Pharm ATI 3.0

A nurse is assessing a client who has multidrug-resistant tuberculosis and takes ethambutol. The nurse should identify which of the following findings as an adverse effect of this medication? A. Mottling of the extremities B. Orange-red urine and bodily secretions C. Yellowing of the sclera D. Loss of red/green color discrimination

D. Loss of red/green color discrimination Ethambutol is an antitubercular medication that impairs ribonucleic acid synthesis. A common adverse reaction is the loss of red/green color discrimination due to optic neuritis. The nurse should notify the provider of this finding and expect to discontinue the medication.

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse requires intervention? A: instructing the client to administer a PCA dose prior to a dressing change B: providing increased fluids while the client is using the PCA pump C: informing the client's partner that only the client should administer the PCA doses D: maintaining the client on bed rest while the PCA pump is in use

D: maintaining the client on bed rest while the PCA pump is in use

A nurse is preparing to administer raloxifene to a client. Which of the following conditions is a contraindication for the administration of this medication? Osteoporosis Hyperthyroidism Myocardial infarction DVT

DVT Increases risk for blood clots like estrogen

A nurse is administering Adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during administration of Adenosine? Seizures Cinchonism Dyspnea Transient pallor of the face

Dyspnea d/t bronchoconstriction- should be short lived

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from a provider for which of the following medication for daily management of this condition? A) celecoxib B) prednisone C) adalimumab D) abatacept

A) celecoxib

A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to watch for and report to the provider? Weight gain Myalgia Hypoglycemia Severe constipation

Myalgia s/s of lactic acidosis

An 18-month-old toddler who has Kawasaki disease (KD). The child is receiving intravenous immune globulin (IVIG). The guardian asks the nurse to administer the child's scheduled measles, mumps, and rubella (MMR) vaccine before discharge. Which of the following responses should the nurse provide? A. "Your child will not be able to receive the MMR vaccine for at least 3 months after discharge." B. "I cannot administer routine vaccines to children while they are in the hospital." C. "Your child can receive the MMR vaccine once his fever is gone." D. "I can administer the measles and rubella vaccines, but I cannot administer the mumps vaccine."

A. "Your child will not be able to receive the MMR vaccine for at least 3 months after discharge." The nurse should explain to the guardian that IVIG given for the treatment of KD contains antibodies that can interfere with the action of live-virus vaccines like MMR. The MMR immunization should be postponed for 3 to 6 months.

A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child's serum phenytoin level is 14 mcg/mL. Which of the following actions should the nurse take? A. Administer the dose B. Administer half the dose C. Do not administer the dose D. Clarify the dose with the provider

A. Administer the dose This is within the normal range

A patient is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout? a. naproxen b. allopurinol c. probenecid d. sulfinpyrazone

a. naproxen

A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? "I will be able to stop taking this medication 6 months after my surgery." "I am likely to develop higher blood pressure while taking this medication." "I am likely to lose my hair while taking this medication." "I am taking this medication to boost my immune system."

"I am likely to develop higher blood pressure while taking this medication."

A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times? 0800 0745 0900 1030

0745

A nurse is caring for a client who is receiving cefotetan 1g via intermittent IV bolus every 12 hr to treat a postoperative infection. Which of the following manifestations should the nurse monitor for as an adverse effect of the medication? A. Disorientation B. Epistaxis C. Constipation D. Jaundice

B. Epistaxis

A nurse is reviewing a medical record of a client who has a prescription for a combination of oral contraceptive. The nurse should identify that which of the following findings is a contraindication to receiving this medication? A. High cholesterol level B. Liver disease C. Family history of ovarian cancer D. Client reports of hypermenorrhea

B. Liver disease other contraindications thrombophlebitis or breast cancer

A nurse is reviewing the medical record of a client who is experiencing a migraine and has a new prescription for sumatriptan. Which of the following factors in the client's medial history should the nurse identify as a contraindication to receiving this medication? A. renal impairment B. ischemic heart disease C. severe osteoporosis D. cirrhosis

B. ischemic heart disease Medication causes vasoconstriction and coronary vasospasm. also contraindicated in MI, CAD, uncontrolled HTN, or other heart disease

A nurse is reinforcing teaching with a client who has a prescription for doxycycline for the treatment of a Helicobacter pylori infection. Which of the following instructions should the nurse include in the teaching? A. "Take this medication with meals to decrease gastrointestinal upset." B. "Continue this medication if you become pregnant." C. "Wear protective clothing while in the sun." D. "Expect to have severe diarrhea while taking this medication."

C. "Wear protective clothing while in the sun."

A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I should let my doctor know if I have yellowing of my eyes." B. "This medication will stop my liver from making cholesterol." C. "I should expect to experience some bruising when I begin this medication." D. "I will take this medication at the same time as my gemfibrozil."

A. "I should let my doctor know if I have yellowing of my eyes." Jaundice AE d/t hepatitis

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? A. Amantadine B. Bupropion C. Phenelzine D. Hydroxyzine

A. Amantadine This client is experiencing Parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following findings is the nurse's priority? A. Mood changes B. Nausea C. Altered sense of taste D. Skin rash

A. Mood changes The greatest risk to the client is the development of neuropsychiatric effects that can progress to depression and suicide. Therefore, the highest priority is a change in the client's mood.

A nurse is caring for a client who is developing acute pulmonary edema and has a new prescription for furosemide 40 mg IV bolus. The nurse should plan to administer the medication using which of the following methods? A. Undiluted administered over 2 min B. Diluted administered over 20 min C. Undiluted administered as rapidly as possible D. Diluted administered over 5 min

A. Undiluted administered over 2 min

A nurse is caring for a client who was recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe methotrexate at which of the following times? A. Within 3 months of the initial diagnosis B. When NSAIDs have not provided pain relief C. During an exacerbation of symptoms D. Once bone degeneration progresses

A. Within 3 months of the initial diagnosis DMARD started within 3 months to prevent or delay joint degeneration

A nurse is caring for a client with premenstrual disorder (PMD) who has a prescription for fluoxetine. The client asks the nurse, "When should I notice the benefits of this medication?" Which of the following responses should the nurse make? A. You should expect decreased manifestations within a few days. B. Manifestations decrease after about 2 months. C. You should expect decreased manifestations immediately. D. Manifestations will decrease after several weeks.

A. You should expect decreased manifestations within a few days. unlike when it is used to treat depression, manifestations will improve more quickly

Nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which finding is a nurse priority? A. paresthesia B. alopecia C. stomatitis D. constipation

A. paresthesia

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse take into consideration? A. Increased intestinal transit rate B. Accelerated excretion of fluids C. Reduced renal blood flow D. Decreased hepatic metabolism

B. Accelerated excretion of fluids There are physiological changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow. This results in increased glomerular filtration. To compensate for accelerated excretion, dosages of medications that glomerular filtration eliminates must be increased to achieve a comparable therapeutic effect.

A nurse is caring for a client who is taking memantine for alzheimer's disease. Which of the following laboratory results should the nurse recognize as increasing the client's risk of decreased clearance of the medication? A. AST 30 units/ liter B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

B. Creatinine clearance 35 mL/min

A nurse is caring for a client who has atrial fibrillation and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure? A. Amlodipine B. Diltiazem C. Nifedipine D. Lidocaine

B. Diltiazem The nurse should anticipate a prescription for diltiazem, which blocks calcium channels in the heart and blood vessels, thereby lowering blood pressure. Also, it is an antiarrhythmic medication that is used during cardioversion to treat atrial fibrillation

A nurse is caring for a client who is taking streptomycin. Which of the following medications should the nurse identify as increasing risk for ototoxicity when taken with streptomycin? A. Cefoxitin B. Furosemide C. Naproxen D. Amphotericin B

B. Furosemide. furosemide a loop diuretic increases risk of ototoxicity when taken with streptomycin an aminoglycoside. Naproxen and amphotericin B increase risk of nephrotoxicity when taken with streptomycin.

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.) A. BUN B. PTT C. Aspartate aminotransferase (AST) D. Urinalysis E. Alanine aminotransferase (ALT)

B. PTT C. Aspartate aminotransferase (AST) E. Alanine aminotransferase (ALT) Valproic acid can alter coagulation; therefore, PT and PTT should be monitored. It also can cause life-threatening hepatotoxicity; the client should have baseline liver function tests (LFTs) before starting this medication, and LFTs should be repeated at regular intervals during therapy.

A nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medication's peak level is 9.3 mcg/mL. Which of the following actions should the nurse take? A. administer half of the prescribed dosage at the client's next scheduled dose. B. tell the client that the medication seems to be effective. C. advise the client to drink more water throughout the day. D. ask if the client has been experiencing any peripheral neuropathy

B. tell the client that the medication seems to be effective. Normal range is 5-10

A nurse is providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A. "You can take ibuprofen for headaches while taking this medication." B. "You may experience increased swelling in your lower extremities while taking this medication." C. "You should eat foods that are high in potassium while taking this medication." D. "You should take this medication at bedtime."

C. "You should eat foods that are high in potassium while taking this medication."

A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refused to eat breakfast. Which of the following actions should the nurse take first? Encourage the client to eat the toast on the breakfast tray. Administer an antiemetic .Inform the client's provider. Check the client's apical pulse.

Check the client's apical pulse. concern for digoxin toxicity

The nurse is caring for a client who has had a levonorgestrel- releasing intrauterine device (IUD) in place for 1 year. Which of the following should indicate that the client is experiencing an adverse effect? A. Developed sensitivity to copper. B. Vaginal irritation or inflammation C. Decreased menstrual bleeding D. Spotting between menses cycles

D. Spotting between menses cycles

A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider? BUN 18 mg/dL Platelets 78,000/mm3 Hemoglobin 14.2 g/dL Aspartate aminotransferase (AST) 35 units/L

Platelets 78,000/mm very low and puts the pt at risk for severe bleeding

A nurse is assessing a client who has oral Theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline? Constipation Tremors Fatigue Bradycardia

Tremors

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function tests

c. Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effect while using amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? a. blood pressure 180/70 mmHg b. oxygen saturation rate 94% c. heart rate 51/min d. respiratory rate 21/min

c. heart rate 51/min

A nurse is planing to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse include? a. Choose an IV port for IV bolus injection of diphenhydramine as near as possible to the client's hanging IV bag b. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine c. Allow the infusion to keep running while administering the diphenhydramine via IV bolus d. Aspirate to check for IV potency before administering the diphenhydramine

d. Aspirate to check for IV potency before administering the diphenhydramine It is important to confirm IV latency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse is teaching a client about the adverse effects of omeprazole. Which of the following client statements indicates an understanding of the teaching? A. "If I experience severe diarrhea, I will call my doctor." B. "Pneumonia is associated with long-term use of this medication." C. "I will need to take this medication with food." D. "I should take vitamin B12 while using this medication."

A. "If I experience severe diarrhea, I will call my doctor." Clients who experience diarrhea while taking omeprazole or other (PPIs) should report this finding to the provider immediately. Omeprazole and other PPIs are associated with a dose-related increase in the risk of infection with C. diff, which is a bacterium that can cause severe diarrhea.

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following pieces of information should the nurse include in the teaching? A. Respiratory depression can occur 7 min after the morphine is administered. B. The morphine will peak in 10 min. C. Withhold the morphine if the client has a respiratory rate of <16/min. D. Administer the morphine over 2 min.

A. Respiratory depression can occur 7 min after the morphine is administered. Respiratory depression can occur within 7 minutes of the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine.

A nurse is reviewing a prescription for fexofenadine for a 7 year old with seasonal allergies. Which of the following findings should the nurse clarify with the provider? A. The prescription says to avoid taking the medication with orange juice B. The prescription says to take standard tablets C. The prescription says to take 30 mg twice daily D. The prescription says to administer the medication orally.

B. The prescription says to take standard tablets The prescription says to take standard tablets.-The nurse should identify that standard tablets are designed for individuals 12 years or older. Therefore the nurse should clarify the prescription as a 7 year old should be receiving the oral disintegrated suspension. The therapeutic effect of fexofenadine is decreased when taken with orange juice so the nurse should not question this. 30 mg twice daily is an appropriate dose for a 7 year old. fexofenadine is taken orally.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. hyperthyroidism B. intestinal obstruction C. glaucoma D. low blood pressure

B. intestinal obstruction. intestinal obstructionMetoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.

A nurse is assisting with a client's laceration repair in which the provider will use both lidocaine and epinephrine. The nurse should inform the client that the epinephrine will perform which of the following actions? A: act as a catalyst for the anesthetic properties of lidocaine B: delay systemic absorption of the anesthetic properties of lidocaine C: open the blood vessels for rapid anesthesia from the lidocaine D: prevent medication toxicity during the procedure

B: delay systemic absorption of the anesthetic properties of lidocaine

A nurse is caring for a client with a pseudomonas infection who has a new prescription for ticarcillin-clavulanate. Which of the following data should the nurse collect before administering this medication? A. Indications of superinfection B. Peak and trough medication levels C. Baseline BUN and creatinine D. History of allergy to aminoglycoside antibiotics

C. Baseline BUN and creatinine It is a penicillin antibiotic and is excreted by the kidneys.

A nurse is preparing a discharge teaching plan for a client who is scheduled to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? A. Stop taking the medication if a rash occurs. B. Take the medication on an empty stomach to enhance absorption. C. Schedule the medication on alternate days to decrease adverse effects. D. Treat shortness of breath with an extra dose of the medication.

C. Schedule the medication on alternate days to decrease adverse effects. Some of the adverse effects caused by long-term glucocorticoid therapy (e.g. suppression of the adrenal gland) can be avoided by using alternate-day therapy.

A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first? Acamprosate Naltrexone Chlordiazepoxide Disulfiram

Chlordiazepoxide Long acting benzo to treat acute alcohol withdrawal

A nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching? A. "If you miss a pill, take the missed pill with your next dose." B. "If you miss 2 pills during the second and third week, discard the inactive placebo pills and begin a new pack." C. "If you miss 3 pills during the second week, take a pill as soon as possible and continue with your scheduled doses." D. "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks."

D. "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks."

A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority? a. Pulmonary function b. CBC c. Urinary ouput d. Peripheral edema

a. Pulmonary function Bleomycin can cause severe lung injury, including pneumonitis and pulmonary fibrosis, which affects a significant percentage of clients receiving this medication; therefore, pulmonary function is the priority assessment.

A nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? a. Psoriatic arthritis b. Hepatitis B virus c. Ulcerative colitis d. Ankylosing spondylitis

b. Hepatitis B virus The nurse should identify that infliximab is a tumor necrosis factor (TNF) antibody medication that is used to reduce the disease manifestations and to delay disease progression. Infliximab has immunosuppressant properties that can increase the risk of infection. Clients who have an active or chronic infection such as hepatitis B virus should not take infliximab.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? a. Nausea b. Metallic taste c. Fever d. Drowsiness

c. Fever

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? a. Thrombophlebitis b. Hyperactive reflexes c. Muscle weakness d. Hypoglycemia

c. Muscle weakness d/t hypokalemia