Pharm Exam 3 Practice Questions

The nurse is teaching a client with newly diagnosed type 1 diabetes about insulin therapy. Which statements indicate the client needs more teaching concerning insulin therapy? Select all that apply. 1. "If I have a headache or start getting nervous, I will drink some orange juice." 2. "If I pass out at home, a family member should give me a glucagon injection." 3. "Because I am taking my insulin daily I do not have to adhere to a diabetic diet." 4. "I will check my blood glucose with my glucometer at least once a day." 5. "I should administer my insulin in my abdomen for best absorption."

"3. "Because I am taking my insulin daily I do not have to adhere to a diabetic diet."

The client diagnosed with Addison's disease is being discharged. Which statement indicates the client needs more discharge teaching? 1. "I will be sure to keep my dose of steroid constant and not vary." 2. "I may have to take two forms of steroids to remain healthy." 3. "I will get weak and dizzy if I don't take my medication." 4. "I need to notify any new HCP of the medications I take."

1. "I will be sure to keep my dose of steroid constant and not vary."

The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning the storage of insulin? 1. "I will keep my unopened vials of insulin in the refrigerator." 2. "I can keep my insulin in the trunk of my car so I will have it at all times." 3. "It is all right to put my unopened insulin vials in the freezer." 4. "If I prefill my insulin syringes, I must use them within 1-2 days."

1. "I will keep my unopened vials of insulin in the refrigerator."

The nurse should question the order of acetaminophen (Tylenol) for which client? 1. A client with cirrhosis of the liver 2. A client with chronic obstructive pulmonary disease 3. A client with breast cancer 4. A client who is taking warfarin (Coumadin)

1. A client with cirrhosis of the liver

The parent of a 1-year-old child calls the clinic to ask about medications that can be administered to reduce fever. Which medication should the nurse discuss with the parent? 1. Acetylsalicylic acid (aspirin), an antipyretic. 2. Diphenhydramine (Benadryl), an antihistamine. 3. Docosanol (Abreva), an anti-infective. 4. Docusate sodium (Colace), a gastrointestinal agent.

1. Acetylsalicylic acid (aspirin), an antipyretic. -use tylenol/ibuprofen bc ASA has risk of Reye's syndrome

The client with deep vein thrombosis is being treatedwith a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following? 1. Activated partial thromboplastin time (aPTT) 2. Prothrombin time (PT) 3. Platelet counts 4. International normalized ratio (INR)

1. Activated partial thromboplastin time (aPTT)

Which information should the nurse teach the client who is prescribed a glucocorticoid inhaler? 1. Advise the client to gargle after each administration. 2. Instruct the client to use the inhaler on a PRN basis. 3. Encourage the client not to use a spacer when using the inhaler. 4. Teach the client to check his or her forced expiratory volume daily.

1. Advise the client to gargle after each administration.

A client with asthma asks which of the prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse will instruct the client to use: 1. Albuterol, a beta agonist bronchodilator, by inhalation. 2. Beclomethasone, a glucocorticoid anti-inflammatory drug, by inhalation. 3. Ipratropium, an anticholinergic bronchodilator, by inhalation. 4. Zafirlukast, a leukotriene modifier, by mouth.

1. Albuterol, a beta agonist bronchodilator, by inhalation.

The nurse should inform the client who is prescribed a nebulizer treatment with albuterol (Proventil, VoSpire) that a common adverse effect is: 1. An increased heart rate with palpitations. 2. A predisposition to infection. 3. Sedation. 4. Temporary dyspnea.

1. An increased heart rate with palpitations.

A 4-year-old child with respiratory distress secondary to asthma has an order for a nebulizer treatment. The type of medication most likely to be given for asthma management is a: 1. Beta agonist. 2. Beta antagonist. 3. Corticosteroid. 4. Leukotriene modifier.

1. Beta agonist.

The nurse administered 12 units of regular insulin to the patient with type 1 diabetes at 0700. Which meal prevents the client from experiencing hypoglycemia? 1. Breakfast. 2. Lunch. 3. Supper. 4. HS snack.

1. Breakfast.

Which complication should the nurse assess for in the elderly client newly diagnosed with hypothyroidism who has been prescribed levothyroxine (Synthroid)? 1. Cardiac dysrhythmias. 2. Respiratory depression. 3. Paralytic ileus. 4. Thyroid storm.

1. Cardiac dysrhythmias.

The nurse in the emergency department is preparing to administer the thrombolytic medication alteplase (Activase) to a client whose initial symptoms of a stroke began 2 hours ago. Which interventions should the nurse implement? Select all that apply. 1. Check the client's armband for allergies. 2. Hang the medication via IVPB and infuse over 90 minutes. 3. Check the results of the client's CT scan of the brain. 4. Teach the client this medication dissolves clots. 5. Monitor the client's PTT during drug administration.

1. Check the client's armband for allergies. 2. Hang the medication via IVPB and infuse over 90 minutes. 3. Check the results of the client's CT scan of the brain. 4. Teach the client this medication dissolves clots. 5. Monitor the client's PTT during drug administration.

The nurse is caring for the client diagnosed with type 2 diabetes. The client is complaining of a headache, jitteriness, and nervousness. Which interventions should the nurse implement? Select all that apply. 1. Check the client's serum blood glucose level. 2. Give the client a glass of orange juice. 3. Determine when the last antidiabetic medication was administered. 4. Assess the client's blood pressure and apical pulse. 5. Administer prescribed insulin via sliding scale.

1. Check the client's serum blood glucose level. 2. Give the client a glass of orange juice. 3. Determine when the last antidiabetic medication was administered. 4. Assess the client's blood pressure and apical pulse.

The overweight client diagnosed with type 2 diabetes reports to the clinic nurse that he has lost 35 pounds in the past 4 months. Which intervention should the nurse implement first? 1. Determine if the client has had an increase in hypoglycemic reactions. 2. Instruct the client to make an appointment with the health-care provider. 3. Ask the client if he has been trying to lose weight or has it happened naturally. 4. Check the client's last weight in the chart with the weight obtained in the clinic.

1. Determine if the client has had an increase in hypoglycemic reactions.

A client has been ordered methylprednisolone (Medrol Dosepak) for treatment of a significant poison ivy rash. The nurse will teach the client to report which adverse effects to the health care provider? Select all that apply. 1. Edema 2. Tinnitus 3. Eye pain or vision changes 4. Dizziness upon standing 5. Abdominal pain

1. Edema 3. Eye pain or vision changes 5. Abdominal pain

The client diagnosed with a migraine headache rates the pain at a 4 on a 1-10 scale. Which medication should the nurse administer? 1. Ibuprofen (Motrin) po, a nonsteroidal anti-inflammatory drug. 2. Butorphanol (Stadol) IM, an opioid analgesic. 3. Dihydroergotamine (D.H.E. 45), an ergot alkaloid, intranasally. 4. Sumatriptan (Imitrex), subcutaneous, a selective serotonin receptor agonist.

1. Ibuprofen (Motrin) po, a nonsteroidal anti-inflammatory drug.

The nurse is administering 0800 medications. Which medication should the nurse question? 1. Ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug, to a 49-year-old female with a peptic ulcer. 2. Omeprazole (Prilosec), a proton-pump inhibitor, to an 18-year-old male with a duodenal ulcer. 3. Digoxin (Lanoxin), a cardiotonic, to a 76-year-old male with a potassium level of 4.2 mEq/L. 4. Riopan, an antacid, to a 67-year-old client diagnosed with congestive heart failure who is complaining of indigestion.

1. Ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug, to a 49-year-old female with a peptic ulcer.

The nurse should monitor the client who is taking beclomethasone (Qvar) for evidence of: Select all that apply. 1. Infection. 2. Hyperglycemia. 3. Urinary retention. 4. Tachycardia. 5. Photophobia.

1. Infection. 2. Hyperglycemia.

Which of the following should the nurse include in the teaching plan for a client receiving subcutaneous heparin? Select all that apply. 1. Inject medication in the deep fatty layer of the abdomen. 2. When brushing your teeth, use a soft toothbrush. 3. Hold direct pressure on any puncture sites for 15 minutes. 4. Use dental floss daily after brushing. 5. Take a daily aspirin tablet, 325 mg, to prevent inflammation at the injection site.

1. Inject medication in the deep fatty layer of the abdomen. 2. When brushing your teeth, use a soft toothbrush. 3. Hold direct pressure on any puncture sites for 15 minutes.

The client is complaining of severe chest pain radiating down the left arm and is nauseated and diaphoretic. The HCP suspects the client is having a myocardial infarction (MI) and has ordered morphine sulfate (MS), a narcotic analgesic, for the pain. Which interventions should the nurse implement? Select all that apply. 1. Instruct the client not to get up out of the bed without notifying the nurse. 2. Administer the morphine sulfate (MS) intramuscularly in the ventral gluteal muscle. 3. Dilute the morphine sulfate (MS) to a 10-mL bolus with normal saline. 4. Administer the morphine sulfate (MS) slowly over 5 minutes. 4. Question the order because morphine sulfate (MS) should not be administered to a client with a myocardial infarction (MI).

1. Instruct the client not to get up out of the bed without notifying the nurse. 3. Dilute the morphine sulfate (MS) to a 10-mL bolus with normal saline. 4. Administer the morphine sulfate (MS) slowly over 5 minutes.

The nurse is teaching the client with type 1 diabetes how to use an insulin pen injector. Which information should the nurse discuss with the client? 1. Instruct the client to dial in the number of insulin units needed to inject. 2. Demonstrate the proper way to draw up the insulin in an insulin syringe. 3. Discuss that the insulin pen injector must be used in the abdominal area only. 4. Explain that the traditional insulin syringe is less painful than the injector pen.

1. Instruct the client to dial in the number of insulin units needed to inject.

A client has been taking a thiazide diuretic for treatment of hypertension and has been prescribed hydrocortisone (Cortef) for a significant allergic reaction to shellfish. Which symptom should be immediately reported to the provider? 1. Irregular heart rate and rhythm 2. Delayed wound healing 3. Weight gain of 2 to 3 pounds in one week 4. Elevated serum lipid levels

1. Irregular heart rate and rhythm

An anti-inflammatory agent is ordered to be given intravenously to the client for pain. Which anti- inflammatory agent is administered parenterally? 1. Ketorolac (Toradol, Acular) 2. Ketoprofen (Oruvail) 3. Ibuprofen (Motrin, Advil) 4. Celecoxib (Celebrex)

1. Ketorolac (Toradol, Acular)

The client diagnosed with hyperthyroidism is prescribed an antithyroid medication. Which interventions should the nurse implement? Select all that apply. 1. Monitor the client's thyroid function tests. 2. Monitor the client's weight weekly. 3. Monitor the client for gastrointestinal distress. 4. Monitor the client's vital signs. 5. Monitor the client for activity intolerance.

1. Monitor the client's thyroid function tests. 2. Monitor the client's weight weekly. 3. Monitor the client for gastrointestinal distress. 4. Monitor the client's vital signs. 5. Monitor the client for activity intolerance.

An older adult client with chronic bronchitis has been receiving low-dose therapy with dexamethasone for several months to reduce the inflammation occurring secondary to the bronchitis. What teaching should this client receive to reduce the risk of osteoporosis related to dexamethasone use? Select all that apply. 1. Perform weight-bearing exercises at least three to four times weekly. 2. Increase dietary intake of calcium and vitamin D-rich foods. 3. Remain sedentary except during periods of exercise. 4. Increase fluid intake, including carbonated sodas, but avoid alcohol. 5. Request a prescription for a bisphosphonate drug from the provider.

1. Perform weight-bearing exercises at least three to four times weekly. 2. Increase dietary intake of calcium and vitamin D-rich foods.

The nurse is preparing to administer warfarin (Coumadin), an anticoagulant. The client's current INR is 3.6 Which intervention should the nurse implement? Select all that apply. 1. Question administering the medication. 2. Prepare to administer AquaMEPHYTON (vitamin K). 3. Notify the health-care provider to increase the dose. 4. Administer the medication as ordered. 5. Assess the client for abnormal bleeding.

1. Question administering the medication. 2. Prepare to administer AquaMEPHYTON (vitamin K). 5. Assess the client for abnormal bleeding. we want to decrease the dose bc it is over the therapeutic range!

The nurse is monitoring the client for adverse effects associated with morphine. Which adverse effects would be the expected? Select all that apply. 1. Respiratory depression 2. Hypertension 3. Urinary retention 4. Constipation 5. Nausea

1. Respiratory depression 3. Urinary retention 4. Constipation 5. Nausea

The elderly female client has been diagnosed with compression fractures of the vertebrae and has been taking large doses of ibuprofen for pain. Which intervention should the nurse implement? 1. Teach the client not to take the medication on an empty stomach. 2. Have the HCP order PTT/PT and INR laboratory tests. 3. Ask the HCP to prescribe a narcotic medication for the client. 4. Determine why the client thinks she needs so much medication.

1. Teach the client not to take the medication on an empty stomach.

The nurse is preparing to administer liothyronine (Cytomel), a thyroid hormone, to a client diagnosed with hypothyroidism. Which data should cause the nurse to question administering the medication? 1. The client is complaining of being nervous. 2. The client's oral temperature is 98.9°F. 3. The client's blood pressure is 110/70. 4. The client is complaining of being tired.

1. The client is complaining of being nervous.

A client takes aspirin (acetylsalicylic acid) daily for pain in the right knee. Which toxic effects may be present with aspirin overdosage? Select all that apply. 1. Tinnitus 2. Hyperventilation 3. Gastrointestinal bleeding 4. Decreased urinary output 5. Peripheral neuropathy

1. Tinnitus 2. Hyperventilation 3. Gastrointestinal bleeding 4. Decreased urinary output

The female client diagnosed with systemic lupus erythematosus (SLE) complains to the nurse that she has pain; she is stiff when she gets up in the morning; and she takes ibuprofen, an NSAID, to help ease the pain and stiffness. Which question is most important for the nurse to ask the client? 1. "How often do you have to take the ibuprofen?" 2. "Do you take the medication on an empty stomach?" 3. "Does the medication help with menstrual cramping too?" 4. "Have you noticed an improvement in the pain and stiffness?"

2. "Do you take the medication on an empty stomach?"

The client diagnosed with Addison's disease asks the nurse, "Why do I have to take fludrocortisone (Florinef), a mineral corticosteroid?" Which statement is the nurse's best response? 1. "It will keep you from getting high blood sugars." 2. "Florinef helps the body retain sodium." 3. "Florinef prevents muscle cramping." 4. "It stimulates the pituitary gland to secrete ACTH."

2. "Florinef helps the body retain sodium."

The nurse on a medical unit is providing discharge instructions to a client who is prescribed fluticasone (AeroBid), a glucocorticoid, and a metered-dose inhaler. Which statement by the client warrants intervention? 1. "I will use a spacer when using my inhaler." 2. "I will hold the medication in my mouth for 10 seconds." 3. "I will wait a few minutes between puffs." 4. "I will notify my HCP if I get mouth sores."

2. "I will hold the medication in my mouth for 10 seconds."

A client was started on rosiglitazone for type 2 diabetes. He tells the nurse that he has been taking it for 5 days, but his glucose levels are unchanged. What is the nurse's best response? 1. "You should double the dose. That should help." 2. "You need to give the drug more time. It can take several weeks before it becomes fully effective." 3. "You will need to add a second drug since this one has not been effective." 4. "You most likely require insulin now."

2. "You need to give the drug more time. It can take several weeks before it becomes fully effective."

Before administering a morning lispro insulin (Humalog) injection, which activity should the nurse perform?Select all that apply. 1. Obtain a morning urine sample for glucose and ketones. 2. Check the client's finger-stick glucose level. 3. Ensure that breakfast trays are present on the unit and the client may eat. 4. Obtain the client's pulse and blood pressure. 5. Assess for symptoms of hypoglycemia.

2. Check the client's finger-stick glucose level. 3. Ensure that breakfast trays are present on the unit and the client may eat. 5. Assess for symptoms of hypoglycemia.

The client with arterial occlusive disease has been taking 325 mg of aspirin daily for 1 month. The client tells the nurse, "I have been having a lot of stomach pain." Which priority intervention should the nurse implement? 1. Instruct the client to take a non-enteric-coated aspirin. 2. Encourage the client to take the medication with food. 3. Discuss the need to take only one 81-mg aspirin a day. 4. Tell the client to notify the health-care provider.

2. Encourage the client to take the medication with food.

The nurse administered 25 units of Humulin N to a client with type 1 diabetes at 1600. Which intervention should the nurse implement? 1. Assess the client for hypoglycemia around 1800. 2. Ensure the client eats the nighttime (HS) snack. 3. Check the client's serum blood glucose level. 4. Serve the client the supper tray.

2. Ensure the client eats the nighttime (HS) snack.

The female client diagnosed with low back pain has been self-medicating with ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug (NSAID), around the clock. The client calls the clinic and tells the nurse that she has been getting dizzy and light-headed. Which intervention should the nurse implement? 1. Tell the client to get up from a sitting or lying position slowly. 2. Have the client come to the clinic for lab work immediately. 3. Suggest the client take the ibuprofen with food or an antacid. 4. Discuss changing to a different nonsteroidal anti-inflammatory medication.

2. Have the client come to the clinic for lab work immediately.

The male client diagnosed with iatrogenic Cushing's disease calls the clinic nurse and informs the nurse he has a temperature of 100.1°F. Which intervention should the nurse implement? 1. Tell the client to take acetaminophen and drink liquids. 2. Instruct the client to come to the clinic for an antibiotic. 3. Have the client go to the nearest emergency department. 4. Encourage the client to discuss his feelings about the disease.

2. Instruct the client to come to the clinic for an antibiotic.

The nurse is administering medications to clients on an orthopedic unit. Which medication should the nurse question? 1. Ibuprofen (Motrin), an NSAID, to a client diagnosed with back pain. 2. Morphine, an opioid analgesic, to a client with back pain rated a 2 on a pain scale of 1-10. 3. Methocarbamol (Robaxin), a muscle relaxant, to a client with chronic back pain. 4. Propoxyphene (Darvon N), a narcotic, to a client with mild back pain.

2. Morphine, an opioid analgesic, to a client with back pain rated a 2 on a pain scale

The client diagnosed with history of a gastric ulcer is having a transient ischemic attack (TIA) and is prescribed a daily 325-mg aspirin. Which information should the nurse include to discuss with the client? Select all that apply. 1. Encourage the client to take aspirin with one glass of water. 2. Notify the health-care provider if ringing in the ears occurs. 3. Instruct the client to take an enteric-coated brand of aspirin. 4. Notify the health-care provider if the client has black, tarry stools. 5. Explain that gastrointestinal distress is expected when taking aspirin.

2. Notify the health-care provider if ringing in the ears occurs. 3. Instruct the client to take an enteric-coated brand of aspirin. 4. Notify the health-care provider if the client has black, tarry stools. 5. Explain that gastrointestinal distress is expected when taking aspirin.

The client diagnosed with type 1 diabetes is complaining of a dry mouth, extreme thirst, and increased urination. Which interventions should the nurse implement? Select all that apply. 1. Administer one amp of intravenous 50% glucose. 2. Prepare to administer intravenous regular insulin. 3. Inject Humulin N subcutaneously in the abdomen. 4. Hang an intravenous infusion of D5W at a keep open rate. 5. Check the client's blood glucose level via a glucometer.

2. Prepare to administer intravenous regular insulin. 5. Check the client's blood glucose level via a glucometer.

A 30-year-old client with depression has attempted suicide by overdosing on acetaminophen (Tylenol). The nurse in the emergency department will anticipate that the client's treatment will consist of: 1. An intravenous infusion with normal saline to infuse at 1,000 mL per hour. 2. The administration of acetylcysteine (Acetadote) by intravenous infusion. 3. Preparation for cardioversion due to the impending arrhythmia. 4. The assessment of liver enzymes to determine hepatotoxicity.

2. The administration of acetylcysteine (Acetadote) by intravenous infusion.

The client diagnosed with hypothyroidism is prescribed levothyroxine (Synthroid). Which assessment data supports the client needs to take more medication? Select all that apply. 1. The client has a 2-kg weight loss. 2. The client complains of being too cold. 3. The client has exophthalmos. 4. The client's radial pulse rate is 90 bpm. 5. The client complains of being constipated.

2. The client complains of being too cold. 5. The client complains of being constipated.

The client has developed Cushing's syndrome as a result of long-term steroid therapy. Which assessment findings support this condition? 1. The client is short of breath on exertion and has pale mucous membranes. 2. The client has a round face and multiple ecchymotic areas on the arms. 3. The client has pink, frothy sputum and jugular vein distention. 4. The client has petechiae on the trunk and sclerosed veins.

2. The client has a round face and multiple ecchymotic areas on the arms.

A client with type 1 diabetes will use a combination insulin that includes NPH and regular insulins. The nurse is explaining the importance of knowing the peak times for both insulins. Why is this important information for the client to know? 1. The client will be able to estimate the time for the next injection of insulin based on these peaks. 2. The risk of a hypoglycemic reaction is greatest around the peak of insulin activity. 3. It is best to plan activities or exercise around peak insulin times for the best utilization of glucose. 4. Additional insulin may be required at the peak periods to prevent hyperglycemia.

2. The risk of a hypoglycemic reaction is greatest around the peak of insulin activity.

The client with a brain tumor is complaining of headache that is a 5 on a scale of 1-10. The client's medication administration record (MAR) has acetaminophen (Tylenol) 2 po PRN pain, hydrocodone (Vicodin) 2 po PRN pain, morphine 4 mg IVP PRN pain, and lorazepam (Ativan) 1 mg IVP PRN. Which medication should the nurse prepare to administer? 1. Tylenol 2 tablets. 2. Vicodin 2 tablets. 3. Morphine 4 mg IVP. 4. Ativan 1 mg IVP.

2. Vicodin 2 tablets.

The nurse who is caring for a client receiving cyclosporine (Sandimmune) will discontinue the medication immediately and call the provider if which of the following occurs? 1. Red blood cell count above 8.5 million/mm3 2. White blood cell count below 4,000/mm3 3. Platelet count above 100,000/mm3 4. Serum creatinine level less than 1.0 mg/100 mL

2. White blood cell count below 4,000/mm3

The child with an acute asthma attack is prescribed a 7-day course of the systemic corticosteroid prednisolone. The mother asks the nurse, "Doesn't this medication cause serious side effects?" Which statement is the nurse's best response? 1. "Yes, this medication does have serious side effects, but your child needs the medication." 2. "The doctor would not have ordered a medication that has serious side effects." 3. "A short-term course of steroids will not cause serious side effects." 4. "There may be serious side effects if your child takes the medication for a long time."

3. "A short-term course of steroids will not cause serious side effects."

The client diagnosed with type 2 diabetes is prescribed the sulfonylurea glipizide (Glucotrol). Which statement by the client warrants intervention by the nurse? 1. "I have to eat my diabetic diet even if I am taking this medication." 2. "I will need to check my blood glucose level at least once a day." 3. "I usually have one glass of wine with my evening meal." 4. "I do not like to walk every day, but I will if it will help my diabetes."

3. "I usually have one glass of wine with my evening meal."

A client is prescribed beclomethasone (Qvar), a glucocorticoid inhaler. Education by the nurse will include: 1. "Check your heart rate because this may cause tachycardia." 2. "Limit your coffee intake while on this drug." 3. "Rinse your mouth out well after each use." 4. "You may feel shaky and nervous after using this drug."

3. "Rinse your mouth out well after each use."

Which assessment finding would cause the nurse to withhold the regularly scheduled dose of levothyroxine? 1. A 2-lb weight gain 2. A blood pressure reading of 100/70 mmHg 3. A heart rate of 110 beats/minute 4. A temperature of 37.9°C (100.2°F)

3. A heart rate of 110 beats/minute

The client with an acute exacerbation of reactive airway disease is prescribed a nebulizer treatment. Which statement best describes how a nebulizer works? 1. Nebulizers are small, handheld pressurized devices that deliver a measured dose of an antiasthma drug with activation. 2. A nebulizer is an inhaler that delivers an antiasthma drug in the form of a dry, micronized power directly to the lungs. 3. A nebulizer is a small machine used to convert an antiasthma drug solution into a mist that is delivered though a mouthpiece. 4. Nebulizers are small devices that are used to crush glucocorticoids so that the client can place them under the tongue for better absorption.

3. A nebulizer is a small machine used to convert an antiasthma drug solution into a mist that is delivered though a mouthpiece.

A client has a fever and is allergic to aspirin. Which medication will the nurse anticipate administering to reduce the client's fever? 1. Ibuprofen (Motrin, Advil) 2. Ketorolac (Toradol) 3. Acetaminophen (Tylenol) 4. Celecoxib (Celebrex)

3. Acetaminophen (Tylenol)

Which of the following assessment findings would the nurse expect to observe in an adult client experiencing therapeutic effects from levothyroxine (Synthroid)? Select all that apply. 1. Constipation and weight gain 2. Decreased blinking and exophthalmos 3. Decreased reports of fatigue 4. Decreased blood cholesterol levels 5. Pulse rate between 60 and 100 beats/minute

3. Decreased reports of fatigue 4. Decreased blood cholesterol levels 5. Pulse rate between 60 and 100 beats/minute

The client admitted for an acute exacerbation of reactive airway disease is receiving intravenous aminophylline. The client's serum theophylline level is 28 ug/mL. Which intervention should the nurse implement first? 1. Continue to monitor the aminophylline drip. 2. Assess the client for nausea and restlessness. 3. Discontinue the aminophylline drip. 4. Notify the health-care provider immediately.

3. Discontinue the aminophylline drip.

The client diagnosed with rule-out deep vein thrombosis (DVT) is experiencing dyspnea and chest pain on inspiration. On assessment, the nurse finds a respiratory rate of 40. Which medication should the nurse anticipate the health-care provider ordering? 1. Warfarin (Coumadin), an oral anticoagulant. 2. Enoxaparin (Lovenox), a low-molecular-weight heparin. 3. Heparin, an intravenous anticoagulant. 4. Ticlopidine (Ticlid), an antiplatelet medication.

3. Heparin, an intravenous anticoagulant.

A client who has been taking dexamethasone for rheumatoid arthritis was unable to take the drug for several days due to an intestinal virus. The client seeks treatment in the emergency department for complaints of severe nausea, vomiting, lethargy, fever, and hypotension. What drug does the nurse anticipate will be given to this client? 1. Fludrocortisone 2. Ketoconazole (Nizoral) 3. Hydrocortisone (Solu-Cortef) 4. Metyrapone (Metopirone)

3. Hydrocortisone (Solu-Cortef)

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching? 1. Discuss the importance of not using iodized salt. 2. Explain the importance of not taking medication with grapefruit juice. 3. Instruct the client to take the medication in the morning. 4. Teach the client to monitor daily glucose levels.

3. Instruct the client to take the medication in the morning.

The nurse would consider which of the following assessment findings as adverse effects to metformin therapy? 1. Hypoglycemia 2. Gastrointestinal distress 3. Lactic acidosis 4. Weight loss

3. Lactic acidosis

A client who is taking warfarin (Coumadin) states,"I wake up every morning with arthritis pain and I always take aspirin or ibuprofen." The nurse's response would be based on which physiological concepts? 1. Aspirin and ibuprofen (Motrin) will counteract the therapeutic effects of many anticoagulants. 2. Anticoagulants will reduce the half-life of drugs such as aspirin and ibuprofen. 3. Many substances such as aspirin and ibuprofen will increase the risk of bleeding. 4. The combination of aspirin products with anticoagulants will worsen arthritis pain.

3. Many substances such as aspirin and ibuprofen will increase the risk of bleeding.

Despite repeated demonstrations of proper inhaler use by the nurse, the client is unable to return a proper demonstration on the training inhaler. The client is becoming frustrated. What is the best action for the nurse to take? 1. Encourage the client to keep practicing just a little longer. 2. Notify the health care provider that the client is incompetent. 3. Provide a spacer for use with the inhaler. 4. Switch to an oral form of a beta agonist.

3. Provide a spacer for use with the inhaler.

What should the nurse teach the client who is newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid)? 1. Take the pill in the afternoon with a high-fiber snack to prevent stomach upset. 2. Eat plenty of fruits and vegetables such as strawberries, spinach, and kale to replace vital nutrients. 3. Take the dose in the morning before breakfast, as close to the same time each day as possible. 4. The drug may be taken every other day if diarrhea occurs.

3. Take the dose in the morning before breakfast, as close to the same time each day as possible.

The client diagnosed with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol), a glucocorticoid, IVP. Which laboratory test should the nurse monitor? 1. The white blood cell (WBC) count. 2. The hemoglobin and hematocrit. 3. The blood glucose level. 4. The BUN and creatinine.

3. The blood glucose level.

The nurse is administering alteplase (Activase), a thrombolytic, to a client diagnosed with massive pulmonary emboli (PE). Which data indicates the medication is effective? 1. The client's PTT level is within therapeutic range. 2. The client is able to ambulate to the bathroom. 3. The client denies chest pain on inspiration. 4. The client's chest x-ray is normal.

3. The client denies chest pain on inspiration.

The client is prescribed albuterol (Ventolin), a sympathomimetic bronchodilator, metered-dose inhaler. Which behavior indicates the teaching concerning the inhaler is effective? 1. The client holds his or her breath for 5 seconds and then exhales forcefully. 2. The client states the canister is full when it is lying on top of the water. 3. The client exhales and then squeezes the canister as the next inspiration occurs. 4. The client connects the oxygen tubing to the inhaler before administering the dose.

3. The client exhales and then squeezes the canister as the next inspiration occurs.

Which assessment data best indicates the client with type 1 diabetes is adhering to the medical treatment regimen? 1. The client's fasting blood glucose is 100 mg/dL. 2. The client's urine specimen has no ketones. 3. The client's glycosylated hemoglobin is 5.8%. 4. The client's glucometer reading is 120 mg/dL.

3. The client's glycosylated hemoglobin is 5.8%.

What should the nurse teach the client who is to receive alteplase (Activase) as part of the treatment for myocardial infarction? 1. The drug will be given IV, and the client should be able to go home later today. 2. The client should remain quiet and lying down during drug administration and for up to 8 hours after infusion. 3. The risk of bleeding returns to normal within 24 hours after the drug has been infused. 4. An increase in vitamin K-rich foods or a supplement will be needed for the week following the treatment.

3. The risk of bleeding returns to normal within 24 hours after the drug has been infused.

The client diagnosed with type 2 diabetes is receiving the combination oral antidiabetic medication glyburide/metformin (Glucovance). Which data indicates the medication is effective? 1. The client's skin turgor is elastic. 2. The client's urine ketones are negative. 3. The serum blood glucose level is 118 mg/dL. 4. The client's glucometer level is 170 mg/dL.

3. The serum blood glucose level is 118 mg/dL.

The school nurse is teaching a class about type 2 diabetes in children to elementary school teachers. Which information is most important for the nurse to discuss with the teachers? 1. The importance of not allowing students to eat candy in the classroom. 2. The increase in the number of students developing type 2 diabetes. 3. The signs and symptoms of hypoglycemia and the immediate treatment. 4. The need to have the students run or walk for 20 minutes during the recess period.

3. The signs and symptoms of hypoglycemia and the immediate treatment.

Which statement best describes the scientific rationale for prescribing the biguanide metformin (Glucophage)? 1. This medication decreases insulin resistance, improving blood glucose control. 2. This medication allows the carbohydrates to pass slowly through the large intestine. 3. This medication will decrease the hepatic production of glucose from stored glycogen. 4. This medication stimulates the beta cells to release more insulin into the bloodstream.

3. This medication will decrease the hepatic production of glucose from stored glycogen.

The client diagnosed with coronary artery disease is instructed to take 81 mg of aspirin ("baby aspirin," "children's aspirin" or "adult low-dose aspirin") daily. Which statement best describes the scientific rationale for prescribing this medication? 1. This medication will help thin the client's blood. 2. Daily aspirin will decrease the incidence of angina. 3. This medication will prevent platelet aggregation. 4. Baby aspirin will not cause gastric distress.

3. This medication will prevent platelet aggregation.

A client with chronic adrenal insufficiency taking hydrocortisone (Cortef) and fludrocortisone is planning a family vacation. What essential teaching does this client need prior to taking this trip? 1. "Take your blood pressure once or twice while you're gone." 2. "Avoid crowded indoor areas to avoid infections." 3. "Have your vision checked before you leave." 4. "Carry an oral and injectable form of both drugs with you on your trip."

4. "Carry an oral and injectable form of both drugs with you on your trip."

The client with type 2 diabetes is admitted into the medical department with a wound on the left leg that will not heal. The HCP prescribes sliding-scale insulin. The client tells the nurse, "I don't want to have to take shots. I take pills at home." Which statement is the nurse's best response? 1. "If you can't keep your glucose under control with pills, you must take insulin." 2. "You should discuss the insulin order with your HCP because you don't want to take it." 3. "You are worried about having to take insulin. I will sit down and we can talk." 4. "During illness you may need to take insulin to keep your blood glucose level down."

4. "During illness you may need to take insulin to keep your blood glucose level down."

A young woman calls the clinic and reports that her mother had an insulin reaction, and was found unconscious. The young woman gave her a glucagon injection 20 minutes ago, and her mother woke up, but is still groggy and "does not make sense." What should the nurse tell the daughter? 1. "Let her wake up on her own, then give her something to eat." 2. "Place some hard candies in her mouth." 3. "Just let her sleep. People are sleepy after hypoglycemic episodes." 4. "Give her another injection and call the paramedics."

4. "Give her another injection and call the paramedics."

A client with adrenocortical insufficiency has started therapy with fludrocortisone (Florinef). What important intervention related to this drug therapy should the nurse teach the client? 1. "Report any abdominal pain or changes in your stool color." 2. "Return monthly for laboratory work to assess blood lipid levels." 3. "Report any unusual changes in your mood." 4. "Weigh yourself daily, ideally at the same time each day."

4. "Weigh yourself daily, ideally at the same time each day."

The clinic nurse is assessing a client diagnosed with pericarditis. The client reports to the nurse, "I take an aspirin every morning to help prevent a heart attack." Which statement is the nurse's best response based on the client's medical diagnosis? 1. "Aspirin is known to prevent heart attacks. It is excellent that you take it." 2. "Have you noticed that you are bruising more easily since you started taking it?" 3. "I would recommend taking the enteric-coated aspirin to prevent gastric upset." 4. "You should quit taking the aspirin immediately, and I will talk to your HCP."

4. "You should quit taking the aspirin immediately, and I will talk to your HCP."

The nurse is preparing to administer the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen (Motrin) to a client diagnosed with pericarditis. Which intervention should the nurse include in the plan of care? 1. Monitor the blood glucose level. 2. Have the client sit upright for 30 minutes after taking the medication. 3. Instruct the client to drink a full glass of water. 4. Administer the medication with food.

4. Administer the medication with food.

The nurse is caring for several clients who are receiving opioids for pain relief. Which client is at the highest risk of developing hypotension, respiratory depression, and mental confusion? 1. A 23-year-old female, postoperative ruptured appendix 2. A 16-year-old male, post-motorcycle injury with lacerations 3. A 54-year-old female, post-myocardial infarction 4. An 86-year-old male, postoperative femur fracture

4. An 86-year-old male, postoperative femur fracture

The client newly diagnosed with coronary artery disease is being prescribed a daily aspirin. The client tells the nurse, "I had a bad case of gastritis last year." Which intervention should the nurse implement first? 1. Ask the client if he or she informed the HCP of the gastritis. 2. Explain that regular aspirin could cause gastric upset. 3. Instruct the client to take an enteric-coated aspirin. 4. Determine if the client is taking any antiulcer medication.

4. Determine if the client is taking any antiulcer medication.

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with the client diagnosed with hypothyroidism. Which intervention should the nurse discuss with the client? 1. Encourage the client to decrease the fiber in the diet. 2. Discuss the need to monitor the T3, T4 levels daily. 3. Tell the client to take the medication with food only. 4. Instruct the client to report any significant weight changes.

4. Instruct the client to report any significant weight changes.

Which statement best describes the pharmacodynamics of insulin? 1. Insulin causes the pancreas to secrete glucose into the bloodstream. 2. Insulin is metabolized by the liver and muscle and excreted in the urine. 3. Insulin is needed to maintain colloidal osmotic pressure in the bloodstream. 4. Insulin lowers blood glucose by promoting use of glucose in the body cells.

4. Insulin lowers blood glucose by promoting use of glucose in the body cells.

The nurse explains the benefit of using the long-acting insulin glargine (Lantus) over other insulins. What will the nurse tell the client about this insulin? 1. It does not need to be administered by injection. 2. It can be given by intramuscular or subcutaneous injection. 3. It does not require blood glucose monitoring. 4. It has no definite peak but maintains a steady state of insulin in the body.

4. It has no definite peak but maintains a steady state of insulin in the body.

The client newly diagnosed with type 2 diabetes who has been prescribed an oral hypoglycemic medication calls the clinic and tells the nurse that the sclera has a yellow color. Which intervention should the clinic nurse implement? 1. Ask the client if he or she has been exposed to someone with hepatitis. 2. Determine if the client has a history of alcohol use or is currently drinking alcohol. 3. Check to see if the client is taking the cardiac glycoside digoxin. 4. Make an appointment for the client to come to the health-care provider's office.

4. Make an appointment for the client to come to the health-care provider's office.

The nurse in the medical department is preparing to administer Humalog, a rapid-acting insulin, to a client diagnosed with type 1 diabetes. Which intervention should the nurse implement? 1. Ensure the client is wearing a MedicAlert bracelet. 2. Administer the dose according to the regular insulin sliding scale. 3. Assess the client for hyperosmolar, hyperglycemic, nonketotic coma. 4. Make sure the client eats the food on the meal tray that is at the bedside.

4. Make sure the client eats the food on the meal tray that is at the bedside.

The nurse in the intensive care unit is caring for a client diagnosed with a left cerebral artery thrombotic stroke who received a thrombolytic medication in the emergency department. Which intervention should be implemented? 1. Administer the antiplatelet medication ticlopidine (Ticlid) po. 2. Place the client in the Trendelenburg position. 3. Keep the client turned to the right side and high Fowler's position. 4. Monitor the anticoagulant heparin infusion.

4. Monitor the anticoagulant heparin infusion.

An 80-year-old woman, who is scheduled for a total knee replacement next month, currently takes ibuprofen (Motrin, Advil) 600 mg three times per day. Which client teaching intervention is most important? 1. Continue ibuprofen (Motrin, Advil) until surgery. 2. Stop ibuprofen (Motrin, Advil) today. 3. Decrease ibuprofen (Motrin, Advil) to two times per day. 4. Stop ibuprofen (Motrin, Advil) 7 to 14 days before surgery.

4. Stop ibuprofen (Motrin, Advil) 7 to 14 days before surgery.

The client on replacement therapy with levothyroxine (Synthroid) reports feeling nervous and is having occasional palpitations and tremors. The nurse recognizes that these symptoms may indicate what effect is occurring? 1. The client is still experiencing hypothyroidism and the dose may need to be increased. 2. The client now has normal thyroid function and the levothyroxine (Synthroid) is no longer needed. 3. The client has developed diabetes and needs further evaluation. 4. The client is experiencing symptoms of hyperthyroidism and the drug dosage may need to be decreased.

4. The client is experiencing symptoms of hyperthyroidism and the drug dosage may need to be decreased.

The client has had a total right hip replacement. Which medication should the nurse anticipate the HCP prescribing? 1. The oral anticoagulant warfarin (Coumadin). 2. The intravenous anticoagulant heparin. 3. The thrombolytic alteplase (Activase). 4. The low-molecular-weight heparin enoxaparin (Lovenox).

4. The low-molecular-weight heparin enoxaparin (Lovenox).