the client's apical pulse is less than 60 bpm.

What is the primary role of a nurse in medication administration? A. Ensure medications are administered and delivered in a safe manner. B.Inform the client that prescribed medications need to be taken only if the client agrees with the treatment plan. C. Be certain that provider orders are accurate. D. Assure client adherence by watching he client swallow all prescribed medications.

A. Ensure medications are administered and delivered in a safe manner. The primary responsibility of the nurse is to ensure client safety when administering prescribed medications. Client adherence includes much more than watching the client take their medications. Accurate provider orders are part of ensuring safe medication administration

Which of the following is the part of the Nursing Process that has the nurse assess the effectiveness of the medication? A. Evaluation. B. Diagnosis. C. Implementation. D. Assessment.

A. Evaluation. The purpose of evaluation in the nursing process is to determine whether the goals and outcomes have been adequately met by the client.

A client who is admitted for an elective dental procedure reports that the last time he received nitrous oxide for a procedure he had what felt like a​ "hangover" for days afterward. Which intervention should the nurse plan to help avoid this​ adverse effect? A. Have the client breathe​ 100% oxygen for several minutes following the nitrous oxide. B. Report this comment to the anesthesiologist so he will change the agent used. C. Rehydrate the client with intravenous normal saline. D.Provide the client with​ caffeine-containing beverages immediately after the procedure.

A. Have the client breathe​ 100% oxygen for several minutes following the nitrous oxide. Having the client breathe​ 100% oxygen for several minutes following nitrous oxide use has been shown to prevent alveolar hypoxia. It is the alveolar hypoxia that produces the​ "hangover" effect. There is no evidence to support prehydration causing a change for this effect. It is not necessary to change anesthesia agents. Administering caffeine with nitrous oxide may exacerbate dysrhythmias.

A client diagnosed with hypercholesterolemia is prescribed atorvastatin (Lipitor). The nurse is reviewing the client's history and would contact the health care provider about which of these conditions in the client's history? A. Hepatic Disease. B. Renal disease. C. Leukemia. D. Chronic Obstructive Pulmonary Disease.

A. Hepatic Disease.

The nurse is teaching a client about the​ beta2-adrenergic agonist albuterol​ (Proventil) prescribed for exercise induced asthma. Which instruction would reduce the onset of a bronchospasm during​ exercise? A. Inhale a dose of the medication 15 to 30 minutes prior to physical activity. B. Clean the mouthpiece at least once a week. C. After taking the medication, drink a cup of hot tea. D. Inhale a dose of the medication immediately after physical activity.

A. Inhale a dose of the medication 15 to 30 minutes prior to physical activity.

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching? A. Instruct the client to take the medication in the morning before breakfast. B. Discuss the importance of not using iodized salt. C. Explain the importance of not taking the medication with grape juice. D. Teach the client to monitor daily glucose levels.

A. Instruct the client to take the medication in the morning before breakfast. The medication should be taken in the morning to decrease the incidence of drug-related insomnia.

The nurse in the medical department is preparing to administer Humalog Lispro, a rapid-acting insulin, to a client diagnosed with Type I Diabetes. Which intervention should the nurse implement first? A. Make sure the client eats the food on the meal tray that is at the bedside. B. Ensure the client is wearing a MedicAlert bracelet. C. Administer the dose according to the regular insulin sliding scale. D. Assess the client for hyperosmolar, hyperglycemic, nonketotic coma.

A. Make sure the client eats the food on the meal tray that is at the bedside. Humalog peaks in 30 minutes to 1 hour; therefore, the client needs to eat when or shortly after the insulin is administered to prevent hypoglycemia.

Timolol (Timoptic), beta-adrenergic agent, may be used to treat glaucoma. The nurse should teach the clients and family to: A. Monitor pulse and blood pressure. B. Monitor urine output. C. Monitor blood glucose. D. Monitor respiratory rate.

A. Monitor pulse and blood pressure. Beta-adrenergic drugs may reduce resting heart rate and blood pressure. The client family should be taught how to check the pulse and blood pressure before administration and to notify the provider if extremes occur. Beta-adrenergic drugs do not affect urine output, respiratory rate, or glucose levels.

The client diagnosed with hyperthyroidism is prescribed an antithyroid medication. Which interventions should the nurse implement? Select all that apply. A. Monitor the client's thyroid function tests. B. Monitor the client's weight weekly. C. Monitor the client for activity intolerance. D. Monitor the client for gastrointestinal distress. E. Monitor the client's vital signs.

A. Monitor the client's thyroid function tests. B. Monitor the client's weight weekly. C. Monitor the client for activity intolerance. D. Monitor the client for gastrointestinal distress. E. Monitor the client's vital signs.

Which of the following is the Highest nursing priority when a client has an allergic reaction to a newly prescribed medication: A. Notify the provider of the allergic reaction. B. Instruct the client to remain calm. C. Place an allergy bracelet on the client. D. Document the allergy in the medical record.

A. Notify the provider of the allergic reaction.

In the first-pass effect or pre-systemic metabolism, a drug is extensively metabolized in the liver, with only part of the drug reaching the systemic circulation for distribution to sites of action. The first-pass effect occurs when some drugs are given by which of the following routes? A. Orally. B. Intravenously. C. Parentally. D. Rectally.

A. Orally.

A client is to receive recombinant tissue plasminogen activator (Alteplase) after being diagnosed with an acute ischemic stroke. Prior to beginning this infusion, the nurse should check to see if which laboratory results are present? Select all that apply. A. Prothrombin (PT) and Partial Prothrombin Time (PTT) B. Complete Blood Count (CBC) C. Type and Screen for Blood Transfusion. D. Electrolyte levels.

A. Prothrombin (PT) and Partial Prothrombin Time (PTT) B. Complete Blood Count (CBC)

Which of the following DEA regulated Drug Schedules correctly list the highest to the lowest potential for abuse: A. Schedule I, II, III, IV, V B. Schedule V, IV, III, II, I C. Schedule V, II, III, I, IV D. Schedule I, IV, III, V, II

A. Schedule I, II, III, IV, V

The nurse is reviewing a medication history on a client taking an ACE inhibitor. The nurse plans to contact the healthcare provider if the client is also taking which medication? A. Spironolactone (Aldactone). B. Docusate sodium (Colace). C. Morphine sulfate. D. Furosemide (Lasix).

A. Spironolactone (Aldactone). ACE inhibitors can cause hyperkalemia; therefore, it is imperative to monitor a client who is also prescribed a potassium-sparing diuretic.

The client diagnosed with hypothyroidism is prescribed levothyroxine (Synthroid). Which assessment data supports the client needs to take more medication? Select all the Apply. A. The client complains of being too cold. B. The client has exophthalmos (bulging of the eye muscles). C. The client complains of being constipated. D. The client has a 2-kg weight loss. E. The client's radial pulse rate is 90 bpm.

A. The client complains of being too cold. C. The client complains of being constipated.

The client diagnosed with arterial hypertension is receiving furosemide (Lasix). Which data indicates the medication is effective? A. The client's 8-hour intake is 1800mL and the output is 2300mL. B. The client's blood pressure went from 144/88 mmHg to 154/96 mmHg. C. The client has had a weight loss of 1.3 kg in 7 days. D. The client reports occasional light-headedness and dizziness.

A. The client's 8-hour intake is 1800mL and the output is 2300mL. The client has had 500 mL (2300 - 1800 = 500) excess urinary output. This indicates the medication is effective-the diuretic is causing an increase in urinary output.

Which assessment data should the nurse obtain prior to administering a calcium channel blocker? A. The client's blood pressure. B. The client's radial pulse. C. The current telemetry reading. D. The serum calcium level.

A. The client's blood pressure.

Clients in a nursing home have been prescribed permethrin shampoo (Nix) for head lice. The nurse will question the order for the client who has a history of: A. An allergy to sulfites. B. Seizures. C. Diabetes mellitus. D. Hypothyroidism.

A. an allergy to sulfites Contraindications to permethrin use include hypersensitivity to pyrethrins, chrysanthemums, sulfites, or other preservatives.

The client with Type 2 Diabetes is admitted into the medical department with a wound on the left leg that will not heal. The healthcare provider prescribes sliding-scale insulin. The client tells the nurse, "I don't want to have to take shots. I take pills at home." Which statement is the nurse's best response? A."During an illness, you may need to take insulin to keep your blood glucose level down." B. "You are worried about having to take insulin. I will sit down and we can talk." C. "If you can't keep your glucose under control with pills, you have to take insulin." D."You should discuss the insulin order with your healthcare provider because you don't want to take it."

A."During an illness, you may need to take insulin to keep your blood glucose level down." Bood glucose levels elevate during time of stress, sugery, or serious infection. The client with Type 2 Diabetes may need to be given insulin temporarily to help keep the blood glucose level within normal limits.

After listening to the nurse explain the use of the PO version of tretinoin (isotretinoin - Accutane) to a 19 year-old female client, the client demonstrates understanding of the most important point by making which statement at the end of the teaching session: A."Have a pregnancy test prior to beginning therapy and use two forms of contraception." B. "Apply thick layer of isotretinoin twice a day." C. "Increase exposure to sun for added benefit." D. "Keep lips moist and lubricated to prevent inflammation."

A."Have a pregnancy test prior to beginning therapy and use two forms of contraception." Isotretinoin, an oral preparation, is a known teratogen that may result in spontaneous abortion and/or major fetal abnormalities such as hydrocephalus. Prevention of pregnancy is mandatory during isotretinoin therapy.

The nurse is teaching a client with newly diagnosed Type I Diabetes about insulin therapy. Which statements indicate that the client needs MORE TEACHING concerning insulin therapy? Select all that Apply. A. "I should administer my insulin in my abdomen for best absorption." B. "I will check my blood glucose with my glucometer once a week." C. "If I pass out at home, a family member should give me a glucagon injection." D. "If I have a headache or start getting nervous, I will drink some orange juice." E. "Because I am taking my insulin daily, I do not have to adhere to a diabetic diet."

B. "I will check my blood glucose with my glucometer once a week." E. "Because I am taking my insulin daily, I do not have to adhere to a diabetic diet." Even with insulin therapy, the client should adhere to the American Diabetes Association diet, which recommends "carbohydrate counting." This statement indicates the client needs more teaching. Monitoring and documenting the blood glucose level at lease once a day is encouraged to determine the effectiveness of the treatment regimen.

The nurse and the client have established this goal: "The client will verbalize safety considerations for use of tramadol (Ultram) before being discharged from the hospital." Which client statements would support evaluation that this goal has been achieved? (Select all that Apply). A."I will work with my health care provider to taper off the dose of this medication when it is no longer needed." B. "I will not drive until I know how I am going to react to the tramadol." C. "I will not eat aged cheese while taking tramadol." D. "I will limit my alcohol intake to a couple of glasses of wine with dinner." E. "I will avoid taking my regular dose of kava-herbal medication while I am on this drug."

A."I will work with my health care provider to taper off the dose of this medication when it is no longer needed." B. "I will not drive until I know how I am going to react to the tramadol." E. "I will avoid taking my regular dose of kava-herbal medication while I am on this drug." Symptoms such as confusion and visual impairment can occur with tramadol use. Ethanol combined with tramadol may result in death. Caution should be observed when using herbs such as kava that may have an additive CNS depressant effect. There is no contraindication to eating aged cheese with tramadol. If tramadol is abruptly discontinued, symptoms of opioid withdrawal may occur.

A client who had a stroke was prescribed alteplase (Activase). Prior to administering this medication, the nurse spoke with the client's spouse. Which comments by the spouse would the nurse immediately report to the prescriber? Select all that apply. A."I've been worried about him. He has been having black, tarry stools for a week or more." B. "I've tried so hard to help him control his hypertension through the years." C."He has never had a seizure until the one he had today and I am wondering if he hit his head during the seizure activity?" D. "He has never been in the hospital except for when he had his hip surgery 5 years ago." E. "I wonder if he was having little strokes when he fell off the ladder last week."

A."I've been worried about him. He has been having black, tarry stools for a week or more." C."He has never had a seizure until the one he had today and I am wondering if he hit his head during the seizure activity?" E. "I wonder if he was having little strokes when he fell off the ladder last week." Active internal bleeding (which could be evidenced by black, tarry stools) is a contraindication for use of rt-PA. Seizure at the beginning of the stroke is a contraindication for the administration of rt-PA. Falling off a ladder could cause head injury or other trauma that would be a contraindication to rt-PA administration.

The client with Type 2 Diabetes is schedule for a CT scan of the abdomen with contrast dye. The client is taking metformin (Glucophage), a biguanide. Which instruction should the nurse discuss with the client? A.Do not take the metformin (Glucophage) after the procedure until the healthcare provider approves and restarts it. B. Take half the dose of the morning insulin on the day of the test. C. Administer the insulin in the morning of the test. D. Take the medication as prescribed because it will not affect the test.

A.Do not take the metformin (Glucophage) after the procedure until the healthcare provider approves and restarts it. Metformin has a potential side effect of producing lactic acid. When it is administered simultaneously or within a close time span of the contrast dye used for the CT scan, lactic acidosis could result. It is recommended to hold the medication prior to and up to 48 hours after the scan. The HCP should obtain a BUN and creatinine to determine kidney function prior to restarting metformin.

An adult client with a history of​ obesity, asthma, peripheral vascular​ disease, and migraine headaches tells the nurse she saw an advertisement in a magazine for a drug for migraine​ headaches: "The drug was​ Imitrex; it looked very​ effective, and I wonder why my provider​ hasn't talked to me about using it for my​ headaches." What is the​ nurse's best response to this question about sumatriptan​ (Imitrex)? A. "I think it would be good for you. Bring in the ad." B. "Your peripheral vascular disease is a contraindication for the​ drug." C. "You have​ asthma, so you cannot use the​ drug." D. ​"Once you lose some​ weight, the drug will be perfect for​ you."

B. "Your peripheral vascular disease is a contraindication for the​ drug." Sumatriptan​ (Imitrex) is contraindicated in clients with peripheral vascular​ disease, CAD, and cerebrovascular disease due to the risk of myocardial infarction. Clients with asthma can safety use sumatriptan. The drug is not ideal for this client due to her health history. Obesity is not a contraindication for sumatriptan.

Before administering drugs by the enteral route, the nurse should evaluate which of the following? A. Compatibility of the drug with IV fluid. B. Ability of the client to swallow medications. C. Patency of the injection port. D. Ability of the client to lie supine.

B. Ability of the client to swallow medications. The enteral route involves the process of swallowing by definition.

What are the four phases of pharmacokinetics that a drug goes through? A. Absorption, distribution, ionization, and metabolism. B. Absorption, distribution, metabolism, and excretion. C. Diffusion, bioavailability, metabolism, and excretion. D. Active transport, ionization, diffusion, and excretion.

B. Absorption, distribution, metabolism, and excretion. Pharmacokinetics includes Absorption, Distribution, Metabolism, and Excretion (ADME).

Unexpected and undesired drug reactions are labeled: A. Idiosyncratic reactions. B. Adverse effects. C. Unaltered reactions. D. Enzyme-specific reactions.

B. Adverse effects. Undesired, inadvertent, and unexpected dangerous effects of medication are labeled adverse effects.

The nurse is reviewing the laboratory work for a patient who is taking atorvastatin (Lipitor). Which laboratory value is most useful for monitoring this drug? A. Blood urea nitrogen (BUN). B. Aspartate aminotransferase (AST). C. International normalized ratio (INR). D. C-reactive protein (CRP).

B. Aspartate aminotransferase (AST). AST is a liver enzyme that is helpful for monitoring liver function (hepatotoxicity). Lipitor, a lipid-lowering drug, is a commonly prescribed example of a hepatotoxic drug. The BUN is a measure of kidney function. The INR is a comparative rating of prothrombin time ratios that is used to monitor patients taking the anticoagulant agent warfarin. The CRP is elevated in inflammatory and neoplastic disease, myocardial infarction, and the third trimester of pregnancy. It is used as a cardiac risk marker.

Hydroxychloroquine sulfate (Plaquenil) has been prescribed for a 24-year-old client for the control of his auto-immune disease. The nurse will teach the client to immediately report: A. Dry mouth. B. Blister-like rash to the oral mucosa or on the skin. C. Leg cramps. D. Lethargy.

B. Blister-like rash to the oral mucosa or on the skin.

The nurse administered 12 units of fast acting Lispro insulin to the patient with Type I Diabetes at 7:00 AM. Which meal prevents the client from experiencing hypoglycaemia? A. Supper. B. Breakfast. C. HS snack. D. Lunch.

B. Breakfast. Fast acting Lispro insulin peaks in 0.5 - 1 hour; therefore, the breakfast meal would prevent the client from developing hypoglycemia. Lunch would cover a 0700 dose of Humulin N, an intermediate-acting insulin. Supper would cover a 1600 dose of Humulin R, a short-acting insulin. The HS (nighttime) snack would cover a 1600 dose of Humulin N.

The client should be aware of potential side effects of prostaglandins latanoprost (Xalatan) used in the treatment of glaucoma. The nurse should include which of the following in the teaching plan: A. Hypertension. B. Brown pigmentation of the treated eye. C. Dilation of pupils. D. Loss of eyelashes.

B. Brown pigmentation of the treated eye. Side effects include eye irritation, conjunctival edema, burning, stinging, redness, blurred vision, pain, itching, the sensation of foreign body in the eye, photophobia, and visual disturbances. The client may experience the phenomenon of increasing amounts of brown pigmentation in the treated eye only and thickening of the eyelashes and hair adjacent to the treated eye. Loss of eyelashes, hypertension, and dilation of the pupils do not occur with the use of prostaglandins.

The nurse is preparing to administer spironolactone (Aldactone). Which priority intervention should the nurse implement? A. Give the medication with food. B. Check the client's potassium level. C. Encourage consumption of potassium-rich foods. D. Monitor the client's bowel movments.

B. Check the client's potassium level. When preparing to administer a potassium-sparing diuretic, the nurse should check the potassium level because both hyperkalemia and hypokalemia can result in cardiac dysrhythmias that are life threatening. Therefore, checking potassium level is the priority intervention.

Which of the following is the priority of the nurse when assessing a client prior to administering the first dose of any medication to a client: A. Client's understanding of drug action. B. Client's history of medication allergies. C. Client's level of consciousness. D. Client's understanding of the purpose of the medication.

B. Client's history of medication allergies. Assessment of allergies and reactions to medications is essential when administering a new medication. Hypersensitivity responses can occur with any medication and severe adverse reactions may by systemically absorbed.

When a newly admitted client is placed on heparin intravenously, the nurse acknowledges that heparin is effective for preventing new clot formation in clients who have which disorder(s)? (Select all that apply.) A. Ruptured Spleen. B. Deep Venous Thrombosis (DVT). C. Pneumonia. D. Chronic Obstructive Pulmonary Disease (COPD). E. Pulmonary Embolism (PE).

B. Deep Venous Thrombosis (DVT). E. Pulmonary Embolism (PE).

A client who is in kidney (renal) failure may have a diminished capacity to excrete medications. It is imperative that this client be assessed for what development? A. Decreased creatinine levels. B. Drug toxicity. C. Increased levels of potassium. D. Decreased levels of blood urea nitrogen.

B. Drug toxicity. The kidneys are the primary site of excretion. Renal failure increases the duration of the drug's action because of decreased excretion. The client must by assessed for drug toxicity.

The nurse observes the client instill eye drops for gluacoma. The client asks, "why should I hold pressure to my lacrimal duct for approximately 2 minutes after I instill the drops?" The nurse explains to the client that this method is the best technique because: A. It prevents corneal injury. B. It helps to prevent systemic absorption. C. It reduces excessive lacrimation. D. It prevents scleral staining.

B. It helps to prevent systemic absorption. Holding pressure to the lacrimial duct helps prevent systemic absorption because the medication can reach the systemic circulation by entering through the tear duct if pressure is not held for approximately 2 minutes, which is the amount of time it takes for the medication to be absorbed into the eye.

Which of the following is an Incorrect statement regarding nursing diagnoses? A. It is a clinical judgment made by the nurse. B. It identifies the medical problem experienced by the client. C. It determines nursing interventions for which the nurse is accountable. D. It identifies the client's response to actual or potential health and life processes.

B. It identifies the medical problem experienced by the client. NANDA classifies a nursing diagnosis as a clinical judgment about individual, family, or community responses to actual or potential health/life processes. Per NANDA, during diagnoses provide the basis for the selection of nursing interventions to achieve outcomes for which the nurse is accountable.

Which medication should the nurse question administering to a client diagnosed with stage C congestive heart failure? A. Acetaminophen (Tylenol). B. Nifedipine (Procardia). C. Atenolol (Tenormin). D. Spironolactone (Aldactone).

B. Nifedipine (Procardia).

The nurse is discharging a client diagnosed with gastroesophageal reflux disease (GERD). Which information should the nurse include in the teaching? A. If any discomfort is noted, take an ibuprofen (NSAID) for the pain. B. Notify the healthcare provider if the medication does not resolve the symptoms. C. There are no complications of GERD as long as the client takes the medications. D. Immediately after a meal, lie down for at least 45 minutes.

B. Notify the healthcare provider if the medication does not resolve the symptoms. The client should always be informed of what symptoms to report to the HCP.

The nurse in the healthcare provider's office is completing as assessment on a client who has been prescribed the cardiac glycoside digoxin (Lanoxin) for congestive heart failure. Which data indicates the medication has been effective? A. The client's heart rate is 55 bpm. B. The client has clear breath sounds bilaterally. C. The client's sputum is pink and frothy. D. The client has 2+ pitting edema of the sacrum.

B. The client has clear breath sounds bilaterally.

The client complaining of "acid" when lying down at night asks the nurse if there is any medication that might help. Which statement is the nurse's best response? A."Have you had x-rays or other tests to determine if you have cancer or some other serious illness?" B."There are several over-the-counter and prescription medications available to treat this. You should discuss this with the healthcare provider." C."There are no medications to treat this problem, but losing weight will sometimes help the symptoms." D."Acid reflux at night can lead to serious complications. The only treatment is to have tests done to determine the cause."

B."There are several over-the-counter and prescription medications available to treat this. You should discuss this with the healthcare provider." PPIs, H2 blockers, and antacids all treat symptoms of acid reflux. The nurse should encourage the client to discuss which medication is best with the HCP.

The nurse is discussing the oral hypoglycemic medication glipizide with the client diagnosed with Type 2 Diabetes. Which information should the nurse discuss with the client? A.Tell the client to notify the healthcare provider every time the client experiences a headache, nervousness, or sweating. B.Instruct the client to take the oral hypoglycemic medication with food to decrease gastric upset. C. Explain that hypoglycemia will not occur with oral hypoglycemic medications. D. Recommend the client check the ketones in the urine every morning.

B.Instruct the client to take the oral hypoglycemic medication with food to decrease gastric upset. The nurse is discussing the oral hypoglycemic medication glipizide with the client diagnosed with Type 2 Diabetes. Which information should the nurse discuss with the client?

The nurse is preparing to administer a calcium channel blocker, loop diuretic, and a beta blocker to a client who is diagnosed with uncontrolled hypertension. Which intervention should the nurse implement? A. Hold the medication and notify the healthcare provider. B. Contact the pharmacist to discuss the medications. C. Assess the client's blood pressure. D. Administer the medications as prescribed.

C. Assess the client's blood pressure.

The client with liver dysfunction experiences toxicity to a drug following administration of several doses. This adverse reaction may have been prevented if the nurse had followed which phase of the nursing process? A. Evaluation. B. Implementation. C. Assessment. D. Planning.

C. Assessment.

The client diagnosed with hyperthyroidism is prescribed the antithyroid medication propylthiouracil (PTU). Which statement by the client warrants immediate intervention by the nurse? A. "Since taking PTU, I am not as hot as I used to be." B. "I do not seem to be drowsy and sleepy all the time." C. "I have a sore throat and have had a fever." D. "I have gained 2 pounds over the past month since I started taking PTU."

C. "I have a sore throat and have had a fever." The antithyroid medication may affect the body's ability to defend itself against bacteria and viruses; therefore, the nurse should intervene if the client has any type of fever, sore throat, chills, malaise, or weakness.

The client diagnosed with high blood pressure is ordered the ACE inhibitor, lisinopril. Which statements by the client indicate to the nurse the discharge teaching has been effective? Select all that Apply. A. "If I forget to take my medication, I will take two doses the next day." B."If if get leg cramps, I should increase my potassium supplements without needing to ask my healthcare provider." C. "I should get up slowly when I am getting out of my bed." D. "I can eat anything I want as long as I take my medication every day." E. "I should check and record my blood pressure once a day."

C. "I should get up slowly when I am getting out of my bed." E. "I should check and record my blood pressure once a day." Antihypertensive medications in general cause orthostatic hypotension. Therefore, the client should be taught to get up slowly from lying to sitting and sitting to a standing position to help prevent dizziness and light-headedness. The blood pressure must also be checked daily.

The nurse cares for a client diagnosed with gout. The nurse instructs the client about allopurinol (Zyloprim). Which statement by the client indicates to the nurse the need for further instruction? A. "This medication increases the excretion of uric acid through the kidneys." B. "I should take the medication with meals to decrease upset stomach." C. "It will be necessary for me to decrease my fluid intake now." D. "It will take at least 2 to 3 weeks for my gout symptoms to improve."

C. "It will be necessary for me to decrease my fluid intake now." It takes approximately 2 to 3 weeks for serum uric acid levels to return to normal limits after allopurinol therapy is initiated. When taking allopurinol, the client should consume enough fluids to maintain a urine output of at least 2 liters per day; will prevent formation of uric acid kidney stones. Allopurinol should be taken with or immediately after meals to decrease gastric irritation. Allopurinol decreases the formation of uric acid by blocking the enzyme necessary for uric acid formation. Allopurinol is used to treat chronic gout and will decrease the size of tophi and prevents formation of new tophi.

The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the prescribed timolol (Timoptic) blocker when the clients makes which statement: A. "This eyedrop is the only treatment available for glaucoma." B. "I can stop using the eyedrop once my intraocular pressure is normal." C. "This eyedrop will reduce the intraocular pressure." D. "The medicine will help to increase my intraocular pressure."

C. "This eyedrop will reduce the intraocular pressure." Ophthalmic beta-blockers such as timolol are administered to reduce intraocular pressure by decreasing production of aqueous humor. The medication must be continued as a lifelong therapy to maintain a stable intraocular pressure.

The client is admitted to the medicine unit and is ordered to be placed on a sliding scale insulin protocol. The client's blood glucose is 248 mg/dL. How much insulin should the nurse adminster to the client? Blood Glucose Dosage 0 - 150 mg/dL 0 units 151 - 200 mg/dL 2 units 201 - 250 mg/dL 4 units 251 - 300 mg/dL 6 units 301 - 350 mg/dL 8 units A. 2 units. B. 6 units. C. 4 units. D. 0 units.

C. 4 units.

Which patient should NOT be prescribed alendronate (Fosamax) for osteoporosis? A. A female patient being treated for high blood pressure with an ACE inhibitor. B. A patient on a calorie restricted diet. C. A patient on bed rest who must maintain a supine position. D. A patient who is allergic to iodine/shellfish.

C. A patient on bed rest who must maintain a supine position.

A client with cirrhosis of the liver exhibits decreased metabolic activity. This will require what possible change in the client's drug regimen? A. An increased dose of prescribed drugs. B. All prescribed drugs must be given by intramuscular injection. C. A reduction in the dosage of drugs. D. A change in the timing of medication administration.

C. A reduction in the dosage of drugs. The liver is the primary site of drug metabolism. Clients with severe liver damage, such as that caused by cirrhosis, will require reductions in drug dosage because of the decreased metabolic activity.

A nurse is preparing to administer a heparin injection to a client for prevention of deep vein thrombosis while hospitalized. What is an essential nursing intervention? A.Draw up the medication in an intramuscular (IM) syringe with a 22-gauge, 1-½ inch needle. B. Utilize the Z-track method to inject the medication. C. Administer the medication into the subcutaneous tissue. D. Rub the administration site after injecting.

C. Administer the medication into the subcutaneous tissue.

A client is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout? A. Allopurinol. B. Probenecid. C. Colchicine. D. Sulfinpyrazone.

C. Colchicine. This medication is used to prevent or treat gout attacks (flares). Usually gout symptoms develop suddenly and involve only one or a few joints. The big toe, knee, or ankle joints are most often affected. Gout is caused by too much uric acid in the blood. When uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints. Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s).

The nurse is caring for a 78-year-old client who has multiple medications ordered to treat various medical problems. The nurse considers which of the following common age physiological change will most likely require a reduction in medication dosage for this client? A. Decreased efficiency in drug distribution. B. Increased total body fluid proportionate to body mass. C. Decreased rate of drug metabolism by the liver. D. Increased rate of drug excretion.

C. Decreased rate of drug metabolism by the liver.

The client being discharged after sustaining an acute myocardial infarction is prescribed the ACE inhibitor lisinopril (Zestril). Which instruction should the nurse include when teaching about this medication? A. Instruct the client to monitor their blood pressure weekly. B. Encourage the client to take the medication on an empty stomach. C. Discuss the need to rise slowly from lying to a standing position. D. Teach the client to take the medication at night only.

C. Discuss the need to rise slowly from lying to a standing position.

Because of the physiologic and biochemical changes of aging in the geriatric patient, the nurse recognizes which adjustment in medications may be necessary? A. The parental route of administration is preferred. B. Medications will need to be given more frequently. C. Dosages of medications may need to be decreased. D. Drugs should be given in the early AM.

C. Dosages of medications may need to be decreased. Due to the decline in liver and kidney function in the geriatric patient, dosages of medications may need to adjusted to combat the physiological aging process of decreased metabolism and excretion of drugs.

The nurse administered 25 units of Humulin N to a client with Type I Diabetes at 5:00 PM. Which intervention should the nurse implement based on the knowledge that the insulin will peak in 4 - 12 hours. A. Assess the client for hypoglycemia around 6:00 PM. B. Serve the client the supper tray. C. Ensure the client eats the nighttime (HS) snack. D. Check the client's serum blood glucose level.

C. Ensure the client eats the nighttime (HS) snack. Humulin N is an intermediate-acting insulin that peaks 4 - 12 hours after administration; therefore, the client would experience signs of hypoglycemia around after 9pm. The nurse needs to ensure the client eats the nighttime (HS) snack to help prevent nighttime hypoglycemia.

The client diagnosed with a head injury after a skiing accident is ordered to have a head CT scan. The client is requesting to receive morphine sulfate IV prior to being transported to the radiology department. What teaching should the nurse include when discussing the administration of morphine sulfate to the client? A. Explain to the client that fentanyl will work best to control pain. B.Morphine sulfate can not be taken with any other routine medications; therefore, the client should not receive the drug. C. Explain to the client that morphine sulfate is contraindicated because this could put the client at potential risk of increased cerebrospinal fluid (CSF) pressure. D. Inform the client that an intravenous line (IV) will be started prior to the procedure and the client can receive the morphine sulfate at that time.

C. Explain to the client that morphine sulfate is contraindicated because this could put the client at potential risk of increased cerebrospinal fluid (CSF) pressure. Morphine sulfate reduces the sensitivity of the respiratory center to CO2 thus decreasing tidal volume and rate and producing respiratory depression. The resulting increase in CO2 produces vasodilation and increases CSF pressure. Morphine sulfate can be given with most routine medications. Morphine sulfate and fentanyl are contraindicated in patients with head injuries.

Which medication should the nurse question administering? A. Verapamil to a client with angina. B. Carvedilol to a client with an apical pulse of 72. C. Furosemide to a client complaining of leg cramps. D. Lisinopril to a client with a BP of 118/84 mmHg.

C. Furosemide to a client complaining of leg cramps.

The period of time needed for a medication to be reduced by 50% in the body is referred to as: A. First-pass effect. B. Therapeutic Response. C. Half-life. D. Efficacy.

C. Half-life.

The nurse is completing a medical history for a client with asthma. For which reason would the​ beta2-adrenergic agonist albuterol​ (Proventil) be contraindicated for this​ client? A. Connective tissue disease. B. Spinal stenosis. C. High blood pressure. D. Mitral valve prolapse.

C. High blood pressure.

Which statement best describes the pharmacodynamics of insulin? A. Insulin is metabolized by the liver and muscle and excreted in the urine. B. Insulin causes the pancreas to secrete glucose into the bloodstream. C. Insulin lowers blood glucose by promoting use of glucose in the body cells. D. Insulin is needed to maintain colloidal osmotic pressure in the bloodstream.

C. Insulin lowers blood glucose by promoting use of glucose in the body cells. This statement explains the pharmacodynamics, which is the drug's mechanism of action or way that insulin is utilized by the body. Over time, elevated glucose levels in the bloodstream can cause long-term complications, including nephropathy, retinopathy, and neuropathy. Insulin lowers blood glucose by promoting the use of glucose in body cells.

A nurse is caring for a cancer patient receiving subcutaneous morphine sulfate for pain. Which of the following nursing actions is most important in the care of this patient? A. Monitor urine output. B. Monitor heart rate. C. Monitor respiratory rate. D. Monitor temperature.

C. Monitor respiratory rate. Morphine sulfate can suppress respiration and respiratory reflexes, such as cough. Patients should be monitored regularly for these effects to avoid respiratory compromise. Morphine sulfate does not significantly affect urine output, heart rate, or body temperature.

The charge nurse on an orthopedic unit is transcribing orders for a client diagnosed with 2/10 back pain. Which health care provider order should the charge nurse question? A. CBC and CMP (complete metabolic panel) lab work. B. Carisoprodol (SOMA), a muscle relaxant, PO, twice daily. C. Morphine sulfate, an opioid agonist, 10 mg IV Push every hour. D. tramadol (Ultram), centrally acting nonopioid analgesic, 50 mg PO every 6-8 hours PRN.

C. Morphine sulfate, an opioid agonist, 10 mg IV Push every hour. Morphine sulfate is a potent analgesic with addictive properties, and the nurse should question a routine administration of this medication. The health care provider may have failed to write PRN after the order. Many medications can affect the kidneys or the liver and the blood counts. Baseline data should be obtained. There is no reason to question this order. Soma comes in one strength, so this order is complete. There is no reason to question this order.

A client has been started on gemfibrozil (Lopid) in combination with atorvastatin (Lipitor) for treatment of severely elevated triglyceride levels. When the client develops bruising and epitaxis, the nurse anticipates which provider order? A. The dose of atorvastatin will be reduced. B. A p.r.n. analgesic will be ordered. C. Obtain labs to assess the patient's clotting state. D. An ECG will be ordered.

C. Obtain labs to assess the patient's clotting state. Fibric acid derivatives, such as gemfibrozil, can increase bleeding times. Example: the INR or prothrombin time will help to evaluate the client's clotting state. The statin is not the cause of the problem. An analgesic or ECG would not help to correct the underlying problem.

Which statement is an advantage to administering a proton-pump inhibitor (PPI) rather than an antacid to a client diagnosed with gastroesophageal reflux disease (GERD)? A. Antacids are more potent than PPis in relieving the symptoms of GERD. B. PPIs have more side effects than antacids. C. PPIs require less frequent dosing than antacids. D. PPIs are less expensive than antacids.

C. PPIs require less frequent dosing than antacids. PPIs require less frequent administration than do antacids, which require frequent administration, seven or more times a day, for therapeutic effects. The fewer times a client is expected to take a medication, the more likely the client is to comply with a medication regimen.

The nurse receives the patient's lab values throughout warfarin drug therapy. The expected therapeutic level is: A. aPTT one to two times the patient's baseline level. B. aPTT of three to four times the normal control value. C. PT/INR one and a half to two times the control value. D. PT one to two times the patient's last result.

C. PT/INR one and a half to two times the control value. aPT/INR is the coagulation study that monitors oral anticoagulant use, such as warfarin. As a result of one and half to two times the control value indicates adquate anticoagulation. aPTT is the coagulation study that monitors heparin use. aPT level of one would indicate a less than therapeutic level of anticoagulation.

Mrs. Walker requires pain relief for a recent sunburn. The provider orders benzocaine 20% topical spray to apply to Mrs. Walker's affected areas and then the phone reception is interrupted and the phone conversation is disconnected. When the nurse calls the provider back, which 5 right would the nurse need to clarify? A. Right brand name of the drug. B. Right patient. C. Right time and frequency of drug administration. D. Right cost of the drug.

C. Right time and frequency of drug administration. Interpret the prescriber's order accurately (i.e., drug name, dose, frequency of administration). Question the prescriber if any information is unclear or if the drug seems inappropriate for the client's condition.

A patient calls the clinic today because he is taking atorvastatin (Lipitor) to treat his high cholesterol and is having pain in both of his legs. You instruct him to: A.Stop taking the medication and make an appointment to be seen in the clinic next week. B.Continue taking the medication and make an appointment to be seen in the clinic next week. C. Stop taking the medication and come to the clinic to be seen today. D. Ambulate for about 30 minutes and call to be seen in the clinic if symptoms continue.

C. Stop taking the medication and come to the clinic to be seen today. Muscle aches, soreness, and weakness may be early signs of myopathy such as rhabdomyolysis associated with the HMG-CoA reductase class of antilipemic agents. This patient will need an immediate evaluation to rule out myopathy. Additional doses may exacerbate the problem. Exercise will not reverse myopathy and delays diagnosis.

Which client should the nurse question administering the antidiarrheal medication diphenoxylate (Lomotil)? A. The 28-year-old client receiving aminoglycoside antibiotics. B. The 78-year-old client with chemotherapy associated diarrhea. C. The 68 year-old client diagnosed with glaucoma. D. The 44-year-old client with coronary artery disease.

C. The 68 year-old client diagnosed with glaucoma. The client with glaucoma should not receive Lomotil because of the drug's anticholinergic effect, which will increase the intraocular pressure.

The nurse is preparing to administer a 9:00 AM medication of morphine sulfate 1 mg IV to the following clients. Which client should the nurse QUESTION administering the medication? A. The client who drank a full glass water and ate a large meal. B. The client who is complaining of lower back pain. C. The client who has a blood pressure of 88/58 mm/Hg. D. The client who has a a normal platelet count.

C. The client who has a blood pressure of 88/58 mm/Hg. The blood pressure is below 100/60 mm/Hg; therefore, the nurse should question administering morphine sulfate due to the risk of causing an additional CNS adverse effect of hypotension. The patient drinking water or eating a large meal should not affect the absorption of the morphine sulfate when given via the IV route. Lower back pain is not a contraindication for morphine sulfate administration. The client's platelet count is within the normal range and would not piose a risk of being a contraindication for morphine sulfate administration.

The client with essential hypertension is prescribed metoprolol (Lopressor). Which assessment data should make the nurse question administering this medication? A. The client is complaining of a yellow haze. B. The client has an occipital headache. C. The client's apical pulse is 56 bpm. D. The client's blood pressure is 112/90 mmHg.

C. The client's apical pulse is 56 bpm. The nurse would question administering a beta blocker if the client's apical pulse was less than 60 bpm because this medication decreases the heart rate.

The client is diagnosed with hypothyroidism and is taking the thyroid hormone levothyroxine (Synthroid). Which data indicates the medication is effective? A. The client tells the nurse that the client only needs 3 hours of sleep. B. The client's temperature is 96.0F and respiratory rate is 10. C. The client's apical pulse is 84 bpm and the blood pressure is 128/78 mmHg. D. The client reports having a soft, formed stool every 4 days.

C. The client's apical pulse is 84 bpm and the blood pressure is 128/78 mmHg. If the thyroid medication is effective, the client's metabolism should be within normal limits, and this pulse and blood pressure support this.

The client diagnosed with congestive heart failure is taking digoxin (Lanoxin). Which data indicates the medication is effective? A. The client's blood pressure is 110/68 mmHg. B. The client's potassium level is 5.3 mEq/L. C. The client's lungs are clear bilaterally. D. The client's radial pulse rate is regular.

C. The client's lungs are clear bilaterally.

The nurse is teaching a client about safe drug administration when using topical permethrin for the treatment of scabies. The nurse determines that instruction has been effective when the client states: A. "I need to rinse off the topical medication after it has been on my skin for a few days." B. "I need to sign a consent for this medication." C."I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion." D. "I should cover the area with a clean cloth when applying the medication."

C."I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion." The nurse should teach the patient, family, or caregiver to report any redness, swelling, itching, excoriation, or burning to the health care provider.

Which statement indicates to the nurse that the client needs further medication instruction about cholestyramine (Questran)? A. "I should take this medication 1 hour after or 4 hours before my other medications." B. "The medication may cause constipation, so I will increase fluid and fiber in my diet." C."It is not necessary to stir the powder in 6-8 oz of fluid to maintain potency of the medication." D. "I might need to take fat-soluble vitamins to supplement my diet."

C."It is not necessary to stir the powder in 6-8 oz of fluid to maintain potency of the medication."

A 16-year-old adolescent who is 6 weeks pregnant has acne that has been exacerbated during the pregnancy. She asks the nurse if she can resume taking her PO tretinoin (Retin-A) prescription. The best response by the nurse is: A. "You should reduce your PO Retin-A dose by half during pregnancy." B. "Since you already have a prescription for PO Retin-A, it is safe to take during pregnancy." C."The PO formulation of Retin-A is known to cause birth defects; therefore, it is not recommended that you take it during pregnancy." D. "You should check with your provider at your next visit."

C."The PO formulation of Retin-A is known to cause birth defects; therefore, it is not recommended that you take it during pregnancy." The PO formulation of Retin-A is Category D and demonstrates positive evidence of human fetal risk. There is a high risk that infants will be severely deformed if this PO formulation of the drug is administered during pregnancy.

Nurses have a legal and moral responsibility to report medication errors. The steps of reporting these errors include: A. Identifying potential unsafe medication facilities. B. Monitoring unsafe medication orders. C.Examining interdisciplinary causes of errors and assisting professionals in ways to avoid mistakes. D. Punishing the nurse committing the error.

C.Examining interdisciplinary causes of errors and assisting professionals in ways to avoid mistakes.

The healthcare provider prescribed lisinopril for a client diagnosed with congestive heart failure. Which instruction should the nurse provide? A. A dry cough is expected early in the morning on arising. B. Eat a banana or drink orange juice at least twice a day. C.Notify the healthcare provider or go to the emergency room if you develop localized edematous oral mucosa membranes. D. The symptoms of congestive heart failure improve rapidly.

C.Notify the healthcare provider or go to the emergency room if you develop localized edematous oral mucosa membranes. A condition in which there are localized edematous areas, accompanied by itching of the skin and mucous membranes is called angioedema. This is an adverse reintervention to an ACE inhibitor and should be reported to the healthcare provider or the client should report to the emergency room immediately.

The nurse is reconciling the medications with a client who is being discharged. Which of the following indicates there is a "discrepancy?" A. There is justification for a difference in the medication orders. B.There is agreement between the client's home medication list and current medication orders. C.There is lack of congruence between a client's home medication list and current medication orders. D. Sample medications have been included in the medication list.

C.There is lack of congruence between a client's home medication list and current medication orders. The medications ordered for, administered to, or dispensed to the client while under the care of a health care organization are compared to those on the list and any discrepancies (e.g., omissions, duplications, potential interactions) are resolved. A complete list of the client's medications is communicated to the next provider of service when a client is referred or transferred to another setting, service, practitioner, or level of care within or outside the organization. The complete, accurate list of medications is also provided to the client on discharge from the organization. The next provider of service checks the Medication Reconciliation List again to make sure it is accurate and in concert with any new medications to be ordered or prescribed.

Mr. Dow works the evening shift. The provider orders a medication that must be taken three times a day on an empty stomach. He asks you if he can take his evening dose with supper for convenience. How should you respond? A. "It does not matter if the drug is taken on an empty stomach or not." B. "It it is only the one meal, the food will not make a difference." C. "Food may increase the effectiveness of the medication." D. "Food may slow the absorption of the drug."

D. "Food may slow the absorption of the drug."

The client diagnosed with essential hypertension is taking furosemide (Lasix). Which statement by the client warrants notifying the client's healthcare provider? A. "I usually have one or two cups of coffee a day." B. "I get a little dizzy when I get up too fast." C. "I really wish my mouth would not be so dry." D. "I have been experiencing really bad leg cramps."

D. "I have been experiencing really bad leg cramps." Leg cramps could indicate hypokalemia, which is potentially life threatening secondary to cardiac dysrhythmias. This needs to be reported to the healthcare provider so that the dosage can be reduced or potassium supplements can be ordered for the client.

The home health nurse is caring for a client diagnosed with congestive heart failure who has been prescribed the cardiac glycoside digoxin (Lanoxin) and the loop diuretic furosemide (Lasix). Which statements by the client indicate the medications are effective? Select all that Apply. A. "I keep my feet propped up as much as I can during the day." B. "My blood pressure has been high over the past week." C. "I am staying on my diet, and I don't salt my foods anymore." D. "I have not gained any weight since my last doctor's visit." E. "I am able to walk next door now without being short of breath."

D. "I have not gained any weight since my last doctor's visit." E. "I am able to walk next door now without being short of breath." A symptom of CHF is shortness of breath. The fact that the client can ambulate without being short of breath is an improvement of symptoms, which shows that the medication are effective. Weight gain would indicate that the client is retaining fluid and the medications are not effective. No weight gain indicates the medication is effective.

The client diagnosed with Type 2 Diabetes is prescribed the sulfonylurea glipizide (Glucotrol). Which statement by the client warrants intervention by the nurse? A. "I have to eat my diabetic diet even if I am taking this medication." B. "I do not like to walk every day, but I will if it will help my diabetes." C. "I will need to check my blood glucose level at least once or more than once a day." D. "I usually have one glass of wine with my evening meal."

D. "I usually have one glass of wine with my evening meal." Sulfonylureas and biguanides may cause an Antabuse-like reaction when taken with alcohol, causing the client to become nauseated and vomit. Advise the client to abstain from alcohol and to avoid liquid OTC medications that may contain alcohol. Alcohol also increases the half-life of the medication and can cause a hypoglycemia reaction.

The nurse helps a client establish goals to control asthma with medications. The nurse emphasizes that the preferred drugs for long-term "control" of asthma are: A. Antihistamines. B. Anticholinergics. C. Inhaled Beta-2 adrenergic agonist. D. Inhaled corticosteroids.

D. Inhaled corticosteroids. Inhaled corticosteroids are the drugs of choice for the prevention of asthmatic attacks and for the management of chronic asthma. Although symptoms will improve in the first 1 to 2 weeks of therapy, 4 to 8 weeks may be required for maximum benefit p. 740 Adams & Urban

Mrs. Smith is 12 hours post appendectomy. Her husband asks the nurse to reduce the amount of morphine sulfate that his wife is receiving. He states, "When I had my appendix out, I needed half the pain medication that she does." Based on the nurse's knowledge, what is the best nursing response? A. "I agree she is taking far too much pain medication." B."I will call the physician for an order to decrease the dose and the frequency of your wife's pain medication." C. "You should discuss your wife's pain management with the physician." D. "Pain is a subjective experience, we all feel pain differently."

D. "Pain is a subjective experience, we all feel pain differently." Pain is a subjective experience. Stressors such as anxiety, depression, fatigue, anger, and fear tend to increase pain; rest, mood elevation, and diversionary activities tend to decrease pain. Pain is a complex physiologic, psychological, and sociocultural phenomenon that must be thoroughly assessed if it is to be managed effectively.

The mother of a client who has been diagnosed with head lice has completed the application of permethrin (Nix) shampoo. Which of the following is the next step the nurse should teach the mother regarding the treatment of head lice: A. "Check the heads of your child's friends before allowing them to play together." B. "You are fine now; just watch your child for a reinfection." C. "Keep your child's hair short so it will be easier to treat next time." D. "Remove all nits from the hair shaft with a nit comb or a fine-tooth comb."

D. "Remove all nits from the hair shaft with a nit comb or a fine-tooth comb." The client's mom should be instructed to clear the dead lice eggs with a fine-toothed comb as the next step after shampooing with Nix for proper head lice treatment.

The nurse is discussing the System to Manage Accutane (tretinoin) Related Teratogenicity (SMART) with a client who has severe acne. Which statement by the female client would cause the healthcare provider to Not Prescribe PO tretinoin (Accutane)? A. "My menstrual cycles have been regular and heavy." B. "I will have to come in every month for a pregnancy test." C. "I hope this works because I am so tired of being ugly." D. "The only contraception I use is birth control pills."

D. "The only contraception I use is birth control pills." The client must use two forms of birth control when taking PO Accutane (tretinoin) because it is extremely damaging to the fetus. The SMART protocol has been instituted to ensure that no female clients are or become pregnant while taking this medication.

What is the best information for the nurse to provide to the client who is receiving spironolactone (Aldactone) [potassium-sparing diuretic]and furosemide (Lasix) [Loop (high-ceiling) diuretic] therapy? A."Using two drugs increases the osmolality of plasma and the glomerular filtration rate." B."Moderate doses of two different diuretics are more effective than a large dose of one." C. "This combination prevents dehydration and hypovolemia." D. "This combination promotes diuresis but decreases the risk of hypokalemia."

D. "This combination promotes diuresis but decreases the risk of hypokalemia." Spironolactone is a potassium-sparing diuretic; furosemide causes potassium loss. Giving these together minimizes electrolyte imbalance.

A client who was admitted for a pulmonary embolism requires emergency surgery. The client has been receiving intravenous heparin and has a current aPTT level of >150 seconds. What nursing intervention will the nurse anticipate as a priority before surgery? A. Teach the client about the phenytoin. B. Assess the INR before surgery. C. Administer vitamin K. D. Administer protamine sulfate.

D. Administer protamine sulfate. Protamine sulfate binds with heparin in the bloodstream to inactivate it and thus reverse its effect.

A diabetic client has been diagnosed with hypertension, and the physician has prescribed propranolol, a beta-blocker. When performing discharge teaching, it is important for the client to recognize that the addition of propranolol with a history of diabetes can cause: A. An increase in the incidence of ketoacidosis. B. A decrease in the incidence of ketoacidosis. C. A decrease in the hypoglycemic effects of insulin. D. An increase risk of masked hypoglycemia effects.

D. An increase risk of masked hypoglycemia effects.

The nurse is administering digoxin (Lanoxin) to a client diagnosed with congestive heart failure. Which intervention should the nurse implement? Select all that Apply. A. Assess the client's carotid pulse for 1 full minute. B. Have the client squeeze the nurse's fingers. C. Teach the client to stand up quickly from a sitting position. D. Ask the client if he or she is seeing a yellow haze around objects. E. Check the client's current potassium level.

D. Ask the client if he or she is seeing a yellow haze around objects. E. Check the client's current potassium level. The client's potassium level, as well as the digoxin level, is monitored because high levels of potassium impair therapeutic response to digoxin and low levels can cause toxicity. The most common cause of dysrhythmias in clients receiving digoxin is hypokalemia from diuretics that are usually given simultaneously. Yellow haze indicates the client may have high serum digoxin levels. The therapeutic range for digoxin is relatively small (0.5 to 1.2), and levels 2.0 or greater are considered toxic.

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with the cient diagnosed with hypothyroidism. Which intervention should the nurse discuss with the client? A. Tell the client to take the medication with food only. B. Encourage the client to decrease the fiber in the diet. C. Discuss the need to monitor the T3, T4 levels daily. D. Instruct the client to report any significant weight changes.

D. Instruct the client to report any significant weight changes. The client's weight should be monitored weekly. Weight loss is expected as a result of the increased metabolic rate, and weight changes help to determine the effectiveness of the drug therapy.

A drug is 100% bioavailable when it is administered by which of the following routes? A. Oral. B. Rectal. C. Parental. D. Intravenous.

D. Intravenous.

Prior to administering medication to a hospitalized client who is awake and carrying on a conversation with visitors, what would be the most accurate way for the nurse to check one of the 5 rights "the client's identity"? A. Ask the client, "Are you Dale Jones." B. Match the medication administration record with the client's diagnosis. C. Check the client's room number and bed assignment on the door. D. Ask the client, "Can you tell me your name and date of birth?"

D. Ask the client, "Can you tell me your name and date of birth?" Asking the client to state his or her name is an accurate way to identify a client, provided the client is alert. A second unique identifier, such as date of birth or medical record number, should also be used. This information may be found on the client's indentification bracelet, although the client may be asked to state date of birth. Hospitalized or ill clients are often anxious, medicated, or confused and could respond incorrectly to the question, "Are you Dale Jones?" Because client's bed assignments are sometimes changed to meet unit needs, checking the room assignment poses a risk for incorrect identification. Because the same diagnosis with the same medication may be appropriate for more than one client, matching the medication to the diagnosis or need will place the client at risk.

Mr. Gray calls the nurses' station and request his prn break-through pain relief of fentanyl (Sublimaze) for his chronic lower back pain. Which intervention should the nurse perform prior to administering fentanyl to the client? A. Administer the client's prescribed pain medication. B. Check the MAR to see if there is an non-narcotic medication ordered. C. If visitors are present, wait until the visitors leave to administer the medication. D. Assess the client's perception of pain on a 1-10 pain scale.

D. Assess the client's perception of pain on a 1-10 pain scale. The first action is always to assess the client in pain to determine if the client is having a complication that requires medical intervention rather than PRN pain medication. The nurse should not administer pain medication until after assessing the client's pain. The nurse should assess the client, then administer the pain medication whether the client has visitors or not.

When a client asks how nicotinic acid (niacin) will help to treat high lipid levels, the nurse explains that it should: A. Increase VLDL levels. B. Decrease HDL levels. C. Increase triglyceride levels. D. Decrease LDL levels.

D. Decrease LDL levels. The primary effect of nicotinic acid is to lower VLDL levels. Since LDL is synthesized from VLDL, the client experiences a decrease in LDL levels. It also decreases triglycerides, and increases HDL.

Normal age physiological changes in the geriatric patient may affect excretion and promote accumulation of drugs in the body includes which of the following factors: A. Rigidity of the diaphragm. B. Decreased mental status. C. Increased gastric motility. D. Decreased glomerular filtration rate.

D. Decreased glomerular filtration rate. Decreased glomerular fitration rate is part of the normal aging process in the geriatric patient, which results in decreasing of dosages of medications due to the diminished excretion of medication via the kidneys.

The nurse should assess clients with chronic open-angle glaucoma for: A. Eye pain. B. Excessive lacrimation. C. Colored light flashes. D. Decreasing peripheral vision.

D. Decreasing peripheral vision. Although chronic open-angle glaucoma is usually asymptomatic in the early stages, peripheral vision gradually decreases as the disorder progresses. Eye pain is not a feature of chronic open-angle glaucoma but is common in clients with angle-closure glaucoma. Excessive lacrimation is not a symptom of chronic open-angle glaucoma; it may indicate a blocked tear duct. Flashes of light is a common symptom of retinal detachment.

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is elevated at 6 mEq/L. For this client, the nurse's priority should be to assess her: A. Bowel sounds. B. Neuromuscular function. C. Respiratory rate. D. EKG (12 lead cardiac rhythm test)

D. EKG (12 lead cardiac rhythm test) Although changes in all these findings are seen in hyperkalemia, ECG results should take priority because changes can indicate potentially lethal arrhythmias such as ventricular fibrillation. It wouldn't be appropriate to assess the client's neuromuscular function, bowel sounds, or respiratory rate for effects of hyperkalemia.

In considering the pharmacotherapeutic perspective, which property is considered the greatest maximal response that can be produced from a particular drug: A. Toxicity. B. Interaction with other drugs. C. Potency. D. Efficacy.

D. Efficacy.

The nurse determines that a patient has experienced the beneficial effects of medication therapy with ranitidine (Zantac) when which of the following symptoms is relieved? A. Difficulty swallowing. B. Nausea. C. Belching. D. Epigastric pain.

D. Epigastric pain. Ranitidine is an H2 receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyeracidity, thus relieving epigastric pain.

The patient receiving chemotherapy rings the call bell and reports an onset of nausea. The nurse should prepare a prn dose of which of the following medications? A. Dexamethasone. B. Zolpidem (Ambien). C. Morphine sulfate. D. Ondansetron (Zofran).

D. Ondansetron (Zoran). Ondansetron is a 5-HT3 receptor antagonist antiemetic that is especially effective in reducing cancer chemotherapy-induced nausea and vomiting).

Which statement is the scientific rationale for administering a proton-pump inhibitor (PPI) to a client diagnosed with gastrointestinal reflux disease (GERD)? A. PPI medications block H2 receptors on the parietal cells. B. PPI medications neuralize the gastric secretions. C. PPI medications form a protective barrier against acid and pepsin. D. PPI medications inhibit the enzyme that generates gastric acid.

D. PPI medications inhibit the enzyme that generates gastric acid. PPIs inhibit the enzyme that generates gastric acid.

The nurse observes a coworker preparing to administer a solution of lidocaine with epinephrine via the intravenous route to a client whose heart rate is 150 beats per minute. The appropriate action by the nurse is to: A. Notify the nursing supervisor of the error. B. Document administration of the drug. C. Do nothing: the drug choice and route is correct. D. Prevent administration and question the order with the physician.

D. Prevent administration and question the order with the physician. Solutions of lidocaine containing preservatives or epinephrine are intended for local anesthesia only and must never be given IV for dysrhythmias.

A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to: A. Improve perfusion by increasing blood flow to the area. B. Increase the rate of absorption of the lidocaine. C. Allow more systemic absorption to speed up metabolism of the lidocaine. D. Prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.

D. Prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.

A client uses timolol maleate (Timoptic) eye drops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by: A. Dilating the canals of Schlemm. B. Constricting the pupils. C. Improving the ability of the ciliary muscle to contract. D. Reducing aqueous humor formation.

D. Reducing aqueous humor formation. Timolol maleate is commonly administered to control glaucoma. The drug's action is not completely understood, but it is believed to reduce aqueous humor formation, thereby reducing intraocular pressure. Timolol does not constrict the pupils; miotics are used for pupillary constriction and contraction of the ciliary muscle. Timolol does not dilate the canal of Schlemm.

A client is prescribed a non-selective beta adrenergic blocker who has also been prescribed albuterol. What nursing intervention is a priority for this client? A. Assessment of blood glucose levels. B. Teaching about potential tachycardia. C. Orthostatic blood pressure assessment. D. Respiratory assessment.

D. Respiratory assessment.

Nurse Clarisse is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications? A. Decreased plasma drug levels. B. History of Tourette Syndrome. C. Lack of family support. D. Sensory deficits.

D. Sensory deficits. Sensory deficits could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications. Decreased plasma drug levels do not alter the patient's knowledge about the drug. A lack of family support may affect compliance, not knowledge retention. Tourette syndrome is unrelated to knowledge retention.

The client with hyperthyroidism is prescribed propylthiouracil (PTU) and develops a sore throat. Which laboratory data should the nurse monitor? A. The client's arterial blood gases. B. The client's red blood cell (RBC) count. C. The client's serum potassium levels. D. The client's white blood cell (WBC) count.

D. The client's white blood cell (WBC) count. The client receiving PTU is at risk for agranulocytosis; therefore, the client's WBC count should be checked periodically. Because agranulocytosis puts the client at greater risk for infection, efforts to control invasion of microbes should be strictly observed.

The client taking digoxin (Lanoxin) has a serum digoxin level of 4.2 ng/mL. Which medication should the nurse anticipate the healthcare provider prescribing? A. The healthcare provider will not prescribe any medications. B. The cardiac glycoside digoxin (Lanoxin). C. The loop diuretic furosemide (Lasix). D. The digitalis binder Fab antibody fragments (Digibind).

D. The digitalis binder Fab antibody fragments (Digibind). When digoxin overdose is suspected, as it would be with a digoxin level of 4.2 ng/mL. Fab antibody fragments bind digoxin and prevent it from acting.

The nurse is discussing skin care with a teenaged client who has MILD acne. Which medication or treatment should the nurse discuss with the client? A. Injections of Clostridium botulinum into the acne lesions. B. Applying Vitamin E oil directly to the acne pimples to keep them moist. C. Taking isotretinoin (Accutane) by mouth daily. D. Washing the face and neck morning and night with benzoyl peroxide.

D. Washing the face and neck morning and night with benzoyl peroxide. Benzoyl peroxide is used for mild acne to suppress the growth of P. acnes and promote keratolysis (peeling of the horny layer of the epidermis). Accutane has serious side effects, and its use is restricted to only those with severe, disfiguring acne. Clients with acne have too much oil production. Applying Vitamin E oil would increase the client's problem. Clostridium botulinum is Botox, which is used to decrease the appearance of wrinkles. It is not used to treat acne.

Which factor is most important for the nurse to assess when evaluating the effectiveness of a client's drug therapy: A. Client's promise to comply with drug therapy. B. Client's satisfaction with the drug. C. Cost of the medication. D. Evidence of therapeutic benefit.

D. evidence of therapeutic benefit Once phamacotherapy is initiated, ongoing assessment is conducted to determine the presence of therapeutic effects or adverse effects.

Which statement made by the client indicates understanding about discharge instructions on antihyperlipidemic medications? A."It is important to double my dose if I miss one in order to maintain therapeutic blood levels." B. "I will stop taking the medication if it causes nausea and vomiting." C."Antihyperlipidemic medications will replace the other interventions I have been doing to try to decrease my cholesterol." D."I will continue my exercise program to help increase my high-density lipoprotein (HDL) serum levels."

D."I will continue my exercise program to help increase my high-density lipoprotein (HDL) serum levels." Antihyperlipidemic medications are an addition to, not a replacement for, the therapeutic regimen used to decrease serum cholesterol levels.

A client is frantic because her two children have been sent home from school with head lice. She has treated her kids' scalps but does not know what else to do. What will be the best teaching by the nurse? A. "Do not let your children return to the school until your house is fumigated." B. "Continue to apply the medication to their scalps as directed for another week." C. "Isolate the children from other family members for three days." D."It is imperative to also wash bed linens and clothing in hot water that have come into contact with your children."

D."It is imperative to also wash bed linens and clothing in hot water that have come into contact with your children." Instruct the patient, family, or caregiver to wash bedding, clothing used currently, combs, and brushes in soapy water and dry thoroughly. Vacuum furniture or fabric that cannot be cleaned to remove any errant vermin. Dry clean hats or caps that cannot be washed. Seal children's toys in plastic bags for 2 weeks if they cannot be washed.

A mother tells the nurse that head lice has been discovered in her​ child's hair. What is the best instruction by the​ nurse? A. "Purchase a lotion and apply it to your​ child's scalp. Leave it on for 12​ hours." B. ​"Purchase a​ lotion, apply it to your​ child's head and​ body, and leave it on for 24​ hours." C. ​"Purchase a lotion and apply it to your​ child's head three times a day for 2​ weeks." D."Purchase the over-the-counter permethrin (Nix) shampoo and apply it to your​ child's rinsed scalp and leave the shampoo on the scalp for 10​ minutes prior to rinsing."

D."Purchase the over-the-counter permethrin (Nix) shampoo and apply it to your​ child's rinsed scalp and leave the shampoo on the scalp for 10​ minutes prior to rinsing." The medication should be allowed to remain on the hair and scalp for 10 minutes before removal. The lotion does not need to be left on the head for 12 hours or applied more than once. Leaving the lotion on for 24 hours is excessive​ treatment, and only the head needs treatment.

A client is receiving morphine sulfate IV for acute pain and tells the nurse, "I get dizzy when I stand up." Which of the following is the most appropriate response by the nurse? A. "You may be experiencing a toxic effect of the drug and I will notify the physician." B. "Dizziness is not related to the drug, but I will need to ask you a few more questions." C. "Episodes of dizziness when moving are common symptoms of acute pain." D."This is an expected side effect of the drug, and you should use caution and move slowly when standing up."

D."This is an expected side effect of the drug, and you should use caution and move slowly when standing up." Feeling dizzy when moving from lying or sitting to standing position is referred to as orthostatic hypotension and is a potential side effect of opioid agonist. The client should be instructed to change positions slowly.

The client diagnosed with congestive heart failure is prescribed the angiotensin-converting enzyme (ACE) inhibitor lisinopril. Which statement explains scientific rationale for administering this medication? A. ACE inhibitors block the intervention of the glomerulus filtration rate in the kidney. B. ACE inhibitors decrease the effects of bradykinin in the body. C. ACE inhibitors increase the levels of angiotensin II in the blood vessels. D.ACE inhibitors reduce the levels of angiotensin II, dilate arteries, and reduce blood volume, which reduces the workload of the heart.

D.ACE inhibitors reduce the levels of angiotensin II, dilate arteries, and reduce blood volume, which reduces the workload of the heart. By reducing the levels of angiotensin II, ACE inhibitors dilate blood vessels, reduce blood volume, and prevent or reverse angiotensin II pathological changes in the heart and kidneys.

The provider has ordered topical tretinoin (Retin-A) for the treatment of a teenager's acne vulgaris. When caring for a client who is prescribed this medication, the nurse should instruct the client to: A. It is okay to take your friend's PO version of the acne medication. B. It is recommended to only tan in tanning beds while taking this topical medication. C.If the topical medication causes pain, you do not need to report this side effect to the healthcare provider. D.Avoid additional sun exposure or apply sunscreen when going outside during the day when taking this topical medication.

D.Avoid additional sun exposure or apply sunscreen when going outside during the day when taking this topical medication. Topical tretinoin can cause photophobia while taking this medication and it is recommended to avoid additional sun exposure or apply sunscreen when going outside during the day.

When teaching a client about propranolol hydrochloride, the nurse should base the information on the knowledge that propranolol: A. Increases norepinephrine secretion and thus decreases blood pressure and heart rate. B.Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure. C.Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II. D.Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction.

D.Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction. Propranolol is a beta-adrenergic blocking agent. Actions of propranolol include reducing heart rate, decreasing myocardial contractility, and slowing conduction. Propranolol does not increase norepinephrine secretion, cause vasodilation, or block conversion of angiotensin I to angiotensin II.

The client newly diagnosed with Type 2 Diabetes who has been prescribed an oral hypoglycemic medication calls the clinic and tells the nurse that her sclera has a yellow color. Which intervention should the clinic nurse implement? A. Check to see if the client is taking the cardiac glycoside digoxin. B. As the client if he or she has been exposed to someone with hepatitis. C. Determine if the client has a history of alcohol use of is currently drinking alcohol. D.Make an appointment for the client to come to the healthcare provider's office for evaluation and lab work.

D.Make an appointment for the client to come to the healthcare provider's office for evaluation and lab work.

The nurse is administering 9:00 AM medications to the following clients. Which client should the nurse question administering the medication? A. The client receiving a beta blocker who has an apical pulse of 77 bpm. B. The client receiving a nitroglycerin patch who has a blood pressure of 148/92 mmHg. C. The client receiving an antiplatelet medication who has a platelet count of 150,000. D.The client receiving a calcium channel blocker who drank a glass of grapefruit juice.

D.The client receiving a calcium channel blocker who drank a glass of grapefruit juice. The client receiving a calcium channel blocker should avoid grapefruit juice because it can cause the medication to rise to toxic levels.

The nurse is preparing to administer the following medications. Which medication should the nurse question administering? A. The calcium channel blocker diltiazem to the client with a glucose level of 280 mg/dL. B. The vasodilator hydralazine to the client with a blood pressure of 168/94 mmHg. C. The alpha blocker prazosin to the client with a serum sodium level of 137 mEq/L. D.The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1 mEq/L.

D.The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1 mEq/L. The serum potassium level is low (normal is 3.5 - 5.0 mEq/L). Therefore, because a loop diuretic will cause further potassium loss, the nurse should question administering this medication and obtain a potassium supplement for the client.