Pharm Final Question Collection

A caregiver asks the nurse what the caregiver can give a 9-year-old child for a headache. What is the nurse's best response? "Acetaminophen-aspirin-caffeine works best." "Acetaminophen is appropriate." "The prescriber can order them a triptan." "Ketorolac can be prescribed."

"Acetaminophen is appropriate." Explanation: Acetaminophen is appropriate. Acetaminophen-aspirin-caffeine is recommended for children older than 12 years of age. Ketorolac and triptans are not prescribed for children.

A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply. "Antihistamines are not recommended because they tend to worsen your cough." "Antihistamines are not recommended in your situation but an antibiotic may be useful." "Antihistamines are used for allergy-related coughs." "Antihistamines are effective but only if you also increase your fluid intake." "Antihistamines are recommended for your type of cough, but you must monitor for adverse effects."

"Antihistamines are not recommended because they tend to worsen your cough." "Antihistamines are used for allergy-related coughs." Explanation: Antihistamines are clearly useful in allergic conditions (e.g., allergic rhinitis), but their use to relieve cold symptoms is controversial. Although antihistamines are popular over-the-counter drugs because they dry nasal secretions, they are not recommended because they can also dry lower respiratory secretions and worsen secretion retention and cough. Antibiotics are not recommended for the treatment of a cold. The remaining options do not present with accurate statements.

A nurse is assessing a female client who has been taking NSAIDs. What statement by the client indicates a good understanding of the use of NSAID therapy? "I take as little water as possible when I take my medication." "I drink a glass of wine every night." "I asked my provider to check for blood in my stool on a regular basis." "I don't like to swallow tablets so I crush them."

"I asked my provider to check for blood in my stool on a regular basis." Explanation: Taking some anti-inflammatory drugs can increase the risk of bleeding; therefore, by asking the health care provider to check her stool for bleeding the nurse knows that the client is aware of this. Alcohol and crushing the tablets can interfere in anti-inflammatory metabolism. A full glass of water should be taken with this medication to increase absorption.

A postsurgical client has been provided with a morphine patient-controlled analgesic (PCA) but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond to this client's concerns? "You don't need to worry. It's actually not true that you can get addicted to the medications we use in a hospital setting." "It's important that you accept that your current need to control your pain is more important than fears of becoming addicted." "If you do become addicted, we'll make sure to provide you with the support and resources necessary to help you with your recovery." "It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."

"It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction." Explanation: Addiction to opioids is a rare occurrence among hospital clients who do not have a history of drug abuse. It would be inappropriate to downplay the client's concerns, however. A more appropriate response would be to explain the phenomenon of dependence and to differentiate it from addiction.

A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug? "Take a dose of sumatriptan each morning when you suspect there's a chance of having a migraine." "Lie down when you feel a migraine coming on and take some sumatriptan around 30 minutes later." "Take this drug as soon as you feel the first signs of a migraine." "Take a dose of sumatriptan after you feel that you're unable to endure the pain of your migraine."

"Take this drug as soon as you feel the first signs of a migraine." Explanation: Administer sumatriptan as soon as the headache begins. Sumatriptan is more efficacious when given before the headache escalates. However, it is not normally taken on a prophylactic basis.

A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this client's statements? "I'll refer you to a specialist because it could be that you have a disease affecting your bowels or stomach." "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." "Because we become more prone to constipation as we age, you'll likely need to increase the number of stool softeners you take." "Try using a different over-the-counter laxative and see that if you resolves your problem."

"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." Explanation: Chronic use of laxatives may lead to dependency on the laxative to expel a bowel movement. This pattern is especially common among older adults. This phenomenon is more likely than a pathological condition. It would be inappropriate to suggest more (or different) laxatives.

A client is in the hospital recovering from surgery and is using a client-controlled anesthisia (PCA) pump. The client's adult child tells the nurse they are concerned about the possibility of morphine overdose because their parent keeps pressing the button on the PCA. In addition to reassessing the client's pain, what is the nurse's best response? "The device has maximum limits programmed, so your parent cannot get more than a specific amount." "If they follow the directions given, that will not happen." "I'll teach you some techniques to take their focus off the pain so they don't press the button so often." "I'll come and teach them again how to use the PCA safely and effectively."

"The device has maximum limits programmed, so your parent cannot get more than a specific amount." Explanation: A PCA system using morphine provides a baseline, constant infusion of morphine and gives the client control of the system to add bolus doses of morphine if the client believes that pain is not being controlled. The system prevents overdose by locking out extra doses until a specific period of time has elapsed. Offering to teach relaxation techniques to the family member does not address the expressed concern.

A female client asks why she must consult with the health care provider when she uses cold products for her children. What is the nurse's best response? "Your health insurance requires that you notify the health care provider whenever you administer over-the-counter medications to your children." "There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies." "Notification is just a precaution to protect you and your children." "You really aren't required to do so, it is just a precaution."

"There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies." Explanation: There is a risk of overdose and hepatotoxicity because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies. An overdose can occur with large doses of one product or smaller amounts of several different products. In addition, toxicity has occurred when parents or caregivers have given the liquid concentration intended for children to infants.

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium? "This medication will only soften your stools over the next couple of days." "You'll usually have a bowel movement within 2 to 3 hours of taking this." "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days." "This medication will cause your bowels to contract more strongly than they normally do."

"This medication will only soften your stools over the next couple of days." Explanation: Surfactant laxatives (e.g., docusate calcium or docusate sodium) decrease the surface tension of the fecal mass to allow water to penetrate into the stool. They also act as a detergent to facilitate admixing of fat and water in the stool. As a result, stools are softer and easier to expel. These agents have little, if any, laxative effect. Their main value is to prevent straining while expelling stool. They usually act within 1 to 3 days and should be taken daily.

The nurse collects the past medical history of a client new to the clinic. The client reports an allergy to penicillin. What questions about the allergy should the nurse ask the client? Select all that apply. "Were you offered alternative medications?" "Do others in your family have similar allergies?" "How many doses were administered before the reaction occurred?" "Had the medication ever been prescribed before the time when the reaction occurred?" "What signs and symptoms were displayed with the reaction?"

"What signs and symptoms were displayed with the reaction?" "How many doses were administered before the reaction occurred?" "Had the medication ever been prescribed before the time when the reaction occurred?" Explanation: It is important to determine what the allergic reaction was and when the client experienced it (e.g., after first use of drug, after years of use). If they have been prescribed this medication before with no reaction and then had a reaction the next time it was prescribed, this would be important information to know. Some clients report having a drug allergy, but closer investigation indicates that their reaction actually constituted an anticipated effect or a known adverse effect to the drug. It would not necessarily be important to find out family allergy history or alternatives offered to the client in the past.

A client received erythromycin before dental surgery. The client has a past history of a cardiac surgery. The rest of the client's history is unremarkable. What does the nurse teach the client about this medication? "You cannot receive other antibiotics because of your cardiac history." "You are receiving this medication to prevent infection that may affect your heart." "You need this medication to decrease the extraction pain of surgery." "This medication will help them remove your tooth easier."

"You are receiving this medication to prevent infection that may affect your heart." Explanation: The client with a prior history of a heart defect is at risk for bacteria growing in the area of the defect. The client should receive prophylactic antibiotics with any surgery or invasive procedure. The medication does not decrease pain, nor does it make it easier to remove a tooth. Other antibiotics are sometimes given as well as a macrolide.

Your client receives IV vancomycin every 12 hours. You know that this infusion should run over: 30 minutes. 3 to 4 hours. 2 to 4 hours. 1 to 2 hours.

1 to 2 hours. Explanation: For systemic infections, vancomycin is given IV and reaches therapeutic plasma levels within 1 hour after infusion. It is very important to give IV infusions slowly, over 1 to 2 hours, to avoid an adverse reaction characterized by hypotension, flushing, and skin rash. This reaction, sometimes called "red man syndrome," is attributed to histamine release.

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long? 2 days 12 hours 1 day 7 days

2 days Explanation: The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for more than 2 days. Diarrhea lasting more than 2 days can indicate infection or a condition that will require more intense treatment with prescription medication. Dehydration can occur if untreated. Diarrhea of 12 hours to 1 day can be viral. Diarrhea for 7 days can be life threatening.

A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? Ascorbic acid Ibuprofen Acetylsalicylic acid Acetaminophen

Acetylsalicylic acid Explanation: In children and adolescents, aspirin is contraindicated in the presence of viral infections, such as influenza or chickenpox, because of its association with Reye's syndrome. Acetaminophen and ibuprofen are safe to administer for fever reduction and pain relief in children and adolescents since no connection with Reye's syndrome has been established. Ascorbic acid is safe to administer to children but is not used to reduce fever or pain.

The nurse prepares to administer acetylcysteine by nebulization to an adult client diagnosed with chronic bronchitis. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. Provide drug after meals and before bedtime to remove mucous, which causes difficulties in breathing. Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber. Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. Instruct client that the drug irritates gastric vagal receptors to stimulate respiratory tract fluid.

Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber. Explanation: The nurse should instruct the client that the mucolytic drug attacks protein bonds in mucous and liquefies it, so it is easier to expel the mucous. Guaifenesin, an expectorant, irritates gastric vagal receptors stimulating respiratory tract fluid to increase and liquifies the mucous. The bronchodilator is administered first to dilate the bronchi so that the mucolytic will be more effective. The optimal times to administer the drug are upon rising, before meals, and at bedtime to effectively remove mucous that causes problems with breathing. Providing the drug after meals will increase nausea and vomiting, potential adverse effects. Therapeutic effects the nurse assesses includes increase in mucous raised from the lungs, a decrease of respirations to a normal range, and stabilization of SaO2 at 90% or greater. The nurse would report adverse effects to the prescriber that reflect the drug is not therapeutic, including chest tightness, bronchospasm, and inability to expel mucous.

The healthcare provider prescribes codeine 20 mg PO q4h as an adjunctive therapy to a client's NSAID. What is the nurse's best action? Contact the care provider to question the frequency of administration. Administer the medication as prescribed and monitor the client's pain. Contact the care provider to question the dose. Contact the care provider to question concurrent use of an NSAID and codeine.

Administer the medication as prescribed and monitor the client's pain. Explanation: The correct dosage for codeine administered for pain by mouth is 15 to 60 mg q4-6h. Narcotics and NSAIDs can be safely administered at the same time. Consequently, there is no apparent need to question this order.

A client is taking a nonsteroidal anti-inflammatory agent. Which instruction should the client be given in regard to administration? Administer the medication every other day. Administer the medication with food. Crush enteric-coated tablets for impaired swallowing. Administer the medication with orange juice.

Administer the medication with food. Explanation: To prevent gastrointestinal irritation, instruct the client to administer the medication with food. The administration of an NSAID with orange juice will increase gastric acid and not protect the gastric mucosa. Crushing enteric-coated tablets will eliminate the protection of the gastric mucosa. Nonsteroidal anti-inflammatory agents administered every other day will not protect the client from gastric irritation.

The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration? Electrolytes Allergy to opioids Pain Allergy to aspirin

Allergy to aspirin Explanation: Bismuth salts have antibacterial and antiviral activity. Bismuth subsalicylate contains salicylate, and the client should be assessed for an aspirin allergy before administration. It is important to assess for pain and electrolyte balance but is not the primary assessment to be made. The nurse would not need to assess for allergy to opioids because bismuth does not contain opioids.

The nurse has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next? No further action is required because the naloxone has already been administered. Administer a second dose and then notify the provider to obtain an order. Call the provider as another dose of opioid antagonist may be necessary. Continue to monitor the client's vital signs and oxygen saturation levels.

Call the provider as another dose of opioid antagonist may be necessary. Explanation: The effects of some opioids may last longer than the effects of naloxone. A repeat dose of naloxone may be ordered if results obtained from the initial dose are unsatisfactory. Therefore, calling for an order would be an appropriate response. Taking no action in light of respiratory depression, or merely continuing to monitor the client, could lead to deterioration in the client's condition. No medication should be administered without a provider order.

Which of the following is a serious risk involved in the use of NSAIDs? Cardiovascular thrombosis Increased granulocyte count Increased WBC count Sickle cell anemia

Cardiovascular thrombosis Explanation: A serious risk involved in the use of NSAIDs is cardiovascular thrombosis. Increased granulocyte count, increased WBC count, or sickle cell anemia is not caused by NSAIDs. Sickle cell anemia results from an inherited abnormality of hemoglobin. NSAIDs may cause decreased granulocyte count, decreased WBC count, or aplastic anemia.

Tuberculosis caused by drug-resistant organisms should be considered in which clients? Select all that apply: Clients who have been treated in the past Clients who are HIV positive Clients who have no response to therapy Clients who have asthma Clients who smoke

Clients who have no response to therapy Clients who have been treated in the past Explanation: Tuberculosis caused by drug-resistant organisms should be considered in clients who have no response to therapy and in patients who have been treated in the past.

Which agent acts directly on the medullary cough center? Ephedrine Codeine Tetrahydrozoline Benzonatate

Codeine Explanation: Codeine, a centrally acting antitussive, works directly on the medullary cough center. Benzonatate provides local anesthetic action on the respiratory passages, lungs, and pleurae. Ephedrine and tetrahydrozoline are topical nasal decongestants.

Linezolid can be used to treat which of the following infections? Select all that apply. Methicillin-resistant Staphylococcus aureus (MRSA) Vancomycin-resistant Enterococcus faecium (VREF) Community-acquired pneumonia (CAP) Nosocomial pneumonia Acute otitis media

Community-acquired pneumonia (CAP) Vancomycin-resistant Enterococcus faecium (VREF) Methicillin-resistant Staphylococcus aureus (MRSA) Nosocomial pneumonia Explanation: Linezolid can be used to treat VREF, MRSA, CAP, nosocomial pneumonia, and skin and skin structure infections

Constipation is a frequent problem. The nurse knows that which of these statements regarding constipation is correct? Constipation is defined as the absence of daily bowel movements. Constipation is characterized by hard, dry stools. Opioid drugs relieve constipation. Dietary fiber causes constipation.

Constipation is characterized by hard, dry stools. Explanation: Opioid drugs decrease gastrointestinal motility and cause constipation, which can be severe. The number of bowel movements per week varies greatly among individuals. Daily movements are experienced by some individuals, while others have two or three per week. Increasing dietary fiber usually decreases risk for constipation and is encouraged for people who experience this discomfort. Constipation is hard, dry stools that are difficult to pass.

A nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate? Consult with the prescriber about lowering the dosage of the drug. Administer the drug through the IV route. Administer an antacid with the drug. Provide aggressive bowel program.

Consult with the prescriber about lowering the dosage of the drug. Explanation: The nurse should lower the dosage of the drug when caring for a client with renal impairment who has been prescribed an opioid analgesic, but only after consulting with the prescriber and obtaining a prescription to do so. The nurse has to provide an aggressive bowel program to clients who experience an adverse reaction on their GI system due to the action of the opioid analgesics. Use of an antacid is recommended only if prescribed by the primary health care provider under specific circumstances. The nurse need not administer the drug through the IV route for a client with renal impairment who has been prescribed opioid analgesics.

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works by inhibiting allergen response. Dextromethorphan works by relaxing the smooth muscles in the bronchioles. Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works in the medulla to suppress the cough reflex.

Dextromethorphan works in the medulla to suppress the cough reflex. Explanation: Dextromethorphan is related chemically to the opiate agonists and can suppress coughing as effectively as narcotics. Cough suppression occurs by several mechanisms, but mainly the drug directly affects the cough center in the medulla. Therapeutic doses do not affect ciliary activity.

A client has been prescribed metronidazole for treatment of Giardia. What instruction is most important for the nurse to give to this client? Do not eat dairy foods while taking this medication. Do not drink alcohol while taking this medication. Regularly use sunscreen products while taking this medication. Do not smoke while taking this medication.

Do not drink alcohol while taking this medication. Explanation: Clients who are receiving metronidazole should not drink alcohol because the client will develop a disulfiram-type reaction if alcohol is consumed while the client is receiving metronidazole.

A new mother required an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will be the most effective drug for the nurse to administer? Docusate Bisacodyl Magnesium sulfate Castor oil

Docusate Explanation: Docusate is a stool softener that will make expulsion of stool easier in a traumatized body area following an episiotomy. Care must be taken to choose a mild laxative that will not enter breast milk and not affect the newborn if the mother is nursing. Docusate is the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate because they do not soften the stool and are harsher laxatives that can enter breast milk.

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction? Taper off the drug rather than abruptly stopping it. Drink a full glass of water when taking a dose of the drug. Take the first dose together with diphenhydramine to reduce the chance of an allergic reaction. Take the drug immediately before a meal, unless the meal will contain large amounts of fat.

Drink a full glass of water when taking a dose of the drug. Explanation: Clients taking penicillins should take oral doses with a full glass of water to ensure sufficient hydration while taking the medication. The drugs should otherwise be taken on an empty stomach. Tapering is unnecessary, and it is not advised to take the drug with diphenhydramine in an effort to reduce the allergy risk.

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.) Bowel obstruction Vomiting Drowsiness Decrease heart rate Dizziness

Drowsiness Dizziness Explanation: The use of centrally acting antitussives increase risk of injury related to the drowsiness, dizziness, and sedation. Recognition of these side effects is important to decreasing patient risk of injury during therapy.

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug? The peak drug effect will occur earlier. Desired effect will be lessened. Duration of action will be prolonged. Onset of desired effect will be shortened.

Duration of action will be prolonged. Explanation: Clients with renal impairment should take minimal doses of morphine for the shortest effective time because usual doses may produce profound sedation and a prolonged duration of action. Desired effect, onset, and peak are not concerns.

When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause? C. difficile E. coli Pseudomonas Staphylococcus aureus

E. coli Explanation: The most common cause of traveler's diarrhea is E. coli.

What is first-line therapy for infants and children 1 to 4 years of age with diarrhea? Paregoric Electrolyte replacement Difenoxin (Motofen) Bismuth salts (Pepto-Bismol)

Electrolyte replacement Explanation: Special precautions need to be taken to monitor for electrolyte and fluid disturbances and supportive measures taken as needed. Serious fluid volume deficits may rapidly develop in children with diarrhea. Appropriate fluid replacement should include oral rehydration solutions.

Determining the cause of diarrhea in a patient is important. It enables choosing the correct treatment. The nurse recognizes that a stool specimen is sometimes necessary to determine correct therapy. The nurse recognizes that a green, liquid stool may be from which of the following? Escherichia coli Shigella Cholecystitis Inflammatory bowel disease

Escherichia coli Explanation: Infections caused by Salmonella or E. coli usually produce green and liquid or semiliquid stools. Shigella usually produces blood-tinged mucus. Inflammatory bowel disorders often produce nonbloody mucus.

A nursing instructor is preparing a teaching plan for a nursing class on opioid analgesics. Which body system would the nursing instructor describe as not adapting to and compensating for the secondary effects of this class of drugs? GI system nervous system respiratory system cardiovascular system

GI system Explanation: The one body system that does not adapt and compensate for the secondary effects of opioids is the GI system. Slow motility and constipation are seen with all opioid use. The respiratory system shows depressed respiratory rate and rhythm. The cardiovascular system can have tachycardia, bradycardia, palpitations, peripheral circulatory collapse, and facial flushing. The central nervous system is where the opioid binds causing a sense of euphoria, weakness, headache, sedation, agitation, tremor, increased intracranial pressure to name a few.

A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply. Administration of an anticoagulant Life support, if indicated Administration of activated charcoal Gastric emptying

Gastric emptying Administration of activated charcoal Life support, if indicated Explanation: Salicylate poisoning is a life-threatening event. Treatment of salicylate poisoning includes gastric emptying, either with syrup of ipecac or gastric lavage; administration of activated charcoal; and life support, if indicated. There is no antidote for salicylate poisoning.

A 12-year-old cancer client is receiving morphine 5-10 mg PO q6 hours. The 12-year-old reports being in pain. The nurse checks the medication record and finds that it has been 5 1/2 hours since the client last received pain medicine. What would the nurse do? Tell the client to wait another 30 minutes before receiving pain medication. Ask the parents whether they think the client really needs the pain medicine at this time. Give the client 5 mg of morphine PO. Notify the health care provider that the dosage is not strong enough.

Give the client 5 mg of morphine PO. Explanation: With oral administration, peak activity occurs in about 60 minutes. The duration of action is 5 to 7 hours. PO dosage with immediate-release morphine, 5-30 mg q4h PRN.

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? Codeine Guaifenesin Aspirin Dextromethorphan

Guaifenesin Explanation: Expectorants, such as guaifenesin, are agents given orally to liquefy respiratory secretions and allow for easier removal. Dextromethorphan and codeine are antitussives used to suppress coughing.

You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect? Hyperphosphatemia Hypomagnesemia Hypochloremia Hypernatremia

Hypernatremia Explanation: Patients with congestive heart failure are at risk of fluid retention and edema with sodium-containing laxatives.

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug? Hypotension Blurred vision arrhythmias Ataxia

Hypotension Explanation: Orthostatic hypotension is commonly seen with some narcotics. Ataxia, blurred vision, and arrhythmias are not generally adverse effects of an opioid analgesic.

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment? INH, rifampin, pyrazinamide, ethambutol INH, rifampin, streptomycin, ethambutol INH, streptomycin, pyrazinamide INH, streptomycin, and rifampin

INH, rifampin, pyrazinamide, ethambutol Explanation: The initial phase of treatment for TB involves using the following drugs: isoniazid, rifampin, pyrazinamide, and ethambutol.

Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist? Decrease in the client's pain rating None of these options Increase in the client's pain rating No change in the client's pain rating

Increase in the client's pain rating Explanation: An opioid antagonist will counter not only the negative effects of an opioid medication but the beneficial effects of the opioid (such as pain relief) as well, resulting in an increase in the client's pain rating. It would not result in a decrease or lack of change in the pain rating.

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants? Allow formation of a slippery coat on the intestinal contents Increase the fluid in the intestinal contents Directly stimulate the nerve plexus in the intestinal wall Selectively antagonize opioid binding

Increase the fluid in the intestinal contents Explanation: Bulk laxatives increase the fluid in the intestinal contents, which enlarges bulk and stimulates local stretch receptor and activates local activity. Chemical stimulant laxatives directly stimulate the nerve plexus in the intestinal wall. Mineral oil, a lubricant, forms a slippery coat on the contents of the intestinal tract. Methylnaltrexone acts as a selective antagonist to opioid binding at the mu receptor.

Which medication will be administered for the treatment of salicylate overdose? Intravenous furosemide Intravenous sodium bicarbonate Inhaled acetylcysteine Intravenous meperidine

Intravenous sodium bicarbonate Explanation: Intravenous sodium bicarbonate produces alkaline urine in which salicylates are more rapidly excreted thus helping to resolve salicylate overdose. None of the remaining options bring about the production of alkaline urine.

Which of the following antitubercular drugs are used during the continuation treatment phase of tuberculosis? Select all that apply: Pyrazinamide Rifampin Ciprofloxacin Ethambutol Isoniazid

Isoniazid Rifampin Explanation: The continuation phase includes only the drugs isoniazid and rifampin.

The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means? It is a drug that reduces the likelihood of drug abuse and dependence. It is a drug that no longer has a patent and can be sold by its generic name. It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. It is a drug that has a special caution because use of this drug is more likely to have adverse effects.

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. Explanation: A drug with no ceiling effect is one in which there is no upper limit to the dosage that can be given to clients who have developed tolerance to previous dosages. This characteristic is especially valuable in clients with severe cancer-related pain because drug dosage can be increased and titrated to relieve pain when pain increases or tolerance develops. None of the other statements explain the terminology.

What is a contraindication to use of a fluoroquinolone? Lactation Weight Gender Height

Lactation Explanation: Fluoroquinolones are contraindicated in patients with known allergy to any fluoroquinolone and in pregnant or lactating patients because potential effects on the fetus and infant are not known. Weight, height, and gender are not absolute contraindications to taking fluoroquinolones.

Lactulose (Chronulac, Cephulac) is prescribed for a client. The nurse knows that which of these statements regarding lactulose are correct? Select all that apply. Lactulose produces defecation within 6 hours. Lactulose increases accumulation of ammonia in the intestine. Lactulose should produce two or three soft stools every day. Lactulose can cause electrolyte imbalance. Lactulose is used to manage hepatic encephalopathy.

Lactulose is used to manage hepatic encephalopathy. Lactulose can cause electrolyte imbalance. Lactulose should produce two or three soft stools every day. Explanation: Lactulose is used for hepatic encephalopathy, which allows ammonia to accumulate. Lactulose decreases levels of ammonia in the intestines and stimulates two or three bowel movements every day. The onset of action of lactulose is 24 to 48 hours.

Which should be included when assessing pain? (Select all that apply.) Intensity of pain Location of the pain What medications client usually takes to relieve the pain What factors cause the pain to improve or worsen

Location of the pain Intensity of pain What factors cause the pain to improve or worsen What medications client usually takes to relieve the pain Explanation: Nursing assessment of a client's pain should include a description of the pain, location, intensity, severity and duration, factors that influence pain, and how the client has previously treated the pain.

The nurse is caring for a client newly admitted for chronic opioid abuse. What medication does the nurse expect to be prescribed to the client? Flumazenil Naloxone Disulfiram Methadone

Methadone Explanation: Opioid withdrawal symptoms are treated with methadone. Naloxone is used to treat acute opioid intoxication or overdose, but it is not used to treat opioid abuse. Flumazenil treats benzodiazepine overdoses, while disulfiram is prescribed to support alcohol sobriety.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? Peripherally acting antitussive Expectorant Antihistamine Mucolytic Centrally acting antitussive

Mucolytic Explanation: Mucolytic drugs may be used by patients suffering from conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumonia, or tuberculosis to reduce the viscosity of respiratory secretions by direct action on the mucus. Mucolytic drugs increase or liquefy respiratory secretions to aid the clearing of the airways in high-risk respiratory patients who are coughing up thick, tenacious secretions. Expectorants increase the production of respiratory secretions, which in turn appear to decrease the viscosity of the mucus. This helps to raise secretions from the respiratory passages. Antitussives are cough suppressants. Antihistamines are used to treat allergic reactions.

The client returns to the unit following surgery. The client reports being in pain. After checking the medication administration record in the client's chart, the nurse sees that the client has not received the morphine the health care provider has ordered for over an hour. As the order reads q 1-2 hours, the nurse administers the low dose of the morphine. The PACU nurse calls to tell the floor nurse that the nurse forgot to chart the last dose of morphine the client had received just before the client was transferred to the floor. What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids? Buprenorphine (Buprenex) Naloxone hydrochloride (Narcan) tartrate Nalbuphine hydrochloride (Nubain) Butorphanol

Naloxone hydrochloride (Narcan) tartrate Explanation: Naloxone is the drug of choice for treatment of opioid overdose. Butorphanol is a morphinan-type synthetic opioid analgesic. Brand name Stadol was recently discontinued by the manufacturer. It is now only available in its generic formulations. Buprenex (buprenorphine hydrochloride) is a narcotic under the Controlled Substances Act due to its chemical derivation from thebaine. Nalbuphine is a synthetic opioid used commercially as an analgesic under a variety of trade names, including Nubain.

The nurse should monitor the client for which common side effects of erythromycin therapy? Nausea, vomiting, and diarrhea Headache and fever Urticaria and ophthalmic drainage Shortness of breath and sore throat

Nausea, vomiting, and diarrhea Explanation: Gastrointestinal problems (e.g., nausea, vomiting, and diarrhea) are common side effects of erythromycin and other macrolides. Headache, fever, ophthalmic drainage, urticaria, shortness of breath and sore throat are no common side effects.

Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection? Nausea Respiratory difficulty Increased bleeding Nephrotoxicity

Nephrotoxicity Explanation: When cephalosporin is administered with aminoglycosides, it increases the risk for nephrotoxicity and should be closely monitored. Nausea is an adverse reaction of cephalosporins in patients with gastrointestinal tract infection. The risk of bleeding increases when cephalosporin is administered with oral anticoagulants. Risk for respiratory difficulty increases if alcohol is consumed within 72 hours after certain cephalosporin administration.

The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply. Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated. Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. Draw the trough level 30 to 60 minutes after drug is administered, and report level above 10 to 12 mcg/mL. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. Obtain peak level before administering next dose of drug, and report level above 2 mcg/mL.

Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated. Explanation: The trough or lowest drug concentration is obtained before administering the next scheduled dose, and the nurse would report a level above 2 mcg/mL. The peak of the drug occurs 30 minutes after the 30-minute infusion has ended. The nurse would report levels above 10 to 12 mcg/mL. When the drug levels are elevated, ototoxicity and nephrotoxicity are more likely to occur. The nurse would test cranial nerve VIII for hearing and any presence of vertigo (dizziness) or tinnitus (ringing in the ears) at baseline and periodically during therapy and report changes immediately to the prescriber. The estimated creatinine clearance provides information about the glomerular filtration rate and the kidney's ability to excrete the drug properly. The blood urea nitrogen (BUN) level reflects hydration. The client must be hydrated before beginning therapy and during to help prevent nephrotoxicity. The nurse would provide adequate hydration of 2 to 3 L with noncaffeinated fluids to help flush out the drug's metabolites to prevent nephrotoxicity.

A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer? Diphenoxylate (Lomotil) Psyllium (Metamucil) Oral rehydration solutions Octreotide (Sandostatin)

Oral rehydration solutions In treating children under the age of 5 years, the parents should be instructed on the administration of oral rehydration solutions. Diphenoxylate is contraindicated in children younger than 2 years. Octreotide and psyllium are not the drugs of choice for this child.

A nurse should recognize which situations necessitate the need for an opioid antagonist. Which situations necessitate the need for an opioid antagonist? (Select all that apply.) Postoperative acute respiratory depression Reversal of opioid induced hypotension Suspected acute benzodiazepine overdosage Suspected acute opioid overdosage Reversal of phenytoin toxicity

Postoperative acute respiratory depression Reversal of opioid induced hypotension Suspected acute opioid overdosage Explanation: Opioid antagonists are used for the treatment of the following: postoperative acute respiratory depression, reversal of opioid adverse effects (hypotension, bradycardia, etc.), and suspected acute opioid overdosage.

A client is receiving acetaminophen for fever. The client also has inflammation in the knees and elbows with pain. Why will acetaminophen assist in reducing fever but not in decreasing the inflammatory process? Prostaglandins decrease the gastric acid secretion. Acetaminophen has an antiplatelet effect to decrease edema. Prostaglandin inhibition is limited to the central nervous system. Acetaminophen inhibits cyclooxygenase (COX-1 and COX-2) only.

Prostaglandin inhibition is limited to the central nervous system. Explanation: The action of acetaminophen on prostaglandin inhibition is limited to the central nervous system. Aspirin and other nonselective NSAIDs inhibit COX-1 and COX-2. Acetaminophen does not produce an antiplatelet effect. Prostaglandins do not affect gastric secretions.

The nurse should know that lactulose achieves a therapeutic effect by which means? Relaxing the muscle tone of the ileocecal valve and anal sphincter Decreasing the viscosity of intestinal contents in the duodenum Pulling water into the intestinal lumen by osmotic pressure Irritating the intestinal mucous membrane

Pulling water into the intestinal lumen by osmotic pressure Explanation: Lactulose is a disaccharide that is not absorbed from the GI tract. It exerts laxative effects by pulling water into the intestinal lumen. It does not change muscle tone, change the viscosity of bowel contents, or irritate the intestinal epithelium.

A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit? Maintain the head of the client's bed at ≥ 45°. Put side rails up and place bed in low position. Encourage fluid intake. Create a restful, dark, quiet environment.

Put side rails up and place bed in low position. Explanation: Older clients are more susceptible to the central nervous system effects of narcotics; it is important to ensure their safety by using side rails and placing the bed in the low position in case the client tries to get up unaided. Postoperative clients are allowed nothing by mouth until bowel function returns so an oral medication or encouraging fluids would not be appropriate. This client will require careful observation for respiratory depression, so a dark room would be unsafe. There is no need to keep the head of the client's bed raised.

The nurse is giving instructions to a client who will be having a colonoscopy in the morning. The client will be taking polyethylene glycol-electrolyte solution for bowel cleaning. What information will help increase the palatability of this medication? Add ice cubes to each glass of liquid. Allow the liquid to warm up before drinking it. Refrigerate the solution until it is cold. Warm the liquid in the microwave for 25 seconds before using it.

Refrigerate the solution until it is cold. Explanation: The client should refrigerate the solution to increase the palatability and also to ensure its potency.

A client has been prescribed a fentanyl patch for chronic pain. What client teaching should the nurse provide to the client and family upon discharge? Apply it for breakthrough pain. Apply it to the chest only. Remove the patch every 3 days. Remove it daily and clean skin.

Remove the patch every 3 days. Explanation: A fentanyl patch has a slow onset of action, but duration lasts about 72 hours making a new application necessary every 3 days. The patch can and should be applied to other areas of the skin, not solely on the chest with skin cleaning done prior to each new application. Fentanyl is not effective for breakthrough pain.

The client has been taking acetaminophen daily for two years. The health care provider has now prescribed ketoprofen in addition to the acetaminophen. The nurse plans to educate the client on NSAIDs and acetaminophen and that their interaction can cause what condition? Immunologic disorders Renal impairment Hematologic disorders Respiratory impairment

Renal impairment Explanation: When the client has experienced long-term acetaminophen use and NSAIDs are added, the client is at increased risk of renal impairment. There is no additional risk to the respiratory, hematologic, or immune system.

A client is treated for HIV with NNRTIs. The client develops tuberculosis, and the health care provider includes rifampin in the treatment regimen. Why would this be cause for concern? Rifampin causes exacerbation of HIV infections. Rifampin increases adverse side effects of anti-HIV drugs. Rifampin causes critical anemias in clients with HIV. Rifampin decreases blood levels of anti-HIV drugs.

Rifampin decreases blood levels of anti-HIV drugs. Explanation: A major difficulty with treatment of TB in clients with HIV infection is that rifampin interacts with many PIs and NNRTIs. If the drugs are given concurrently, rifampin decreases blood levels and therapeutic effects of the anti-HIV drugs.

Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis? Select all that apply: Methylcellulose (Citrucel) Sennosides (Senokot) Glycerin (Fleet Babylax) Bisacodyl (Dulcolax) Lactulose (Chronulac)

Sennosides (Senokot) Bisacodyl (Dulcolax) Explanation: Irritant or stimulant laxative, like sennosides (Senokot) and bisacodyl (Dulcolax), produce their laxative effect by direct action on the intestine to increase peristalsis.

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Fasting blood sugar and 2-hour postprandial blood sugar Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels Red blood count, white blood count, and differential Serum alanine transaminase, aspartate transaminase, and bilirubin

Serum alanine transaminase, aspartate transaminase, and bilirubin Explanation: The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity.

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action? Anti-inflammatory effects allowing absorption of fluids Decreases GI secretions Antimicrobial effects Slows peristalsis by acting on the smooth muscles of the intestine

Slows peristalsis by acting on the smooth muscles of the intestine Explanation: Diphenoxylate with atropine is chemically related to opioid drugs; therefore, they decrease intestinal peristalsis, which often is increased when the client has diarrhea.

The nurse is reviewing the discharge instructions with the client going home on an opioid analgesic for pain management. What would the nurse include in the instructions? Select all that apply. Rise slowly from a sitting or lying position. Take a laxative/stool softener. Keep the room well lit during the day. Limit fluid intake. Keep a record of bowel movements.

Take a laxative/stool softener. Keep the room well lit during the day. Rise slowly from a sitting or lying position. Keep a record of bowel movements. Explanation: Constipation is an issue in clients receiving opioid analgesics, therefore taking a laxative/stool softener may be necessary, as well as increasing fluid intake and keeping a record of bowel movements. A drop in blood pressure (orthostatic hypotension) would require care in rising from a sitting or lying position. Miosis (pinpoint pupils) decreases the ability to see in dim light.

A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply. Avoid excessive intake of citrus products or milk products. Continue therapy for at least 1 week. Dissolve the drug in 90 to 120 mL of water. Take the drug with food or milk to improve absorption. Notify the PHCP in case of fever, chills, or cough.

Take the drug with food or milk to improve absorption. Continue therapy for at least 1 week. Notify the PHCP in case of fever, chills, or cough. Explanation: The nurse should instruct the client to take the drug with food or milk to improve its absorption, to continue therapy for at least 1 week, and to notify the PHCP in case of fever, chills, or cough. The nurse should instruct the client receiving fosfomycin drug therapy to dissolve the drug in 90 to 120 mL of water. The nurse instructs the client undergoing methenamine drug therapy to avoid excessive intake of citrus products or milk products.

The nurse is providing education to a client who has been prescribed naltrexone. What effect should the nurse teach the client to expect if an opioid is taken? Visual hallucinations A sudden onset of nausea and vomiting The absence of usual physiological effects A decline in neurological function

The absence of usual physiological effects Explanation: Naltrexone is a pure opioid antagonist that blocks opioids from occupying receptor sites, thereby preventing their physiologic effects. It will not cause neurologic deficits, GI upset, or hallucinations.

A family member asks the nurse why a second dose of an opioid antagonist is needed. Which response by the nurse is correct? When a client is on multiple medications, more opioid antagonist is needed to be effective. The opioid medication that was given may last longer than the opioid antagonist medication. The opioid antagonist is not a very high dose, so more than one dose is needed to have an effect. Depending on the client's metabolism, multiple doses may be required to have an effect.

The opioid medication that was given may last longer than the opioid antagonist medication Explanation: The duration of an opioid medication may exceed the length of action of an opioid antagonist, thus requiring multiple doses to have a therapeutic effect. The other answers are incorrect because they are not true statements.

The parent of a toddler asks about giving an over-the-counter (OTC) cough and cold product containing pseudoephedrine to the child. What information regarding safety and efficacy should the nurse offer? Risk can be minimized by using age-specific preparations of cough and cold remedies. Media reports about the risks of cough and cold medications in children have greatly exaggerated the risks. Cough and cold remedies are generally safe and effective for children over the age of 2. There are concerns among health professionals about how safe and effective these medications are.

There are concerns among health professionals about how safe and effective these medications are. Explanation: Research seems to suggest that pseudoephedrine appears to be effective in children older than 4 years of age, but the drug's effectiveness in younger children is inconclusive. The U.S. Food and Drug Administration (FDA) does not recommend OTC use of the drug in this age group due to the risk of serious and life-threatening adverse effects, including seizures, decreased level of consciousness, tachycardia, and death. The low doses found in children's preparations may be insufficient to produce therapeutic effects. In addition, the risk of adverse effects and overdosing, particularly with liquid preparation, pose significant threats to safety. Extended-release tablets should not be administered to children younger than 12 years of age, and children should not be given drugs that are packaged for adults.

Clients diagnosed with chronic pain should be given what information regarding opioids' effectiveness? They should be given IM as the preferred route of administration. They should be given on a regular schedule, around the clock. They should be given topically only as a last resort. They should be given as soon as the client feels uncomfortable.

They should be given on a regular schedule, around the clock. Explanation: When opioids are required by clients with chronic pain, the main consideration is client comfort, not preventing drug addiction. Effective treatment requires that pain be relieved and prevented from recurring; titration of opioid dosage is usually the best approach. Analgesics should be given on a regular schedule, around the clock. Oral, rectal, and transdermal routes of administration are generally preferred over injections.

When teaching a client about the action of an opioid antagonist, what should the nurse include in the education? A medication called an opioid antagonist is given to enhance the effect of the opioid. This medication competes with the opioid pain medication, binding to the cell receptors instead. An opioid antagonist acts on the central nervous system to elevate the level of consciousness. An antagonist increases the rate of respirations to counter the effects of the opioid medication.

This medication competes with the opioid pain medication, binding to the cell receptors instead. Explanation: This medication competes with the opioid pain medication by binding to the cell receptors where the opioid would attach. One of the options describes the effect of an adjuvant medication, not an antagonist. The other answers are incorrect because what is listed is not the action of an opioid antagonist.

A client is taking pseudoephedrine to reduce nasal congestion. The nurse should caution the client against use of this decongestant if the client is currently taking what other type of drug? Thyroid preparations Anti-infective agents Proton pump inhibitors (PPIs) Anti-inflammatory agents

Thyroid preparations Explanation: Thyroid preparations should be prescribed cautiously to clients being concurrently prescribed nasal decongestants. Thyroid preparations have the tendency to increase the intended effects of decongestants. PPIs, anti-infectives, and anti-inflammatories do not have this synergistic effect.

Which of the following can occur if the nurse administers naloxone (Narcan) as a rapid IV bolus? Select all that apply: Intense pain Withdrawal Hypotension Vomiting Respiratory depression

Withdrawal Intense pain Vomiting Explanation: Withdrawal, return of intense pain, and vomiting may occur if the nurse administers naloxone (Narcan) as a rapid IV bolus.

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine a stimulant, a decongestant, and an antitussive. an analgesic, an antitussive, and an antiviral. a decongestant, an analgesic, and an antihistamine. an antihistamine, a stimulant, and a decongestant.

a decongestant, an analgesic, and an antihistamine. Explanation: Many over-the-counter cold remedies are combination products that include an antihistamine, a nasal decongestant, and an analgesic. Some may also include an antitussive or an expectorant.

A postsurgical client has been prescribed morphine to address the pain that is anticipated over the next 24 to 48 hours. What is the most effective strategy to manage a client's postsurgical pain for the initial 24 to 48 hours? -administering the maximum safe dose of morphine for 12 to 24 hours and then transitioning to nonsteroidal anti-inflammatory drugs (NSAIDs) -administering morphine on a scheduled basis and supplementing it with additional morphine when the pain worsens -encouraging the client to endure the pain as much as possible before administering morphine -administering morphine every 4 hours, with gradually decreasing doses over the next several days

administering morphine on a scheduled basis and supplementing it with additional morphine when the pain worsens Explanation: In general, morphine should be given continuously or on a regular schedule of intermittent doses, with supplemental or bolus doses when needed for breakthrough pain. None of the other options provide accurate information about the management of postsurgical pain. Reference:

The nurse is providing client teaching about a prescribed opioid analgesic. When monitoring the client for potential adverse effects, what assessment should the nurse prioritize? visual acuity heart rhythm coordination blood pressure

blood pressure Explanation: Orthostatic hypotension is commonly seen in association with some narcotics. For most clients, changes in blood pressure are most likely than arrhythmias, ataxia and changes is vision.

What drugs are examples of second-line opioid agonists/antagonists prescribed for the treatment of moderate-to-severe pain? Select all that apply. nalbuphine naltrexone pentazocine butorphanol methadone

butorphanol nalbuphine pentazocine Explanation: Pentazocine, butorphanol, and nalbuphine are used for moderate-to-severe pain. Methadone is used for severe pain and in the detoxification and maintenance treatment of opiate addicts. Naltrexone is an opioid antagonist prescribed to reverse opioid-induced respiratory depression.

When assessing a client who is to receive celecoxib, a history of which disease process or condition would be most important to assess?

cardiac disease Explanation: Celecoxib is associated with an increased risk of serious cardiovascular thrombosis, myocardial infarction, and stroke, all of which can be fatal. Hence, the nurse should check for history of cardiac diseases in a client being prescribed celecoxib. Use of celecoxib does not increase any risk in clients with a history of peptic ulcer, diabetes, or respiratory disorders.

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system? gastrointestinal renal cardiovascular neurological

cardiovascular Explanation: Because pseudoephedrine is a stimulant, cardiac symptoms are a notable adverse effect, especially in the acute stage of the overdose. All the other systems should be monitored, but the cardiac-related adverse reactions have priority.

Repeated lab work shows positive cultures for a client prescribed drug therapy for tuberculosis (TB) over 4 weeks ago. What are the likely reasons for this failure to achieve treatment goals? Select all that apply. client has been nonadherent with medication therapy prescribed intermittent medication administration a delay in the initial diagnosis of the client administration of defective medication infecting strain of TB is drug resistant

client has been nonadherent with medication therapy a delay in the initial diagnosis of the client infecting strain of TB is drug resistant Explanation: The emergence of drug-resistant TB organisms has long been attributed mainly to poor client adherence to prescribed anti-TB drug therapy—that is, when previously infected clients do not take the drugs and doses prescribed for the length of time prescribed. However, drug-resistant strains can spread from one person to another, and there is increasing evidence that many drug-resistant infections are new infections, especially in people whose immune system is suppressed. Factors contributing to the development of drug-resistant disease include delayed diagnosis and delayed determination of drug susceptibility (which can take several weeks). Adequate drug therapy of clients with active disease usually produces improvement within 2 to 3 weeks. Intermittent administration is not recommended for multidrug-resistant tuberculosis (MDR-TB). Defective medication should not be a factor unless indicated by the Food and Drug Administration in a bulletin.

A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply. reserving at least 8 hours nightly to assure adequate sleep consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day introducing organic foods into the daily diet

consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day Explanation: Nonpharmacologic measures for preventing constipation include increased fiber intake, exercise, and adequate fluids. Organic foods do not have any particular benefit in the prevention of constipation. Adequate sleep has multiple benefits, but reduced constipation is not among these.

A health care provider orders diphenoxylate to treat a client who has severe hepatorenal disease. The nurse calls the provider to question this order because it may precipitate: hypercalcemia. hyperkalemia. hyperglycemia. hepatic coma.

hepatic coma. Explanation: Diphenoxylate should be used with extreme caution in clients with severe hepatorenal disease because hepatic coma may be precipitated.

A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure? (Select all that apply.) inadequate initial drug treatment noncompliance with the therapeutic regimen type of facility where the client resides lack of vegetables in person's diet lack of access to vitamins

inadequate initial drug treatment noncompliance with the therapeutic regimen Explanation: At times, treatment fails because of inadequate initial drug treatment or noncompliance with the therapeutic regimen. Retreatment usually includes the use of four or more antitubercular drugs.

How do opioid analgesics relieve moderate-to-severe pain? preventing the opioid from binding with a receptor site inhibiting the transmission of pain signals from peripheral tissues to the brain inhibiting the transmission of pain signals from the hypothalamus to the spinal cord increasing the production of endorphins in the brain

inhibiting the transmission of pain signals from peripheral tissues to the brain Explanation: Opioids relieve pain by binding to opioid receptors in the brain, spinal cord, and peripheral tissues. Opioids inhibit the transmission of pain signals from peripheral tissues to the brain, reducing the perception of pain sensation in the brain, producing sedation, and decreasing the emotional upsets often associated with pain. They do not inhibit signals from the hypothalamus. Nor do they increase endorphin production.

Which medication is prescribed parenterally for severe pain? acetaminophen naproxen acetylsalicylic acid ketorolac

ketorolac Explanation: Acetylsalicylic acid, other NSAIDs, and acetaminophen are effective in treating mild to moderate pain associated with conditions such as headache, minor trauma, minor surgery, and other acute and chronic conditions. Ketorolac is used for moderate or severe pain, and although it can be given orally, its unique characteristic is that it can be given by injection. Parenteral ketorolac reportedly compares with morphine and other opioids in analgesic effectiveness.

A 2-year-old child from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the family's arrival in the United States 3 weeks ago. History reveals nothing remarkable, but the mother comments on her child's love of (and continual consumption of) ice cream, something not available in their native country. This history supports what possible cause of the child's diarrhea? irritable bowel syndrome inflammatory bowel disorder lactase deficiency Clostridium difficile

lactase deficiency Explanation: Deficiency of lactase, which breaks down lactose to simple sugars (i.e., glucose and galactose) that can be absorbed by the gastrointestinal (GI) mucosa, inhibits digestion of milk and milk products. Lactase deficiency commonly occurs among people of African and Asian descent.

Acetaminophen overdose has the potential to cause fatal: lung damage. liver damage. pancreas damage. kidney damage.

liver damage. Explanation: Potentially fatal hepatotoxicity is the main concern with acetaminophen overdose. It is most likely to occur with doses or 20 g or more.

A 23-year-old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. During the assessment, she informs the nurse that she has been experiencing these symptoms for the last three months on a weekly basis. These symptoms are those of: migraine headache. fever. headache. inflammation.

migraine headache. Explanation: The symptoms suggest that the client is suffering from migraine headaches, which are characterized by an "aura" experience. An aura is a group of neurologic symptoms that develop 10 to 30 minutes before the migraine headache occurs. These symptoms include temporary vision loss, wavy or zigzag lines, or flashing lights.

A client needing to evacuate the colon for endoscopy would likely be prescribed which medication? mineral oil psyllium polyethylene glycol electrolyte solution methylcellulose

polyethylene glycol electrolyte solution Explanation: A client needing to evacuate the colon for endoscopy would likely take polyethylene glycol electrolyte solution as it is a bowel evacuant. Methylcellulose and psyllium are bulk-forming laxatives and will not evacuate the bowel for endoscopy. Mineral oil is an emollient that lubricates the intestinal walls and softens the stool, thereby enhancing passage of fecal material.

A male client who has been on a drug regimen for tuberculosis (TB) for the last 2 months says he has lost his appetite and 10 pounds. What should the nurse suggest to the health care provider for this client to help in the area of nutrition? rifampin pyridium pyridoxine pyrazinamide

pyridoxine Explanation: Frequently the inclusion of pyridoxine (Vitamin B6) is recommended for clients with TB to promote nutrition and prevent neuropathy. Rifampin and pyrazinamide are antitubercular drugs; pyridium is a drug used as a urinary tract analgesic.

An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction? Select all that apply. psyllium enema surgery magnesium citrate rectal suppository

rectal suppository enema Explanation: In adults, a rectal suppository or an enema is preferred for a fecal impaction. Oral laxatives such as magnesium citrate and psyllium are contraindicated but may be given after the rectal mass is removed. Surgery is not indicated at this time.

A nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved? lungs stomach peripheral nerves liver

stomach Explanation: The most common adverse reactions caused by the NSAIDs involve the GI tract, including the stomach, leading to GI bleed and/or possible ulceration. The lungs are not specifically affected by NSAIDs; however, pain associated with respiratory insults such as pneumonia can be relieved. Peripheral nerve pain can also be treated with NSAIDs. There is no injury noted to the liver while taking NSAIDs.

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to: stop taking the medication and come to the clinic as ordered by the health care provider. continue taking the drug because the sensations will resolve with time. lie down after each dose. decrease the dosage by one half.

stop taking the medication and come to the clinic as ordered by the health care provider. Explanation: Cardiovascular adverse effects such as palpitations, tachycardia, hypertension, and arrhythmias are possible with the administration of pseudoephedrine (Sudafed). If the client reports palpitations and tachycardia, the nurse should instruct him to stop the medication and come in to see his provider. This drug produces sympathomimetic effects and could aggravate any existing cardiovascular issues. The nurse would not instruct the client to change the dosage of any drug, and having the client lie down after each dose will not limit or alleviate sympathomimetic effects of the drug. Continuation of the drug would worsen the adverse effects and could cause serious complications.

While caring for a client who is prescribed an opioid antagonist for treatment of respiratory depression caused by opioid therapy, the nurse would assess the client for which adverse reaction? Select all that apply. tachycardia tremors nausea

tachycardia tremors nausea Explanation: The nurse should monitor for tachycardia, tremors, and nausea in the client because these are the adverse reactions associated with the use of opioid antagonists. The other adverse reactions include sweating, vomiting, and increased blood pressure. The nurse need not monitor for fever or diarrhea because these are not adverse reactions caused by opioid antagonists.

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that: crushing the tablet increases the drug's efficacy. there is risk of an extremely high dose available all at once if the tablet is crushed. crushing the tablet is a safe option. the tablet would have no effect if crushed and ingested.

there is risk of an extremely high dose available all at once if the tablet is crushed. Explanation: The nurse should caution the client against crushing the tablet before ingesting it. Crushing allows an extremely high dose of the drug to be available all at once, instead of being released slowly over time. Severe adverse effects are possible when it is used in this manner.

The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent doesn't know why the teeth are discolored and reports that the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask? "Have they ever received ampicillin?" "Have they ever received tetracycline?" "Have they ever received cephalexin?" "Have they ever received gentamicin?"

"Have they ever received tetracycline?" Explanation: The nurse would question whether the child was ever given tetracycline because this drug is commonly associated with discoloration of secondary teeth when it is administered to children who still have their primary teeth. Gentamicin, ampicillin, and cephalexin are not associated with discoloration of the teeth.

A client is concerned because his drug regimen for drug-resistant TB is different from that of his friends. Which explanation by the nurse is accurate? "Treatment is based on the amount of sputum production." "Treatment is based on drug susceptibility reports." "Treatment varies based on the length of time you are ill." "There is a standardized treatment regimen."

"Treatment is based on drug susceptibility reports." Explanation: In drug-resistant TB, there is no standardized treatment regimen; treatment must be individualized for each client according to drug susceptibility reports.

The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours? 2 to 3 L of clear liquids 3 to 4 L of clear liquids 0.5 to 1 L of clear liquids 1 to 2 L of clear liquids

2 to 3 L of clear liquids Explanation: In most cases of acute, nonspecific diarrhea in adults, fluid losses are not severe and clients need only simple replacement of fluids and electrolytes lost in the stool. Acceptable replacement fluids during the first 24 hours include 2 to 3 L of clear liquids (e.g., flat ginger ale, decaffeinated cola drinks or tea, broth, gelatin)

Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake? 2 to 3 days 1 week 3 to 4 days 1 to 2 days

2 to 3 days Explanation: After the colon empties with defecation, it takes 2 to 3 days with normal food intake for the fecal column to re-establish.

A patient is taking acetylsalicylic acid (aspirin) to prevent platelet aggregation. Which dose of aspirin will irreversibly acetylate circulating platelets within a few minutes, with effects lasting for the lifespan of the platelets? 650 mg 81 mg 325 mg 180 mg

325 mg Explanation: A small single dose (325 mg) irreversibly acetylates circulating platelets within a few minutes, and effects last for the lifespan of the platelets (7-10 days). Doses of 81, 180, or 650 mg are not recommended for irreversibly acetylating circulating platelets.

A woman who has given birth to a baby girl by cesarean delivery is experiencing abdominal pain. The client receive a bolus dose of morphine intravenously. The nurse would recommend that the mother refrain from breast-feeding the baby for how long? 1 to 2 hours 4 to 6 hours 2 to 4 hours 6 to 8 hours

4 to 6 hours Explanation: Many sources recommend waiting 4 to 6 hours to breast-feed a baby after receiving a narcotic.

Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose? 81-325 mg 600-650 mg 360-460 mg 180-240 mg

81-325 mg Explanation: The recommended daily dose for prophylaxis of MI, TIA, and CVA is 81-325 mg. The indication stems from aspirin's ability to decrease formation of blood clots.

The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine? An 8-year-old with a fractured femur A 78-year-old with osteoarthritis A 45-year-old, 1-day postoperative mastectomy A 17-year-old, 1-day postoperative appendectomy

A 78-year-old with osteoarthritis Explanation: Older clients are more likely to experience the adverse effects associated with these drugs, including central nervous system, gastrointestinal, and cardiovascular effects.

For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply. A client who has completed anthelmintic therapy A client who is recovering from a myocardial infarction A client with a partial small bowel obstruction A client being assessed for appendicitis A pregnant client who is in early labor

A client who is recovering from a myocardial infarction A client who has completed anthelmintic therapy Explanation: Laxative, or cathartic, drugs are indicated for the short-term relief of constipation; to prevent straining when it is clinically undesirable (such as after surgery, myocardial infarction, or obstetric delivery); to evacuate the bowel for diagnostic procedures; to remove ingested poisons from the lower gastrointestinal (GI) tract; and as an adjunct in anthelmintic therapy when it is desirable to flush helminths from the GI tract. They are not indicated when a client has appendicitis or a partial small bowel obstruction, because both conditions could be exacerbated by stimulating motility. Laxatives are often given postpartum, but intrapartum use would be contraindicated.

What home remedies are effective for mouth dryness and cough? (Select all that apply.) Swishing the mouth with astringent mouthwash. Sucking on hard candy or throat lozenges Administration of over-the-counter antihistamine Adequate fluid intake Humidification of the environment

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges Explanation: An adequate fluid intake, humidification of the environment, and sucking on hard candy or throat lozenges can help relieve mouth dryness and cough. The use of astringent mouthwash will only increase mouth dryness.

The nurse should question an order for bismuth salts for a client with what condition? Hypertension Rheumatoid arthritis Viral gastroenteritis Allergy to aspirin

Allergy to aspirin Explanation: Bismuth salts has aspirin in it and should not be given to a client with an allergy to aspirin. There is no contraindication for a client with rheumatoid arthritis, hypertension, or viral gastroenteritis.

What effects are exerted by aspirin? (Select all that apply.) Anti-inflammatory Antipyretic Analgesic Antiviral Anti-infective

Analgesic Antipyretic Anti-inflammatory Explanation: Aspirin is a salicylate. Salicylates are useful in pain management because of their analgesic, antipyretic, and anti-inflammatory effects.

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) Antibacterial Antipyretic Anti-inflammatory Analgesic Antipruritic

Anti-inflammatory Analgesic Antipyretic Explanation: Like the salicylates, the NSAIDS have anti-inflammatory, antipyretic, and analgesic effects.

To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.) Assist client with hall-walking activities. Assist client with rising from a lying position. Assist client from their bed to the toilet. Advise the client to stay in bed all night. Keep the lights in the client's room turned down.

Assist client from their bed to the toilet. Assist client with rising from a lying position. Assist client with hall-walking activities. Explanation: To decrease the risk of injury to a client taking an opioid, the nurse should assist the client with ambulatory activities and with rising from a sitting or lying position. The nurse should also keep the client's room well-lit during daytime hours, keep the client's room free of clutter, and advise the client to seek assistance when getting out of bed at night.

A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy? Better mobility Blood sugar Body temperature Respiratory rate

Better mobility Explanation: The nurse should report better mobility in the patient after NSAID drug therapy for arthritis. The patient's blood sugar, respiratory rate, and body temperature are not affected and, hence, are not evaluated by the nurse after treatment.

A nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if what occurs? Select all that apply: Diarrhea worsens Diarrhea is not relieved Blood is noted in the stool Constipation Client reports severe abdominal pain

Blood is noted in the stool Diarrhea worsens Client reports severe abdominal pain Diarrhea is not relieved Explanation: A nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if diarrhea is not relieved or becomes worse, if the client has severe abdominal pain, or if blood in the stool is noted.

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug? Paleness of the face Dizziness Polyuria Bradycardia

Dizziness Explanation: Adverse effect of diphenoxylate include tachycardia, urinary retention, flushing, headache, and dizziness as well as nausea and vomiting.

A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching? Add all of the medications to the mucilloid. Discontinue the mucilloid if no bowel movement occurs in 24 hours. Mix the medication with your food at your evening meal. Drink at least 8 ounces of fluid with the medication.

Drink at least 8 ounces of fluid with the medication. Explanation: Psyllium needs to be taken with at least 8 oz of water or other liquid. The nurse would not tell the patient to mix the medication with food, to add all medications to the psyllium, or to discontinue the drug.

The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? Semi-Fowler's Side-lying Supine High Fowler's

High Fowler's Explanation: Teach the patient to sit upright and press a finger over one nare to close it.

A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis? Increased risk of GI bleeding Increased risk of hearing impairment Increased risk of blindness Increased risk of CNS disorders

Increased risk of GI bleeding Explanation: The nurse should caution the older adult against the use of NSAIDs on a long-term basis because they increase the risk of GI bleeding. CNS disorders, hearing impairment, and blindness are not the effects of using NSAIDs on a long-term basis in older patients.

What nursing intervention would not be effective in assisting the client in stopping his or her migraine headache? Administering a nonsteroidal anti-inflammatory drug Keeping the room well lit Administering a triptan Having the client lie quietly

Keeping the room well lit Explanation: Clients should stay in a dark room when experiencing a migraine. The other interventions will help the client.

The nurse is caring for a client who has had impacted stools twice in the past month. What is the most appropriate laxative for this client? Psyllium Docusate Mineral oil Magnesium hydroxide

Mineral oil Explanation: Mineral oil is not absorbed and forms a slippery coat on the contents of the intestinal tract. When the intestinal bolus is coated with mineral oil, less water is drawn out of the bolus and the bolus is less likely to become hard or impacted. Other options shown do not have this same effect of reducing the risk of another impaction as well as helping to eliminate stool.

A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend: Docusate (Colace). Psyllium (Metamucil). milk of magnesia. mineral oil.

Psyllium (Metamucil). Explanation: Psyllium is a bulk-forming laxative. Docusate is a stool softener. Mineral oil is a lubricant. Both are laxatives, having milder action than cathartics, which include the stimulant milk of magnesia.

A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? The fluoroquinolone has a nearly immediate peak. The fluoroquinolone has a broader spectrum. The fluoroquinolone does not have adverse effects. The fluoroquinolone can be given orally.

The fluoroquinolone can be given orally. Explanation: Newer fluoroquinolones have been developed with a broader spectrum of activity that provides improved coverage of gram-positive organisms and, in one case, anaerobes. Fluoroquinolones are often given orally. Like all drugs, they have adverse effects. Peak levels are not immediately achieved, and they do not have a broader spectrum than an aminoglycoside.

The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following? To inhibit platelet aggregation To decrease pain To decrease temperature To treat osteoarthritis

To inhibit platelet aggregation Explanation: Daily low-dose aspirin is prescribed to inhibit platelet aggregation within the heart and brain. Aspirin for osteoarthritis and pain is usually prescribed at a higher dosage. If the client is having elevated temperatures daily, the cause would need to be investigated.

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins: are derived from penicillin. can cause kidney damage in clients who are allergic to penicillins. are ineffective in clients who are allergic to penicillins. can cause allergic reactions in clients who are allergic to penicillins.

can cause allergic reactions in clients who are allergic to penicillins. Explanation: Clients who are allergic to penicillins may also be allergic to cephalosporins. Although this cross-allergenicity (allergy to a drug of another class with similar chemical structure) is rare, cephalosporins are not typically administered to clients who have had life-threatening allergic reactions to a penicillin.

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client: to continue rifampin therapy at least for a year. he should wear glasses during the therapy. that the therapy can cause decreased sexual urge or libido. that there may be an elevation in his blood pressure.

he should wear glasses during the therapy. People going through rifampin therapy are prone to skin discoloration and discoloration of contact lenses. This is because rifampin can discolor bodily fluids, such as urine, saliva, tears, and sputum. People taking rifampin are not known to have decreased sexual urge or have blood pressure elevation. The client should continue the rifampin therapy for the period suggested by the health care provider, which may or may not be a year.

A nurse is preparing a community teaching program about tuberculosis. When describing the individuals who are susceptible, who would the nurse include? Select all that apply. individuals living in crowded conditions individuals less than 6 years of age individuals with human immunodeficiency virus (HIV) individuals more than 30 years of age individuals with asthma

individuals living in crowded conditions individuals with human immunodeficiency virus (HIV) Explanation: Individuals living in crowded conditions, those with compromised immune systems (like those with HIV), and those with debilitative conditions are especially susceptible to tuberculosis. Healthy individuals are not susceptible. Clients with chronic respiratory conditions such as asthma are not usually considered debilitated.

A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed? loperamide omeprazole diphenoxylate sodium bicarbonate

loperamide Explanation: Loperamide is not chemically related to opioid drugs and treats diarrhea by acting directly on the muscle wall of the bowel to slow motility. Diphenoxylate is chemically related to opioid drugs and treats diarrhea by decreasing intestinal peristalsis. Sodium bicarbonate is used to reduce stomach acid levels and should be used only temporarily. Omeprazole is a proton pump inhibitor that relives symptoms of GERD and other stomach conditions.

A 75-year-old client is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the client is being treated for rheumatoid arthritis and hypertension. The client is in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the client's: home environment. activity level. diet. medication history.

medication history. Explanation: Magnesium hydroxide interacts with many drugs, increasing the effects of some and decreasing the effects of others. Therefore, the nurse should check for drug interactions to avoid adverse effects. Factors such as the client's home environment, diet, and activity level should be assessed and could contribute to the client's constipation. However, it would be most important to assess the medications that could be affected by the administration of magnesium hydroxide.

A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what? tachypnea. diarrhea. hypertension. pupil constriction.

pupil constriction. Explanation: Narcotics are associated with pupil constriction, constipation, orthostatic hypotension, and respiratory depression with apnea.

The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply. tachycardia bradypnea vomiting hypertension sedation

tachycardia hypertension vomiting Explanation: The most common adverse effect is an acute narcotic abstinence syndrome that is characterized by nausea, vomiting, sweating, tachycardia, hypertension, tremulousness, and feelings of anxiety. Bradypnea and sedation are not associated with acute narcotic abstinence syndrome.