Pharm ATI Practice Questions
A nurse is assessing a pt w/ rheumatoid arthritis who has been taking high doses of prescribed hydroxychloroquine. Which of the following pt statements should indicate to the nurse that the pt is experiencing an adverse effect of hydroxychloroquine? -I have developed sores in my mouth -I often feel like the room is spinning -I noticed that the whites of my eyes look yellow -I have has a change in my vision recently
I have had a change in my vision recently -The nurse should i.d. that hydroxychloroquine is an antimalarial med used to tx rheumatoid arthritis. Pt's who take hydroxychloroquine in high doses are at risk for developing retinopathy, which can be irreversible and cause blindness
A nurse is teaching a pt who has a new dx of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following pt statements indicates an understanding of the teaching? -I can take my second dose of med no later than 9:00 PM -I should change positions slowly when getting out of bed -If I miss a dose, I should double the next dose -I should notify my provider if I experience a headache while taking this med
I should change positions slowly when getting out of bed -The nurse should i.d. that isosorbide mononitrate is an antianginal med that produces vasodilation. Therefore, this med can cause orthostatic hypotension. Pt's should change positions slowly upon rising to minimize the effects of orthostatic hypotension
A nurse is providing discharge teaching to a pt who has heart faiure and a prescription for digoxin 0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the pt indicates an understanding of the teaching? -I know that blurred vision is expected to happen while I'm taking digoxin -I will measure my urine output each day and document it is my diary -I will skip a dose of my digoxin if my resting heart rate is below 72 beats per min -I will eat fruits and vegetables that have a high potassium content every day
I will eat fruits and vegetables that have a high potassium content every day -hypokalemia is an adverse effect of diuretic therapy. Because the pt is taking digoxin, it is important to maintain a potassium level between 3.5-5.0 to avoid digoxin toxicity
A nurse is caring for a pt who receives gastrostomy tube feedings and insulin. The pt is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously? -0600 -0630 -0645 -0730
0645 -Lispro is a rapid-acting insulin w/ an onset of 15 min. The nurse should admin the insulin dose 15 min prior to the feeding
A nurse on a medical unit is preparing to admin alendronate 40 mg PO for an older adult pt who has Paget's disease of the bone. Which of the following actions should be the nurse's priority? -admin the med to the pt before breakfast in the morning -ambulate the pt to a chair prior to admin the med -give the med to the pt w/ water rather than milk -teach the pt how to take the med at home
ambulate the pt to a chair prior to admin of the med -the nurse should ambulate the pt to a chair and unsure that the pt is sitting upright before administering the alendronate to prevent esophagitis from occurring
A nurse in a postpartum unit is caring for a pt who plans to breastfeed her newborn exclusively. The pt has a prescription for depot medroxyprogesterone acetate (DMPA). At which of the following times should the nurse schedule the pt to receive the first dose of the med? -after 3 months postpartum -at 6 weeks postpartum -within the first 5 days postpartum -during the first week of the first postpartum menstrual cycle
at 6 weeks postpartum -the nurse should tell the pt that the first dose should be administered at 6 weeks postpartum if the pt is exclusively breastfeeding and after ensuring the pt is not pregnant
A nurse is caring for a pt who has alcohol use disorder & was admitted w/ lower-extremity fractures following a motor vehicle crash. A few hrs after admission, the pt develops restlessness and tremors. Which of the following meds should the nurse anticipate administering to the pt first? -acamprosate -naltrexone -chlordiazepoxide -disulfiram
chlordiazepoxide -chlordiazepoxide, a long acting oral benzodiazepine, if a first line med for a pt who is experiencing manifestations of acute alcohol withdrawal. For pts who are nauseated/vomiting, another benzodiazepine can be admin via IV
A nurse is reviewing the medical hx of a client who has spasticity due to multiple sclerosis and a new prescription of tizanidine. Which of the following comorbidities increases the client's risk of adverse effects while taking the med? -pneumonia -benign prostatic hypertrophy -hepatitis -diabetes mellitus
hepatitis -tizanidine can cause liver damage. This med should be used w/ extreme caution in a client who has a new preexisting impairment of hepatic funciton
A nurse is caring for a pt who has osteoporosis and have been taking a vit D supplement. The nurse notes that the pt reports also taking a multivitamin daily. Which of the following finding should indicate to the nurse that the pt might be experiencing vit D toxicity? -hyperkalemia -hypermagnesemia -hypercalcemia -hypernatremia
hypercalcemia -the nurse should i.d. that vit D increases plasma calcium levels by increasing reabsorption from bone, decreasing excretion by the kidneys and increasing absorption from the intestines. Pts who take vit D supplement along w/ a multivitamin daily might be taking too much calcium
A nurse is caring for a pt w/ BPH who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? -seizures -tachycardia -bronchodilation -hypotension
hypotension -nonselective alpha 1 adrenergic antagonists like doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased blood pressure
A nurse is assessing a pt who has been taking simvastatin to treat hyperlipidemia. Which of the following statements by the pt indicates an adverse effect of the med that should be reported to the provider immediately? -I have had occasional constipation -I have has some gas -my head has been hurting from some days -my legs feel weak and achy
my legs feel weak and achy -priority finding is muscle pain and weakness. A serious adverse effect of this med is muscle injury, which can progress to severe myositis. The pt should report any unusual onset of muscle pain or tenderness to the provider immediately
A nurse is caring for a pt who has a new prescription for amphotericin B. The nurse should plan to monitor the pr for which of the following adverse effects? -hyperkalemia -hypertension -constipation -nephrotoxicity
nephrotoxicity -Amphotericin B is an antifungal med used to tx several fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the pts creatinine every 3-4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the pt's creatinine is 3.5 mg/dL or greater
A nurse is admitting a pt who has unstable angina. Which of the following meds should the nurse anticipate administering to the pt? -epinephrine -nitroglycerin -lidocaine -atropine
nitroglycerin -the nurse should anticipate administering nitroglycerin to a pt who has unstable angina. This med acts by relaxing/preventing spasms in the coronary arteries along w/ dilating the arteries, which increases oxygenation and blood flow
A nurse is administering a prescription for nifedipine to a pt who is pregnant. Which of the following pieces of info r/t nifedipine should the nurse monitor and document? -hypoglycemia -uterine ripening -increased blood pressure -number of uterine contractions
number of uterine contractions -a pt who is going into preterm labor can have a prescription for nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into myometrial cells, which can delay labor
A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority? -paresthesia -alopecia -stomatitis -constipation
paresthesia -the greatest risk to this pt is neurotoxicity. Vincristine, a cell-cycle specific chemotherapy agent, interrupts cellular reproduction at mitosis and can cause neurotoxicity. An early finding w/ neurotoxicity is paresthesia (numbing) of the peripheral extremities. As neurotoxicity progresses, the pt can develop autonomic and CNS dysfunction. The nurse should report paresthesia immediately, as the provider might change the dosage or the therapy
A nurse is assessing a pt who has been taking linezolid to tx a staphylococcus aureus infection. Which of the following findings should the nurse report to the provider? -nausea -headaches -paresthesias -insomnia
paresthesias -although these reactions are rare, some pts who take linezolid develop irreversible peripheral neuropathy and reversible optic neuropathy. The nurse should report this finding to the provider because it might warrant switching the pt to another antibiotic
A nurse manager is instructing a newly licensed nurse about routes of med admin. Which of the following routes involves med absorption through the mucous membranes under the tongue? -oral -topical -parenteral -sublingual
sublingual
A nurse is administering insulin glulisine 10 units subq at 0730 to an adolescent pt who has type 1 DM. The nurse should anticipate the onset of action of the insulin at which of the following times? -0800 -0745 -0900 -1030
0745 -insulin glulisine has a very short onset of action of 15 mins. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following the admin of the insulin
A nurse is planning to admin epoetin alfa to a pt who has chronic kidney failure. Which of the following should the nurse plan to review prior to administering this med? -BP -temp -BGL -total protein levels
BP -epoetin alfa often causes HTN, which can lead to stroke/other CV complications. The nurse should monitor the pt's BP & notify the provider about increases. A pt who receives epoetin alfa frequently requires concurrent use of an antihypertensive med
A nurse is caring for a pt who has a new prescription for levothyroxine to tx hypothyroidism. Which of the following findings should the nurse i.d. as an indication that the pt requires intervention? -HR 106/min -dry skin -oral temp 36.8 C (98.2F) -lethargy
HR 106/min -tachycardia can be a manifestation of hyperthyroidism, possibly due to excessive hormone replacement. The pt might require a lower dosage of levothyroxine.
A nurse is caring for a pt who has tuberculosis and is taking rifampin. Which of the following pt statements should indicate to the nurse that the pt is experiencing an adverse effect of the med? -I have noticed my urine is orange in color -I sleep more than I used to -my tongue and moth are sore -my voice seems hoarse
I have noticed my urine is orange in color -the nurse should i.d. that an adverse effect of rifampin can be red-orange colored urine, saliva, sweat, and tears as the med is excreted from the body. The nurse should also inform the pt that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The pt should inform the provider if urine becomes dark in color since this can be an indication of hepaotoxicity
A nurse is providing teaching for a pt who has a new prescription for nitroglycerin administered through a transdermal patch. Which of the following pt statements indicates an understanding of the teaching? -I need to wear the patch continuously for it to be effective -I will stop using the patch immediately if it gives me a headache -I should change the patch whenever I have chest pain -I need to rotate the location of my patch every few days
I need to rotate the location of my patch every few days -the nitroglycerin patch should be rotated to different hairless areas of the pts body every few days to avoid local skin irritation
A nurse is teaching a pt who has a prescription for scopolamine patches for the tx of motion sickness. Which of the following pt statements should indicate to the nurse that the teaching has been effective? -I should apply this patch behind my ear -this patch should be replaced every 7 days -before putting on my patch, I should wipe the area w/ an alcohol swab -I can use a second patch if a single patch is not effective
I should apply this patch behind my ear -the nurse should i.d. that scopolamine patches should be applied behind the ear
A nurse is teaching a pt who has a new prescription for alosetron. Which of the following pt statements indicates an understanding of the teaching? -nausea is a common adverse effect of this med -I should contact my provider immediately if I experience constipation -If I do not respond to tx at the lowest dosage, my provider may continue to increase the dosage at weekly intervals -abdominal pain w/ diarrhea can indicate a serious complication
I should contact my provider immediately if I experience constipation -the nurse should i.d. that constipation is an adverse effect of this med and requires the provider to be notified. The provider may adjust the dose/withhold the med and then instruct the pt to resume taking it once the constipation has resolved
A nurse is teaching about the adverse effects of baclofen w/ a pt who has multiple sclerosis w/ spasms. Which of the following statements should the nurse i.d. as an indication that the pt understands the teaching? -adverse effects include urinary frequency -I should increase my fiber intake to counteract the adverse effect of diarrhea -this med can cause addiction -I should not stop taking this med suddenly
I should not stop taking this med suddenly -the nurse should inform the pt about the adverse effects associated w/ abrupt withdrawal of baclofen such as visual hallucinations, paranoid ideations, and seizures
A nurse is teaching a pt who will be taking dexamethasone daily for pain due to the spinal edema. The nurse should i.d. which of the following pt statements as an indication that the teaching has been effective? -I should eat a snack at bedtime to avoid low blood glucose -I should stay away from people who are ill -I should increase my fluid intake to about 3 quarts per day -I'll call my provider if I am experiencing too much sedation
I should stay away from people who are ill -This med is a glucocorticoid that decreases inflammation by affecting the pt's immune system. As a result, the pt is susceptible to infection and should avoid large crowds as well as people who are ill
A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered-dose inhaler. Which of the following statements by the parent indicates the need for further teaching? -I will give my child a dose as soon as wheezing starts -my child should rinse out his mouth after using the inhaler -my child should exhale completely before placing the inhaler in his mouth -if my child has difficulty breathing in the dose a spacer can be used
I will give my child a dose as soon as wheezing starts -cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic tx of asthma. Its is not a rescue med
A nurse is providing teaching to a pt who has a new prescription for a fentanyl transdermal patch. Which of the following statements by the pt indicates an understanding of the teaching? -the patch will not cause constipation like other pain meds do -I will have to stop drinking grapefruit juice while using the patch -I will place a heating pad over the patch to boot its effectiveness -the patch will give me relief from my pain faster than pills can
I will have to stop drinking grapefruit juice while using the patch -the nurse should instruct the pt to avoid drinking grapefruit juice while using the fentanyl transdermal patch. Grapefruit juice can increase the absorption of the med, raising the amount of fentanyl in the pts blood. This effect can place the pt at risk for CNS and resp depression
A nurse is providing teaching to a pt who has heart failure and is taking spironolactone. Which of the following statements by the pt indicates an understanding of the teaching? -I will increase my intake of citrus fruits, bananas, and potatoes -I will use salt substitutes on my food -I will drink as much water as I can while taking this med -I will watch for increased breast tissue growth while taking this med
I will watch for increased breast tissue growth while taking this med -spironolactone, which is derived from steroids, can cause adverse endocrine effects such as gynecomastia, impotence in men, and irregular menses and hirsutism in women. The nurse should instruct the pt that these changes can occur
A nurse is teaching a pt who has severe chronic gout and a new prescribption for pegloticase. The pt has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase? -you will take this med along w/ allopurinol -you will take this med by mouth -there are very few adverse effects of the med -if you experience a flare-up, you can take an NSAID while receiving this med
If you experience a flare-up, you can take an NSAID while receiving this med -the nurse should instruct this pt who has chronic gout that, during the first few months of tx, and increase in gout manifestations is expected. To reduce the intensity of these manifestations, pts are instructed to take an NSAID such as Naproxen
A nurse is teaching a female pt about vitamin A supplementation. Which of the following pt statments indicates an understanding of the teaching? -vit A supplements are usually prescribed during pregnancy -vit a can be taken in high doses because it is water-soluble -vit A is encouraged for a women who has osteoporosis -a deficiency a vit A can cause night blindness
a deficiency of vit A can cause night blindness -the nurse should i.d. that vitamin A is required for dark light adaptation. When a pt has a deficiency of vit A, night blindness is often the first sign. As the deficiency continues, other eye conditions can arise such as a dry and thickened conjunctiva and degeneration of the cornea
A charge nurse is teaching a newly licensed nurse about the purpose of a pt being prescribed a transdermal fentanyl patch. Which of the following pts should the charge nurse include in the teaching as a pt who requires this med? -a pt who is opioid tolerant -a pt who has difficulty swallowing -a pt who has severe intermittent pain -a pt who is postop following abdominal surgery
a pt who is opioid tolerant -the charge nurse should include in the teaching that a pt who is opioid tolerant can be prescribed a fentanyl patch to manage pain
A nurse is reviewing the lab data for a pt who is receiving clozapine for schizophrenia. The nurse should i.d which of the following findings as a potential adverse effect of the med? -fasting blood glucose 95 mg/dL -triglycerides 135 mg/dL -total cholesterol 175 mg/dL -absolute neutrophil count 1200 mm^3
absolute neutrophil count 1200 mm^3 -the nurse should i.d that an absolute neutrophil count of 1200 mm^3 is less than the expected range of 2500-8000. An adverse effect of clozapine can include agranulocytosis, which is a life threatening condition in which WBCs are severely decreased
A nurse is preparing to administer iron dextran IV to a pt. Which of the following actions should the nurse plan to take? -admin a small test dose before giving the full dose -infuse the med over 30 seconds -monitor the pt closely for HTN after the infusion -admin cyanocobalamin as an antidote if iron dextran toxicity occurs
administer a small test dose before giving the full dose -a serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the med. A small test dose should be administered over 5 mins before giving the full dose. The pt should be monitored carefully for an allergic reaction during and for a period of time following the test dose
A nurse is providing teaching to the parents of a school-age child w/ asthma about meds for bronchospasm. Which of the following inhaled meds should the nurse instruct the parents to use the relieve an acute asthma attack? -salmeterol -cromolyn -fluticasone -albuterol
albuterol -albuterol is a short-acting beta 2 adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One/two puffs ever 4-6 hrs PRN is the usual prescribed dose for a school-age child. If higher/more frequent doses are needed, the provider should eval the pt for worsening asthma
A nurse has administered a med to a pt. Which of the following circumstances should the nurse i.d. as a med error that resulted from a performance deficit by the nurse? -a med safety coordinator was not present -a verbal prescription was transcribed incorrectly -a med w/ a similar name was dispended instead of correct med -an IM injection was given instead of a subq injection
an IM injection was given instead of a subq injection -performance deficits such as using an improper route of admin for a med are the most common causes of med errors that result from human error. The nurse can effectively reduce med errors in the clinical practice by implementing a safety checklist and diligently using the rights of med admin. If the nurse is not following the rights of med admin, then the nurse has a performance deficit
A nurse is caring for a pt who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? -anti-estrogenic -antimicrobial -androgenic -anti-inflammatory
anti-estrogenic -tamoxifen is an anti-estrogen med used to tx cancer of the breast in both pre & postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk
A nurse is preparing to admin nitroglycerin topical ointment to a pt who has angina. Which of the following actions should the nurse take? -cover the applied ointment w/ cotton gauze -apply the ointment using a dose-measuring applicator -apply the ointment using the index finger -massage the ointment into the pt's skin
apply the ointment using a dose-measuring applicator -the nurse should apply the ointment using a dose-measuring applicator. This allows the nurse to measure the correct dose the pt is to receive
A nurse is caring for a pt who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately? -nausea -bloody stools -drowsiness -headache
bloody stools -when using the urgent vs nonurgent approach to pt care, the nurse should determine that the priority finding is bloody stools because adverse effects of tx w/ famotidine might include blood dyscrasias (thrombocytopenia), which can lead to bleeding. This finding should be reported to the provider immediately
A nurse is caring for a pt who is experiencing cycloplegia following the admin of atropine eye drops during an eye exam. Which of the following findings should the nurse expect as a result of cycloplegia? -inability to tolerate bright lights -pinpoint pupils -blurred vision -inability to perform an upward gaze
blurred vision -assessment findings of cycloplegia include blurred vision because focusing on near vision is impaired. This action occurs following the admin of atropine because the paralysis of the ciliary muscle prevents near vision focus. Accommodation, or looking from far to near and vice-versa, is also temporarily impaired
A nurse is caring for a pt who has bronchitis and a prescription for a mucolytic agent. Which of the following finding should the nurse i.d as an adverse effect of this type of med? -fluid overload -bronchospasm -electrolyte imbalance -tachycardia
bronchospasm -the nurse should i.d. that bronchospasm is an adverse reaction to a mucolytic agent. Mucolytic agents such as a hypertonic saline solution or acetylcysteine can irritate the airways, resulting in bronchospasm while producing a cough and thinning mucus secretions
A nurse is monitoring a pt who is receiving phenytoin IV for the tx of status epilepticus. Which of the following findings should the nurse i.d. as an adverse effect of the med? -HTN -cardiac dysrhythmias -gastric discomfort -tachycardia
cardiac dysrhythmias -the nurse should i.d. cardiac dysrhythmias as an adverse effect of phenytoin IV. As a result of this potential complication, cardiac monitoring is required
A nurse is teaching a pt who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this med? -you may need to take a lower dosage when you are ill or experiencing stress -take this med before going to bed because it will make you tired -carry a supply of pills and a single-use injectable preparation w/ you at all times -you will need to stop this med before routine procedures such as a colonoscopy
carry a supply of pills and a single-use injectable preparation with you at all times -the nurse should tell the pt to carry an emergency supply of the med to take during times of unexpected stress. The pt should carry an adequate supply at all times, which should include an injectable preparation plus a supply equal to the regular oral dosage. The single-use injectable preparation should be admin IM if the pt has an emergency and needs an extra dose of the glucocorticoid
A nurse is checking a pt who is receiving an IV infusion of telavancin for Streptococcus pyogenes. Which of the following actions should the nurse include? -check to see if the pt's urine is blue in color -check the pt for pruritus -check for HTN -check for numbness in the limbs
check the pt for pruritus -the nurse should monitor the pt who receives telavancin for pruritus, which can occur if the pt develops generalized exfoliative dermatitis from infusing the med too rapidly. Manifestations of this condition can include flushing, rash, pruritus, urticaria, tachycardia, hypotension
A nurse is caring for a pt who has congestive heart failure and is taking digoxin. The pt reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? -encourage the pt to eat the toast on the breakfast tray -admin an antiemetic -inform the pt's provider -check the pt's apical pulse
check the pt's apical pulse -nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias are possible findings in digoxin toxicity.
A nurse is preparing to administer the influenza vaccine to a pt. Which of the following allergies should the nurse i.d. as a contraindication to the pt receiving this vaccine? -gelatin -chicken eggs -neomycin -prednisone
chicken eggs -the nurse should i.d. that an allergy to chicken eggs is a contraindication to receiving the influenza vaccine. Pt's who have this allergy can experience angioedema and severe respiratory distress if this vaccine is administered
A nurse is reviewing the medical record of a pt who might have hearing loss. Which of the following data from the pt's medical record should the nurse i.d. as a risk factor for hearing loss? -frequent use of steroids -chronic use of salicylates -intermittent use of antacids -habitual use of laxatives
chronic use of salicylates -chronic use of salicylates such as aspirin can lead to ototoxicity, which can manifest as tinnitus or hearing loss
A nurse is caring for a pt who takes sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the admin of the med? -respirations -serum creatinine level -blood pressure -complete blood count
complete blood count -the nurse should i.d. that sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocytic anemia. As a result, the pt's CBC should be periodically monitored, and the nurse should review it prior to administering this med
A nurse is reviewing the lab data for a pt who has Alzheimer's disease and a new prescription for memantine. The nurse should i.d. that which of the following findings increases the pt's risk for reduced clearance of the med? -ALT 60 international units/L -creatinine clearance 35 mL/min -HbA1c 5% -BMI 31
creatinine clearance 35 mL/min -creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidneys' ability to filter waste. A creatinine clearance of 35 mL/min is below the expected range of 87-139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs w/ moderate renal impairment
A nurse is caring for a pt who has Alzheimer's disease and a prescription for memantine. Which of the following lab findings should the nurse i.d. as a contraindication to receiving this med? -ALT 60 units/L -creatinine clearance 35 mL/min -HbA1c 5% -BMI 31
creatinine clearance 35 mL/min -the nurse should i.d. that creatinine clearance is a value of the glomerular filtration rate (GFR) that determines the kidney's ability to filter waste. A creatinine clearance of 35 mL/min is outside of the expected reference range and reveals moderate renal impairment. Memantine is excreted by the kidneys, and a decreased clearance occurs in moderate renal impairment. Therefore, this finding is a contraindication to receiving the med
A nurse is assessing a pt who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provide? -nausea & vomiting -decreased hemoglobin -decreased appetite -anxiety
decreased hemoglobin -priority finding for the nurse to report to the provider is a decreased hemoglobin level. Zidovudine can cause severe anemia & neutropenia from bone marrow suppression, resulting in hematologic toxicity
A nurse is administering brimonidine eye drops to a pt who has glaucoma. Which of the following ocular effects should the nurse expect? -decreased intraocular pressure -blocked growth of new blood vessels -paralysis of accommodation -mydriasis
decreased intraocular pressure -brimonidine is an alpha-2 adrenergic agonist used for the long term tx of open-angle glaucoma. It decreases intraocular pressure by reducing aqueous humor production
A nurse is preparing to administer raloxifenen to a pt. Which of the following conditions is a contraindication for the administration of the med? -osteoporosis -hyperthyroidism -myocardial infarction -deep vein thrombosis
deep vein thrombosis -the nurse should i.d. that raloxifene, like estrogen, increases the risk of DVT, pulmonary embolism, and stroke. Raloxifene is contraindicated for pts who have a hx of venous thrombotic events
A nurse is caring for a pt who is 12 hrs postop following a total hip arthroplasty. Which of the following meds should the nurse anticipate administering to this pt to prevent DVTs? -aspirin -warfarin -ticagrelor -enoxaparin
enoxaparin -the nurse should anticipate the admin of enoxaparin for a client who is 12 hr postop following surgery. Enoxaparin is low=molecular-weight heparin that is used to prevent a DVT by inhibiting the effects of antithrombin & thrombin
A nurse is caring for a pt who is taking streptomycin. Which of the following meds increases the pt's risk of developing ototoxicity when taken w/ streptomycin? -cefoxitin -furosemide -naproxen -amphotericin B
furosemide -furosemide, a high-ceiling (loop) diuretic, increases the risk of developing ototoxicity when taken w/ streptomycin, and aminoglycoside
A nurse is caring for a pt who is pregnant and inquiring about alternative, non-pharm therapies for n/v of pregnancy. Which of the following options should the nurse recommend? -be sure to eat at least 3 lrg meals each day -if you're experiencing nausea when you wake up, wait to eat until lunchtime -you may need to take additional supplements to alleviate nausea -ginger is effective in the tx of n/v
ginger is effective in the tx of n/v -the nurse should recommend seasoning foods w/ ginger to alleviate the pt's n/v. Ginger is derived from the ginger root and is alternative tx to prescribed med for treating n/v during pregnancy
A nurse is reviewing the lab results of a client who is taking a med and notes that the clients blood tests show an elevated level of the enzymes AST and ALT. The nurse should recognize that these findings are potential indication of which of the following conditions? -renal dysfuction -myelotoxicity -hepatic toxicity -cardiac dysrhythmia
hepatic toxicity -the nurse should i.d. that elevated levels of AST & ALT are indication the pt might be at risk for hepatic toxicity. AST & ALT are enzymes that test liver function. The pt should undergo liver function tests, and the nurse should notify the provider of this finding
A nurse is a provider's office is reviewing a pt's med hx. The pt asks the nurse if she should begin taking high-dose vits as she ages. Which of the following pieces of info should the nurse provide about high doses of vitamin supplements? -high doses of eater-soluble vits enhances their therapeutic actions -high doses of water-soluble vits can have adverse effects -high doses of vit supplements are restricted to use during pregnancy -tolerance might develop, resulting in an increased vit need
high doses of water soluble vits can have an adverse effect -high doses of vits can cause harm to the body. Any vit supplements consumed should not exceed the recommended dietary allowance. Elevated levels of vit A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. Excessive intake of beta-carotene can increase the risk of lung cancer in pts who smoke. In addition, increased doses of vit E can increase the risk of death in pts who have chronic illnesses
A nurse is reviewing the medical record of a pt who has postmenopausal osteoporosis and a prescription for raloxifene. Which of the following findings in the pts medical record should the nurse i.d. as a contraindication to receiving this med? -breast cancer -hx of DVT -allergy to calcitonin -current dx of cholecystitis
hx of DVT -the nurse should i.d. that a hx of DVT is a contraindication for receiving raloxifene because this med can cause DVT in pts who has a prior hx. Therefore, the nurse should notify the provider of this finding and request an alternative med prescription for the pt
A nurse is caring for a pt who has a new prescription for enalapril. The nurse should monitor the pt for which of the following adverse effects of this med? -ecchymosis -jaundice -hypotension -hypokalemia
hypotension -enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension & postural hypotension, especially during the first 3 hrs of following the initial dosage
A nurse is caring for a pt who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should i.d. that which of the following is the therapeutic effect of this med? -improves oxygen saturation rate -decreases elevated BP -reduces HR -improves cardiac output
improves cardiac output -The nurse should i.d. that dobutamine is a vasopressor that improves cardiac output and hemodynamic status in pts
A nurse is reviewing the medical record for a pt who has a migraine and a prescription for sumatriptan. Which of the following factors in the pt's medical hx should the nurse i.d. as a contraindication to receiving sumatriptan? -renal impairment -ischemic heart disease -severe osteoprosis -cirrhosis
ischemic heart disease -the nurse should i.d. that ischemic heart disease is a contraindication to receiving sumatriptan. Sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm. This med is also contraindicated in pts who had a myocardial infarction/pts who has coronary artery disease, uncontrolled HTN, or other types of heart disease
A nurse is teaching a pt about the use of a dinoprostone vaginal insert pouch to stimulate labor. Which of the following statements should the nurse include in the teaching? -it is inserted using a catheter -one puch is given every 4 hrs until labor occurs -lie on your back for at least 2 hrs w/out getting up -if labor doesn't occur w/in 6 hrs, a second dose can be administered
lie on your back for at least 2 hrs w/out getting up -the pt should remain supine for at least 2 hrs after the dinoprostone vaginal pouch is inserted to allow a slow release of the med from the pouch to stimulate labor
A nurse is teaching a pt about taking tetracycline PO. Which of the following statements should the nurse include in the teaching? -take this med on a full stomach -limit your consumption of dairy products while taking this medicine -take the med w/ your regular iron supplement -take antacids if you have an upset stomach from using tetracycline
limit your consumption of dairy products while taking this medicine -the nurse should tell the pt to avoid/limit the consumption of dairy products while taking tetracycline. An interval of at least 2 hrs should separate tetracycline ingestion and the ingestion of products that can chelate this med such as milk/calcium
A nurse is administering a med to a pt. The nurse should i.d. that which of the following med distribution factors facilitates the effective passage of the med across the pts cell membrane? -protein binding ability -lipid solubility -hepatic metabolism -slow distribution
lipid solubility -a med being lipid soluble and the presence of a transport system both facilitate the ability of a med to cross cell membranes that separate the med from the blood
A nurse is providing teaching to a newly licensed nurse about caring for a pt who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests? -platelet count -electrolyte levels -thyroid function -liver function
liver function -gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function
A nurse is reviewing the med admin record of a pt who is receiving an opioid med for pain. Which of the following prescriptions should the nurse clarify w/ the provider? -metoprolol -ondansetron -lorazepam -naloxone
lorazepam -the nurse should i.d. that lorazepam can cause CNS depression, which can result in increased resp depression and sedation when administered w/ an opioid. The nurse should clarify the prescription w/ the provider
A nurse working in a mental health facility is admitting a pt w/ opioid use disorder who is experiencing withdrawal. The nurse should anticipate a prescription for which of the following meds from the provider? -methylnaltrexone -methadone -naloxone -hydromorphone
methadone -the nurse should anticipate a prescription from the provider for methadone for a pt who is experiencing opioid withdrawal. Methadone is an opioid med that is used for pain management & tx of withdrawal manifestations in pts who has opioid use disorder
A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the med instead of taking it orally. Which of the following pieces of info should the nurse provide to the parent? -inhaled glucocorticoids are less likely to cause thrush -oral glucocorticoids are hazardous during times of stress -oral glucocorticoids are more likely to slow linear growth in kids -inhaled glucocorticoids are more effective for acute bronchospasms
oral glucocorticoids are more likely to slow linear growth in kids -the chronic use of oral glucocorticoids in high doses by kids can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (the pts airway), resulting in a decreased risk for adrenal suppression
A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? -wt loss -peptic ulcer -hyperkalemia -diplopia
peptic ulcer -the nurse should monitor this pt who is taking glucocorticoids for peptic ulcer due to irritation of the gastric mucosa. The nurse should periodically check the pt's stool for occult blood & instruct the pt to contact the provider if any black/tarry stools occur
A nurse is caring for a pt who received spinal anesthesia 30 mins ago. The pt reports feeling dizzy, and the nurse notes that the pt's blood pressure is 84/54 mmHg. Which of the following actions should the nurse take? -place the pt in the head-down position -assess the placement of the catheter -prepare to admin an IV reversal agent -assist the pt in passive range of motion movements
place the pt in the head-down position -the nurse should i.d. the pt is experiencing an adverse effect from receiving the spinal anesthesia. Hypotension is the common adverse effect of spinal anesthesia due to the loss of venous tone and decreased venous return to the heart. Therefore, the nurse should position the pt in a 10-15 degree, head down position to rapidly promote venous return to the heart, which increases the pts BP
A nurse is caring for a pt at 39 weeks of gestation who has gestational hypertension. The pt has a new prescription for misoprostol for cervical ripening and induction of labor. Which of the following findings in the pts medical hx should the nurse i.d. as increasing the pts risk of complications due to the use of this med? -positive bacterial vaginosis culture -hx of failure to progress -previous cesarean delivery -positive serum Rh sensitization
previous cesarean delivery - the nurse should i.d. that misoprostol is a prostaglandin that promotes cervical ripening. An adverse effect of misoprostol is uterine tachsystole (excessively frequent uterine contractions). Therefore, this med should be used w/ extreme cautions and is contraindicated in pts who have experienced a previous cesarean delivery
A nurse is caring for a pt who is at 6 weeks of gestation and has just received a dx of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following meds? -propylthiouracil -liothyronine -methimazole -iodine-131
propylthiouracil -this med is used to tx hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus. However, methimazole is the preferred med in the second & third trimesters pregnancy
A nurse is assessing a pt who is receiving IV gentamicin 3 times daily. Which of the following findings indicates that the pt is experiencing an adverse effect of this med? -hypoglycemia -proteinuria -nasal congestion -visual disturbances
proteinuria -proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should monitor oliguria and hematuria
A nurse is caring for a pt who has tuberculosis and is taking rifampin. The nurse should monitor the pt for which of the following adverse effects of riampin? -red tinged urine -tinnitus -blurred vision -dry mouth
red-tinged urine -the nurse should i.d. that red-tinged urine, saliva, and tears are adverse effects of rifampin
A nurse is caring for a pt who has asthma and is prescribed a short acting beta2 agonist. Which of the following should the nurse i.d. as the expected outcome of this med? -reduces the frequency of attacks -reverses bronchospasm -prevents inflammation -decreases chronic manifestations
reverses bronchospasm -the nurse should i.d. that the expected outcome of a short acting beta2 agonist is reversal of bronchospasm. Short acting beta 2 agonist bind to beta 2 adrenergic receptors in the lungs, resulting in relaxation of bronchial smooth muscles
A nurse is caring for a pt who has been taking isoniazid and rifampin for 3 weeks for the tx of active pulmonary tuberculosis. The pt reports his urine is an orange color. Which of the following statements should the nurse make? -stop taking the isoniazid for 3 days, and the discoloration should go away -rifampin can turn body fluids orange -i'll make an appointment for you to see the provider this afternoon -isoniazid can cause bladder irritation
rifampin can turn body fluids orange -rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the pts that this effect does not cause harm
A home health nurse is visiting an older adult pt who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3 dimes per day, to the pt for restlessness and anxiety over the past few days. For which of the following adverse effects should the nurse assess the pt? -low grade fever -sedation -diuresis -tonic clonic seizures
sedation -lorazepam is a benzodiazepine w/ anti-anxiety & sedative effects. Older adult pts are especially at risk for CNS depression, even w/ low doses of benzodiazepines. Pts who are 50 yrs or older can have a more profound and prolonged sedation than younger pts
A nurse is providing discharge teaching to a pt who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of info should the nurse include? -seizures can occur w/ this med -you should observe for manifestations of bleeding -check your hands and feet for sensory dysfunction -this med can increase the risk of ototoxicity
seizures can occur w/ this med -the nurse should tell the pt that seizures can occur when receiving imipenem. The pt should notify the provider immediately if these occur
A nurse is assessing a pt who is receiving a continuous morphine IV infusion and finds the pt's resp rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? -flush the IV line w/ saline -administer flumazenil -lower the head of the bed -slow the rate of the infusion
slow the rate of the infusion -the nurse should decrease the infusion rate to reduce the amount of morphine the pt receives and limit the risk of resp depression
The nurse is caring for a pt who has had a levonorgestrel-releasing IUD in place for 1 yr. Which of the following findings should indicate that the pr is experiencing an adverse effect? -developed sensitivity to copper -vaginal irritation/inflammation -decreased menstrual bleeding -spotting between menses cycles
spotting between menses cycles -light spotting & amenorrhea are common adverse effects for pts who use a levonorgestrel-releasing IUD. IUDs can later menses, prompting spotting between menstruation periods.
A nurse is providing teaching for a pt who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus. Which of the following instructions should the nurse include in the teaching? -take both med together for 72 hr and then stop taking the cyclosporine -stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus -alternate taking the meds for 48 hr and then take only the tacrolimus -if adverse reactions to the tacrolimus occur, stop taking it and restart the cyclosporine
stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus -the nurse should instruct the pt that these meds should not be taken concurrently due to the increased risk of developing nephrotoxicity. The pt should stop cyclosporine for 24 hrs prior to beginning the tacrolimus prescription
A nurse is providing teaching to a pt who has rheumatoid arthritis and a prescription for long term prednisone therapy. The nurse should instruct the pt to monitor for which of the following adverse effects? -stress fractures -orthostatic hypotension -gingival ulcerations -weight loss
stress fractures -prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures
A nurse is administering a pts first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? -sucralfate decreases gastric acid secretions -sucralfate forms a gel like substance that protects ulcers -sucralfate inactivated Helicobacter pylori -sucralfate inhibits the production of gastric acid
sucralfate forms a gel like substance that protects ulcers -the primary action of sucralfate is the formation of a gel like protectant that adheres to the ulcer surface. This protective mechanism lasts for 6 hrs and allows the ulcer to heal
A nurse is teaching a pt about a new prescription for extended release oxycodone for pain management. Which of the following statements should the nurse include in the teaching? -swallow this med whole -take this med before meals and at bedtime -constipation decreases w/ continued use -avoid taking other supplemental analgesics w/ this med
swallow this med whole -the nurse should tell the pt that extended-release oxycodone is a long-acting opioid med and should not be cute in half/crushed to prevent immediate absorption of the entire dose. This med should be swallowed whole and is administered ever 12 hr
A nurse is administering subcutaneous epinephrine for a pt who is experiencing anaphylaxis. The nurse should monitor the pt for which of the following adverse effects? -hypotension -hyperthermia -hypoglycemia -tachycardia
tachycardia -adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias due to cardiac stimulation
A nurse is assessing a pt who began taking clozapine 3 weeks ago. Which of the following findings should the nurse report to the provider immediately? -tachypnea & tachycardia -abdominal pain & constipation -enuresis & polyuria -dry mouth & blurred vision
tachypnea & tachycardia -the greatest risk to the pt is the development of myocarditis, a potentially fata adverse effect of clozapine. Myocarditis is an inflammation of the heart muscles that typically occurs w/in 30 days of starting the med. Manifestations of myocarditis include chest pain, palpitations, tachycardia, cardiac arrhythmias, dyspnea, develops myocarditis, and its use should be avoided in the future
A nurse is teaching a pt who has dyspepsia about prescribed antacids. Which of the following statements should the nurse include in the teaching? -take antacids 1 hr apart from other meds -increase your sodium intake to avoid hyponatermia -avoid combining antacids due to an increased risk of adverse effects -antacids are taken 3 times daily
take antacids 1 hr apart from other meds -the nurse should include in the teaching that antacids increase gastric pH, which causes an interference w/ the absorption of various meds. To help minimize these interactions, the pt should take the antacids at least 1 hr apart from other meds
A nurse is caring for a pt who is experiencing acute pain and is receiving morphine. Which of the following findings should indicate to the nurse the need to w/hold the pt's next dose of morphine? -the pt reports inability to void -the pts resp rate is 10/min -the pt has hypoactive bowel sounds -the pt has vomited once in the last 4 hr
the pt's resp rate is 10/min -the nurse should i.d. that morphine can cause resp depression. Therefore, if the pt's resp rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider
A nurse is teaching a pt who is starting pt-controlled analgesia (PCA) following a procedure. Which of the following pt statements indicates an understanding of the teaching? -this method of med can increase the chances of overdose -I should self-administer the med 1 hr before walking -I should expect to receive smaller doses when I am sleeping -this method works by keeping my opioid levels steady
this method works by keeping my opioid levels steady -the nurse should tell the pt that a PCA pump is effective for pain control because it delivers a small amount of med continuously rather than administering a large amount of med infrequently
A nurse is assessing a pt who has hypothyroidism & takes levothyroxine. Which of the following findings indicates that the pt is experiencing acute levothyroxine overdose? -bradycardia -cold intolerance -tremor -hypothermia
tremor -tremors & anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism
A nurse is assessing a pt who reports using several herbal & vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by pts to elicit which of the following therapeutic effects? -urinary health promotion -immune system stimulation -decreased leg pain from arterial disease -prevention of nauseas caused by motion sickness
urinary health promotion -saw palmetto is used primarily for manifestations r/t prostatic conditions such as benign prostatic hypertrophy. Its effectiveness has not been scientifically verified, however. The nurse should instruct the pt to check w/ the provider about interactions between saw palmetto and other meds
A nurse is preparing to admin 100 units of insulin glargine & 4 units of NPH insulin subq to a pt. Which of the following actions should the nurse plan to take? -verify w/ the provider about giving insulin glargine at 1700 -unsure the insulin glargine is a cloudy suspension -request a prescription for giving insulin glargine twice daily -use separate syringes for administering insulin glargine & NPH insulin
use separate syringes for administering insulin glargine & NPH -the nurse should not mix insulin glargine w/ any other insulin. The nurse should admin the NPH insulin & insulin glargine separately
The nurse is teaching a pt who has a prescription for doxycycline for the tx of a Heliobacter pylori infection. Which of the following instructions should the nurse include in the teaching? -take this med w/ meals to decrease GI upset -continue this med if you become pregnant -wear protective clothing while in the sun -expect to have severe diarrhea while taking this med
wear protective clothing while in the sun -the nurse should include in the teaching that all tetracycline meds increase the sensitivity of the skin to ultraviolet light and sunlight. Therefore, pts are encouraged to avoid prolonged exposure to the sun and to wear protective clothing while outside and exposed to the sun
A nurse is teaching a pt who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of info should the nurse include in the teaching? -report GI disturbances immediately -you might find that you develop a dry mouth -you should not experience any CNS alterations -increased urinary frequency is an expected effect
you might find that you develop a dry mouth -a pt who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid/sucking on a hard, sugarless candy can help relieve dry mouth
A nurse is providing teaching to a pt who has multiple sclerosis and a new prescription for baclofen PO. Which of the following pieces of info should the nurse include? -you should take the med on an empty stomach to increase absorption -you can stop taking the med once your back spasms disappear -you can expect to experience urinary frequency when you first start taking the med -you should change positions slowly while takin this med
you should change positions slowly while taking this med -the nurse should teach the pt that dizziness & hypotension are adverse effects of this med. The pt should change positions slowly to minimize orthostatic hypotension
A nurse is caring for a pt w/ premenstrual disorder (PMD) who has a prescription for fluoxetine. The pt asks the nurse, "When should I notice the benefits of this med?" Which of the following responses should the nurse make? -you should expect decreased manifestations w/in a few days -manifestations decrease after about 2 months -you should expect decreased manifestations immediately -manifestations will decrease after several weeks
you should expect decreased manifestations w/in a few days -the nurse should inform the pt that fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to tx PMD. Unlike using fluoxetine to tx depression, using fluoxetine to tx PMD will improve manifestations more quickly
A nurse is providing teaching about antiretroviral med therapy to a pt who has a new dx of AIDS. Which of the following statements should the nurse include in the teaching? -your provider will prescribe a single antiretroviral med at a time -you should take antiretroviral meds on a routine schedule -you should increase your intake of raw fruits and vegetables while taking antiretroviral meds -your provider will prescribe antiretroviral therapy to kill the HIV
you should take antiretroviral meds on a routine schedule -the nurse should inform the pt of the need to take antiretroviral therapy exactly as prescribed and to avoid delaying/skipping any doses, which can result in med resistance
An 18 month old toddler who has Kawasaki disease. The child is receiving IV immune globulin (IVIG). The guardian asks the nurse to admin the child's scheduled measles, mumps, and rubella vaccine before discharge. Which of the following responses should the nurse provide? -your child will not be able to receive the MMR vaccine for at least 3 months after discharge -I cannot admin routine vaccines to children while they are in the hospital -your child can receive the MMR vaccine once his fever is gone -I can admin the measles and rubella vaccine, but I cannot administer the mumps vaccine
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 tx of KD contains antibodies that can interfere w/ the action of live-virus vaccines like MMR. The MMR immunization should be postponed for 3-6 months
