Pharm Final

The nurse is caring for a client with renal insufficiency and reflux issues. What would be the safest way to manage hyperacidity in a client with renal failure?

Calcium Carbonate (TUMS)

What is essential for the nurse to remember when administering potassium supplements?

Hold the medication when potassium levels are above 5.0

While preparing to administer HCTZ (Hydrodiuril) 25mg checks the nurse discovers that the client's potassium level is 2.8 mEq. What should the nurse do next?

Hold the medicine, give the client orange juice and consult the MD for next steps

The nurse would recognize the need for further education if a client taking reflux medications made which statement

I should drink carbonated beverages to neutralize the acid

The nurse is educating a client regarding the use of pantoprazole, a proton pump inhibitor. What statement by the client shows proper understanding of how to take this medication?

I should take this medication on an empty stomach before I eat.

An asthmatic client shows good understanding of leukotriene blocker precautions when he or she makes which comment?

If I take this medicine before bedtime it might help me avoid an asthma attack in the middle of the night."

A client asks why they are taking nifedipine (Procardia). Knowing this is a calcium channel blocker how would the nurse respond?

It is useful for preventing chest pain. It opens your coronary arteries to feed your heart

The lab calls to inform the nurse that a client's PTT level is 150. What antidote to heparin should the nurse have available?

Protamine Sulfate

The nurse understands that a bronchodilator would be most therapeutic in which of these situations?

Shallow breath sounds with wheezes in the upper lobes.

A nurse is caring for a client who asks how albuterol (an adrenergic inhaler) helps his breathing. Which of the following should the nurse include in the response?

The medication will open the airways.

Since Phenergan (promethazine) is a phenothiazine (neuroleptic), clients using it for extended periods should be told to seek professional help if what type of symptoms occur?

Tremors or muscle rigidity

What should the nurse advise a client taking Loop or thiazide diuretics regarding their self-care?

Weigh daily and report any loss or gain exceeding two pounds in 24 hours

Which of the following medications could cause fluid retention and thus contribute to heart failure?

steriods

A hypertensive client is bothered by a persistent, dry cough. Which of the client's medications is the most likely cause?

Enalapril, an ACE inhibitor

A client receiving ipratropium (Atrovent) tells the nurse she is going to stop it because it leaves a bitter taste in her mouth. How should the nurse respond?

"Could you try managing the bitter taste by chewing gum or peppermints?"

Which of these statements indicates good client understanding of nitroglycerin self-care practices?

"I should stop what I am doing and sit down before I take nitroglycerin for chest pain."

A client is prescribed Salmeterol (Serevent) as a long acting beta2 agonist. Which statement would indicate that the client needs more education regarding use of this inhaler?

"I should use it quickly and repeatedly if I develop severe dyspnea.

A nurse is caring for a client who has osteoporosis and is taking a calcium supplements and antacids concurrently. When the client tells the nurse she has been having flank pain, how should the nurse respond?

"You may be suffering from a kidney stone. Let's talk to your provider."

The nurse should question giving oral medications in which of these situations? (Select all that apply)

-Recent episode of bloody emesis -Client returned from a bronchoscopy which required local anesthesia of the gag reflex -Client has a history of severe epigastric pain that suddenly disappeared an hour ago -Client has just been diagnosed with acute pancreatitis

What should the nurse do to protect a client who has just received intravenous atropine for bradycardia?

-Watch the monitor closely -Refrain from feeding the patient until passing flatus -Obtain an order to catheterize the patient

A client has fallen in part due to low blood pressure. Which of the medications listed below may have contributed to the drop in his blood pressure?

-metolazone, a thiazide agent -nifedipine, a calcium channel blocker for angina -candesartan, an ARB (angiotensin receptor blocker)

A client's prescriber has ordered 500 mg of IM Rocephin every 12 hours x 4. The pharmacy has sent a 1 gram bottle of Rocephin powder with instructions to add 2.3 mLs to the vial and shake. Following reconstitution the vial will contain 1 gram in 2.6 mLs. How many mls will the nurse inject to deliver the originally ordered 500 mg dose? (Submit only the number, no text)

1.3

The nurse would recognize the need for further education in a pregnant woman taking Zofran (ondansetron), who makes which of these statements?

Generic Zofran is freely available, and cheaper, via the internet.

The client takes diphenoxylate with atropine (Lomotil) at least twice daily for diarrhea. Which of these added illnesses might be adversely affected by her Lomotil intake?

Glaucoma

It is advisable to give Robitussin (guaifenesin) with either dextromethorphan or codeine in which of the following situations?

Harsh productive dry cough contributing to loss of sleep

A client was started on spironolactone (Aldactone), an aldosterone inhibiting diuretic. What should the nurse advise the client regarding needed self-care?

avoid salt substitute

Which side effect should the nurse tell a client to expect before administering anti-angina nitrates?

headache

A nurse is giving discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?

tachycardia

A nurse is talking with a client who has peptic ulcer disease and is starting therapy with sucralfate (Carafate). The nurse should instruct the client to take the medication

take before meals

Which of these comments by a client taking calcium channel blockers would indicate the need for additional teaching?

"I will take the medication with grapefruit juice"

After two episodes of requiring a suppository last month, a dementia care client's wife is insisting that Milk of Magnesia should be added to his list of daily medications. How should the nurse respond?

"Routinely giving magnesium could alter his electrolytes. Miralax might be a better solution."

The nurse is scheduled to give oral metoprolol 25 mg to a client. Which of these findings would cause the nurse to hold the medication?

BP of 92/44

A client has come to the clinic seeking a prescription for Sildenafil (Viagra). What is a priority assessment question for the nurse to ask?

Do you use nitroglycerin?

A client taking warfarin (Coumadin) presents with bruises, dark tarry stools and an INR is 4.3. What should the nurse do?

Hold the Coumadin and consult the physician about next steps.

. Which of the following is a priority intervention for the patient taking lasix?

Hold the lasix for a potassium of 2.3, and call the physician for further collaboration.

A client is taking atenolol, a beta-adrenergic blocker. Which of the following interventions is most critical for the nurse to include in the plan of care?

Hold the medication if the apical pulse is under 60, and seek parameters

A client is having bursts of ventricular ectopy. Which medication should the nurse be prepared to give to resolve this concern?

Lidocaine

Why is it preferable to manage constipation in elderly clients with daily Miralax or Metamucil as opposed to Milk of Magnesia every third day?

Magnesium accumulates in elderly people with renal failure

Which statement indicates sound understanding of needed self-care precautions in a client taking warfarin (Coumadin)?

My Coumadin dose may need to be readjusted when I take a course of antibiotics

What inhaler sequence should the nurse recommend when filling out an asthma action plan?

Short acting adrenergic inhalers should be followed by long acting adrenergic inhalers.

The nurse is counseling a neighbor regarding over-the-counter acidity reducing agents. What should the nurse advise?

These medications can accentuate or inactivate the effects of other medications so be sure to consult your provider if you are taking them with other medications

A client is to be discharged on digoxin 0.125 mg P.O. daily. What should the nurse include in the client's discharge teaching?

The client should be asked to demonstrate checking their own pulse.

The client is prescribed intravenous metoclopramide (Reglan), as needed. The client asks how the medication works. How should the nurse respond?

"It promotes gastric emptying and suppresses nausea centers in the brain"

A client is starting to take furosemide, a loop diuretic. When is the best time to take this medication?

0800

A client, whose Lipitor dosage was recently increased, asks if there are any precautions he should take. How should the nurse respond?

Call the doctor if you experience muscle weakness, and have your liver enzymes checked.

Prazosin (Minipress) is prescribed for a client with hypertension. Which of these instructions should the nurse include in the teaching plan?

Change from a lying to a sitting position slowly

A nurse is teaching a client about her ACE inhibitor, Zestril (lisinopril). The client asks what the medication is for. What would be the correct response by the nurse?

It is a vasodilator diuretic. It reduces cardiac work and supports circulation

A nurse is giving discharge instructions to a client who has asthma and is about to start using beclomethasone, in addition to his other inhalers. Which teaching points regarding steroid inhalers are essential for safety (Select all that apply)

Rinse your mouth after using any inhaler, especially this one. -This is not a rescue inhaler. Use this as a preventative inhaler only..

The nurse should hold Lanoxin in which of these situations?

When the pulse is 54, and the client complains of nausea and altered vision

A nurse is teaching a client who has asthma the appropriate use of inhaled fluticasone. What advice should the nurse give to help the client avoid inhaled steroid complications?

rinse yours mouth after inhaling the medicine