Pharm exam 3 ATI

A 58 year old man had a myocardial infarction (Mi) has begun rehabilitation and is ready for discharge. He is given a prescription for metoprolol (Lopressor) for blood pressure- why did my doctor give me this medicine? Which explanation by the nurse is correct?

Studies have shown that this medicine has greatly increased survival rates in patients who have had a heart attack

During therapy with a beta blocker, the patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been .... Occurring?

The patient may be developing heart failure

A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? a. Assess for tinnitus b. Report urine output 50 mL/hr. c. Monitor serum potassium levels. d. Elevate the head of the bed slowly before ambulation e. recommend eating a banana daily

a. Assess for tinnitus c. Monitor serum potassium levels. d. Elevate the head of the bed slowly before ambulation e. recommend eating a banana daily

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.) A. Fatigue B. Constipation C. Anorexia D. Rash E. Blurred vision

a. fatigue c. anorexia e. blurred vision

A client with a tracheostomy has difficulty removing excess, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus? a. Dextromethorphan (Robitussin DM) b. Guaifenesin (Humibid) c. Diphenhydramine (Benadryl) d. Benzonatte (Tessalon Perles)

b. Guaifenesin (Humibid)

A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased urine output C. Decreased conduction through the AV node D. Vasoconstriction of renal blood vessels

b. Increased urine output.

*A client is prescribed albuterol via a metered dose inhaler two puffs every 4 hours. The nurse instructs the client to report adverse effects. Which of the following are potential adverse effects of albuterol? a. constipation b. Tachycardia c. Pedal edema d. decreased pulse rate

b. Tachycardia

A client is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during client teaching? a. report clear colored sputum to the prescriber b. force fluids to help loosen and liquify secretions c. report symptoms that last longer than 2 days d. avoid driving a car or operating heavy machinery because of the sedating effects

b. force fluids to help loosen and liquify secretions

After a bronchoscopy with biopsy, the nurse assesses the client. Which of the following signs are of greatest concern and should be reported immediately to the physician? a. dry cough b. laryngeal stridor c. green sputum d. hemoptysis

b. laryngeal stridor

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications? A. Lubiprostone B. Metoclopramide C. Bisacodyl D. Loperamide

b. metoclopramide

A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? (Select all that apply.) A. Hypertension B. Widened QRS complex C. Narrowed QT interval D. Easy bruising E. Swollen joints

b. widened QRS complex d. easy bruising e. swollen joints

The nurse is providing instructions to a client who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the client indicates further instruction is needed? Select all that apply a. "I will continue to use this inhaler, even if I am feeling better" b. "I will use a peak flow meter to measure my response therapy" c. "I will gargle after using the inhaler and then swallow" d. "I will use this inhaler for asthma attacks" e. "I will clean the plastic inhaler casing weekly by removing the canister and then washing the casing in warm soapy water. I will let it dry before assembling" f. "I will rinse my mouth with water after using the inhaler and then split out the water"

c. "I will gargle after using the inhaler and then swallow" d. "I will use this inhaler for asthma attacks"

The prescriber has changed the client's medication regimen to include the leukotriane receptor antagonist (LTRA) montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication? a.when asthma symptoms improve the dosage schedule can be tapered and eventually discontinued b. the proper technique for inhalation must be followed c. it needs to be taken every day on a continuous schedule even if symptoms improve d. the patient needs to keep it close by at all times to treat acute asthma attacks

c. it needs to be taken every day on a continuous schedule even if symptoms improve

*The nurse is assessing a 70 year old male who has recently developed hoarseness. The nurse should conduct a focused assessment to determine: a. Patterns of medication use and history of alcohol consumption b. Exposure to sun and family history of head and neck cancers c. Exposure to wood dust and a high fat diet d. History of tobacco use and alcohol consumption

d. History of tobacco use and alcohol consumption

a client with emphysema has been admitted to the hospital. The nurse should assess the client further for: a. Bronchospasms b. Copious sputum c. Frequent coughing d. Underweight appearance

d. Underweight appearance

A client newly diagnosed with early stage heart failure has a blood pressure of 145/66 mm hg and an ejection fraction of 45%..

A beta blocker and an ace inhibitor

A nurse is teaching a client about probiotic supplements. Which of the following information should the nurse include? (Select all that apply.) A. "Probiotics are micro-organisms that are normally fourd in the Gl tract." B, "Probiotics are used to treat Clostridium difficile." C. "Probiotics are used to treat benign prostatic hyperplasia." D. "You can experience bloating while taking probiotic supplements. E. "If you are prescribed an antibiotic, yau should take it at the same time you take your probiotic supplement."

A. "Probiotics are micro-organisms that are normally fourd in the Gl tract." B, "Probiotics are used to treat Clostridium difficile." D. "You can experience bloating while taking probiotic supplements.

A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A. "Remove the prior dose before applying a new dose." B. "Rub the ointment directly into your skin until it is no longer visible." C. "Cover the applied ointment with a clean gauze pad." D. "Apply the ointment to the same skin area each time."

A. "Remove the prior dose before applying a new dose."

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? A. "Rinse your mouth after each use of this medication." B. "Limit fluid intake while taking this medication. C. "Increase your intake of vitamin B12 while taking this medication. D. "You can take the medication as needed."

A. "Rinse your mouth after each use of this medication."

A nurse is caring for four clients who have peptic ulcer disease. The nurse should identify misoprostol is contraindicated for which of the following clients? A. A client who is pregnant B. A client who has osteoarthritis C. A client who has a kidney stone D. A client who has a urinary tract infection

A. A client who is pregnant

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than 60/min. B. Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium. D. Take with food if nausea occurs.

A. Contact provider if heart rate is less than 60/min.

A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine? (Select all that apply.) A. Digoxin B. Simvastatin C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch

A. Digoxin B. Simvastatin C. Verapamil

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? (Select all that apply.) A. Dry mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation

A. Dry mouth D. Drowsiness E. Urinary hesitation

A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.) A. Headache B. Diarrhea C. Shortened PR interval D. Hyperglycemia E. Prolonged QT interval

A. Headache B. Diarrhea E. Prolonged QT interval

A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A. increase the amount of fiber in the diet. B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet. D. Withhold food for 1 hr after the medication is taken.

A. Increase the amount of fiber in the diet

A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A. Remove the patch each evening. B. Cut each patch in half if angina attacks are under control. C. Take off the nitroglycerin patch for 30 min if a headache occurs. D. Apply a new patch every 48 hr.

A. Remove the patch each evening

A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client to avoid which of the following laxatives? A. Sodium phosphate B. Psyllium C. Bisacodyl D. Polyethylene glycol

A. Sodium phosphate

A nurse is providing information to client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A. Take the medication with food B. Plan to take the medication at bedtime. C. Expect increased swelling of the ankles D. Fluid intake should be limited in the morning.

A. Take the medication with food

A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to manitor for which of the following manifestations as an adverse effect of this medication? A. Weight gain B. Nervousness C. Bradycardia D. Constipation

A. Weight gain

A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol, A. Asthma B. Glaucoma C. Hypertension D. Tachycardia

A. asthma

A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and the blood pressure is 74/44 mg Hg. The nurse should expect a prescription for which of the following IV medications? A. Calcium gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium sulfate

A. calcium gluconate

Which conditions would potentially contribute to decreases in cardiac output?

Acute MI Heart failure GI bleeding

A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A. "Take two more sublingual tablets at the same time." B. "Call the emergency response team." C. "Take a sustained-release nitroglycerin capsule." D. "Wait another 5 minutes then take a second sublingual tablet."

B. "Call the emergency response team."

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions? A. "Expect this medication to suppress your child's cough." B. "Expect this medication to smell like rotten eggs." C. "Expect this medication to cause euphoria." D. "Expect this medication to turn your child's urine orange."

B. "Expect this medication to smell like rotten eggs."

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I should use the spray every 4 hours while I am awake. B. "It can take as long as 3 weeks before the medication takes a maximum effect." C. "This medication can also be used to treat motion sickness." D. "I can use this medication when my nasal passages are blocked."

B. "It can take as long as 3 weeks before the medication takes a maximum effect."

A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching? A. "If constipation develops, switch to a calcium-based antacid." B. "Take this medication two hours before or after other medications." C. "This medication increases the risk for pneumonia.' D. "Have your magnesium level monitored while taking this medication."

B. "Take this medication two hours before or after other medications."

3. A nurse is providing instructions to a client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? A. "You can take this medication to abort an acute asthma attack." B. "Tremors are an adverse effect of this medication." C. "Prolonged use of this medication can cause hyperglycemia." D. "This medication can slow skeletal growth rate."

B. "Tremors are an adverse effect of this medication."

A nurse is providing instructions to a client who has a new prescription for albuterol arid beclorethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching? A. Take the albuterol at the same time each day. B. Administer the albuterol inhaler prior to using the beclomethasone inhaler. C. Use beclomethasone if experiencing an acute episode. D. Avoid shaking the beclomethasone before use.

B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.

A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren

B. Hydrochlorothiazide D. Clonidine E. Aliskiren

A nurse is planning caring for for a client who has a new prescription for for torsemide. The nurse should for should plan to monitor which of the following adverse reactions of this medications? (Select all that apply) A. Respiratory acidosis B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias

B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias

1. A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this modication? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B. Nasal congestion

A nurse is teaching a client who has a new prescription for oieprazole. Which of the following information should the nurse include in the teaching? A. Take this medication at bedtime. B. This medication decreases the production of gastric acid. C Take this medication 2 hr after eating. D. This medication can cause hyperkalemia.

B. This medication decreases the production of gastric acid.

A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide

B. Verapamil

The nurse recognizes that adrenergic drugs cause relaxation of the bronchodilation by stimulating which type of receptors

Beta2 adrenergic

A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include? A. Take an antacid with the sucralfate. B. Take sucralfate with a glass of mill C. Allow a 2-hr interval between these medications. D. Chew the sucralfate thoroughly before swallowing

C. Allow a 2-hr interval between these medications.

5. A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take? A. Hold propranolol for an apical pulse greater than 100/min. B. Administer propranolol to increase the client's blood pressure. C. Assist the client when sitting up or standing after taking this medication. D. Check for hypokalemia frequently due to the risk for propranolol toxicity

C. Assist the client when sitting up or standing after taking this medication.

A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. Which of the following conditions should the nurse monitor the client for as an adverse effect of this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

C. Delirium

A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which the following finding should the nurse report to the provider? A. Blood glucose 150 mg/dL B. Urine output 40 mL/hr C. Dyspnea D. Bilateral equal pupil size

C. Dyspnea

A nurse is teaching a client about cimetidine. Which of the following are adverse effects of cimetidine? (Select all that apply.) A. Increased libido B. Insomnia C. Enlargement of breast tissue D. Confusion E. Decreased sperm count

C. Enlargement of breast tissue D. Confusion E. Decreased sperm count

A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia

C. Neutropenia

A nurse in a provider's office is monitoring blood electrolytes for four clients who tag. digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEg/L

C. Potassium 3.4 mEq/L

A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following indings is a marifestation of amiodarone toxicity? A. Light yellow urine B. Report of tinnitus C. Productive cough D. Blue-gray skin discoloration

C. Productive cough

2. A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? A. Diarrhea B. Anxiety C. Sedation D. Palpitations

C. Sedation

A nurse is monitoring a client who is receiving spironolactone. Which ofthe following findings should the nurse report to the provider. A. Serum sodium 144 mEq/L B. Urine output 120 m L in 4 h C. Serum potassium 5.2 mEq/l D. Blood pressure 140/90 mm Hg

C. Serum potassium 5.2 mEq/l

When monitoring a patient for signs of hyperkalemia, the nurse will assess for what signs?

Cardiac dysrhythmias

A nurse is caring for a client who received prochlorperazine 4 hr ago. The client reports spasms of the face. The nurse should expect a prescription for which of the following medications? A. Fomepizole B. Naloxone C. Phytonadione D. Diphenhydramine

D. Diphenhydramine

A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A. Furosemide B. Captopril C. Ranolazine D. Metoprolol

D. Metoprolol

A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. Bruising B. Report of metallic taste C. Muscle pain D. Report of anorexia

D. Report of anorexia

A client with stable angina is being discharged home with a prescription for a transdermal nitroglycerin patch. The nurse has reviewed discharge instructions on the medication with the client. Which statement by the client indicates that teaching has been effective?

I will rotate the site where I apply the patch

A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He has type II diabetes. When discussing possible adverse effects. The nurse will include which information?

Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia

Severe prolonged stress may cause acute renal failure or stress ulcers to develop due to

Prolonged vasoconstriction and ischemia