pharm final

The nurse is caring for a client in labor. The nurse reviews the physician's prescriptions and notes that the client has a prescription for butorphanol tartrate (Analgesic). The nurse understands that this medication is prescribed for:

ANS: Pain relief

The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which of the following laboratory studies to determine the therapeutic effect of heparin for the client?

ANS: Partial thromboplastin time (PTT)

The client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client's history and physical included a diagnosis of:

ANS: Peptic ulcer disease

The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse reminds the client that which of the following is an anticipated, although unpleasant, side effect of this medication?

ANS: Persistent dry cough

A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which of the following?

ANS: Promote maturation of the fetal lungs.

A nurse working in intensive care unit identifies a patient with bleeding who is receiving heparin, She knows that the patient will need the following medication:

ANS: Protamine Sulfate

The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a newborn. The nurse plans to explain to the parents that the purpose of the medication is to:

ANS: Protect the newborn from contracting an eye infection during birth.

The nurse is speaking with a female client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which of the following would be an important point for the nurse to stress to the client?

ANS: Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy.

The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the client may complain of which of the following?

ANS: Increase in her pain level

An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching?

ANS: "I need to take my vitamin A supplement so that the treatment will work."

The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication?

ANS: "I need to wash the sites gently before I apply the medication."

The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which of the following statements, if made by the parent, indicates an understanding of the administration of this medication?

ANS: "I should use a medicine dropper and place the iron near the back of the throat."

The nurse is administering a prescribed dose of dexamethasone (Decadron) to a client following cranial surgery. Which of the following interventions would the nurse perform to assess for a common side effect of this medication?

ANS: . Obtain a prescription for blood glucose monitoring.

The client has a prescription for sucralfate (Carafate) four times daily. The nurse writes in the medication record to administer the medication at which of the following times?

ANS: . One hour after meals and at bedtime

The nurse monitors the blood glucose level of the client who received NPH insulin at 7 AM with an understanding that the client may experience a hypoglycemic reaction between:

ANS: 1-7pm

A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between:

ANS: 1.5 and 2.0 mEq/L

A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation?

ANS: 14

The nurse is preparing to administer a 50-mcg dose of medication to a client. The medication is available in 100 mcg/5 mL. How many mL should the nurse administer?

ANS: 2.5 mL

What is through level?

ANS: It is the lowest concentration in the patient's bloodstream, therefore, the specimen should be collected just prior to administration of the drug.

The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that the reason for therapy with leucovorin is to:

ANS: Preserve normal cells.

The nurse is assisting in the care of a client who is being seen in the clinic with a suspected acetaminophen (Tylenol) overdose. Which of the following medications should the nurse plan to have readily available if the suspected diagnosis is confirmed?

ANS: Acetylcysteine (Mucomyst)

A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take which of the following actions next?

ANS: Administer another nitroglycerin tablet.

The client has a prescription to receive pirbuterol (Maxair) two puffs and beclomethasone two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by:

ANS: Administering the pirbuterol before the beclomethasone

The client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is a(n):

ANS: Anti-inflammatory agent specific for gout

Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which of the following should the nurse include in the instructions?

ANS: Apply once a day and cover it with sterile dressing.

A client has recently begun medication therapy with a Beta Blocker (Propranolol). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted?

ANS: Audible expiratory wheezes

The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the newborn. Before giving the medication, the nurse explains to the client that this medication will:

ANS: Prevent clotting abnormalities in the newborn.

The client who has developed atrial fibrillation is not responding to medication therapy and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nurse would tell the client to avoid which of the following foods while taking this medication?

ANS: Broccoli

The nurse working in the ambulatory care center is providing medication instructions about methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). The nurse recommends that the mother give medication to the child:

ANS: Just before the noontime meal Rationale: Methylphenidate is best taken shortly before a meal. It should not be taken after 12 noon or 1 PM for children or after 6 PM for adults, because the stimulating effect may keep the client awake. The other options are incorrect.

The client is experiencing diarrhea. The nurse reviews the client's PRN medication prescription sheet and plans to administer which of the following medications for this problem?

ANS: Loperamide (Imodium)

A client has been started on therapy with lithium carbonate (Lithobid). The nurse instructs the client to do which of the following?

ANS: Maintain a fluid intake of 2 to 3 L/day.

A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The nurse checks the medication to ensure that which medication is available as an antidote if needed?

ANS: Calcium gluconate

An older client has been receiving cimetidine (Tagamet). The nurse should report to the physician that the client is experiencing a side effect of the medication if which of the following is noted during the assessment?

ANS: Confusion

The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe:

ANS: Continuation of the presently prescribed dosage

The client with a burn injury is applying mafenide (Sulfamylon) to the wound. The client calls the physician's office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse instructs the client to:

ANS: Continue with the treatment, as expected.

The nurse is collecting data from a client with a history of renal transplantation. The nurse understands that the medication of choice for preventing organ rejection is:

ANS: Cyclosporine (Sandimmune)

A client having a myocardial infarction is receiving alteplase (Activase) therapy. Which of the following actions should be carried out by the nurse to monitor for the most frequent adverse effect?

ANS: Monitor for bleeding.

A nurse is caring for a female client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium (Solaraze). The nurse teaches the client that this medication is from which class of medications?

ANS: Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time?

ANS: One hour after a meal

The therapeutic response of Warfarin needs to be monitored with which lab test

ANS: PT/INR

An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed?

ANS: Decrease in urticaria

Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which of the following is noted in the client?

ANS: Decreased muscle spasms

The client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, "I know this is for gout, but how does it work?" In formulating a response, the nurse understands that allopurinol:

ANS: Decreases uric acid production

A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, diarrhea, and blurry vision. The nurse notes that the client's serum potassium (K) level is 3.0 ng/mL. Based on analysis of the data, what might the nurse anticipate assessing when reviewing the digoxin level results?

ANS: Digoxin level higher than 2 ng/mL

The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse assesses for which of the following manifestations that could indicate digoxin toxicity?

ANS: Double vision, loss of appetite, and nausea

The nurse teaching a mother how to administer ear drops to an infant, tells the mother to pull the child's ear:

ANS: Down and back and direct the solution toward the wall of the canal

The client is taking cetirizine (Zyrtec). The nurse teaches the client to expect which of the following side effects of this medication?

ANS: Drowsiness .

Which of the following are toxic effects of opioid medications: (Select All That Apply)

ANS: Excessive sleepiness, Blue or grayish skin and dark lips or fingernails, Slowed or stopped breathing

The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states that he will report which of the following symptoms to the physician?

ANS: Fever

A patient who took an overdose of Lorazepam is at the emergency room. The nurse will prepare the administration of the following medication

ANS: Flumazenil

The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high doses of this medication can cause which side effect?

ANS: Hypercalcemia

The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat:

ANS: Hypoglycemia from insulin overdose

The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following delivery of an infant. The nurse determines that this medication had the intended effect after evaluating for which of the following findings?

ANS: Improved uterine tone

The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication:

ANS: In the early morning

The client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which of the following when formulating a reply?

ANS: Rebound central nervous system (CNS) excitation could occur, including seizure activity.

A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of magnesium toxicity?

ANS: Respiratory rate of 10 breaths/min

The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution?

ANS: Rinse off immediately following irrigation

The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?

ANS: Rinse the mouth with diluted baking soda or saline.

The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should plan to tell the client to report which of the following immediately?

ANS: Stomatitis and diarrhea

A nurse is assessing a patient newly diagnosed with diabetes who has been prescribed with glipizide. The nurse must notify the provider about which personal history:

ANS: Sulfa allergy Rationale: Glipizide is a sulfa medication

The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which of the following?

ANS: Sulfa drugs

The nurse monitors the client receiving the first dose of albuterol (Proventil HFA) for which of the following side effects of this medication?

ANS: Tachycardia

The client reports frequent use of acetaminophen (Tylenol) for relief of frequent headaches and other discomforts. The nurse should evaluate which of the diagnostic data to determine if the client is at risk for toxicity?

ANS: The liver function studies

The client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse evaluates that the client understands the use of the medication if the client states that:

ANS: The medication will act as a local analgesic.

A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication information to the mother would plan to emphasize which of the following most important instructions about giving this medication to the child?

ANS: Use a straw when giving the medication.

The nurse is preparing a subcutaneous dose of bethanechol (cholinergic drug) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed?

ANS: atropine sulfate

A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which of the following sign/ symptom that indicates an adverse effect of this medication?

ANS: chest pain Rationale: Because of its powerful vasoconstrictor actions, vasopressin can cause adverse cardiovascular effects. By constricting arteries of the heart, vasopressin can cause angina pectoris and even myocardial infarction (MI), especially if administered to clients with coronary artery disease. In addition, vasopressin may cause gangrene by decreasing blood flow in the periphery. The other options are incorrect are nit signs/symptoms of adverse effects of the medication.

The physician has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse teaches the client to monitor for:

ANS: constipation

The physician prescribes cromolyn (Intal) for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will:

ANS: suppress an allergic response

A woman with atrial fibrilation is taking Warfarin, it is having spontaneous bleedings. The nurse know that the antidote for this medication is:

ANS: vitamin K