Pharm II Final Review

Which patient assessment finding contraindicates the use of Bethanechol? Use of an antihypertensive drug History of Asthma Blood pressure 140/83 mmHg Tachycardia

History of Asthma

Which parameter will the nurse assess in a patient who is prescribed metformin for type 2 diabetes mellitus? Headache Cholesterol level Renal Function Weight gain

Renal Function

A nurse is teaching parents how to use an EpiPen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching? "The teacher should call us when symptoms start so that we can bring the EpiPen to school." "The EpiPen should be stored in the refrigerator, because epinephrine is sensitive to heat." "We should jab the device into the thigh until it is empty of solution." "After using the EpiPen, we must go to the emergency department."

"After using the EpiPen, we must go to the emergency department."

Which statement by the nurse indicates an understanding as to why atropine is given in the preoperative environment? "Atropine works as a pain reliever" "Atropine impairs memory" "Atropine decreases secretions" "Atropine induces sleep"

"Atropine decreases secretions"

Which statements should the nurse include in the teaching for a client prescribed warfarin (Coumadin) therapy? "Report to the lab for testing of activated partial thromboplastin time (aPTT)." "Take nonsteroidal anti-inflammatories (NSAIDs) for minor pain relief." "Place ice at the injection site if stinging or burning occurs." "Avoid using a hard toothbrush when brushing your teeth."

"Avoid using a hard toothbrush when brushing your teeth."

Which question should the nurse ask the client that is requesting a refill of prescribed tadalafil (Cialis)? "Do you take blood pressure medication?" "Do you have diabetes mellitus?" "Do you use nitroglycerine?" "Do you have any sexually transmitted diseases?"

"Do you use nitroglycerine?"

A client receiving insulin tells the nurse their blood glucose has been low the last few mornings. Which additional statement made by the client may be a contributing factor to the decrease in the blood glucose? "I have been taking a garlic supplement to prevent colds." "I have been taking vitamin D to help build up my bones." "I have been taking extra vitamin C because so many people have colds." "I have been taking St. John's wort to help with my memory."

"I have been taking a garlic supplement to prevent colds."

How would a nurse respond to the spouse of a client with an intracranial hemorrhage who asks the nurse, "Why aren't they administering an anticoagulant?"? "If necessary, it will be started to prevent pulmonary thrombosis." "If necessary, it will be started to enhance circulation." "It is not advisable because it masks the effects of the hemorrhage." "It is not advisable because bleeding will increase."

"It is not advisable because bleeding will increase."

Which information should the nurse include in the education for a client prescribed finasteride (Proscar)? "Use a condom during intercourse." "Reduce your sodium intake while taking this drug." "Take the medication on an empty stomach." "Do not do heavy exercise while taking this medication."

"Use a condom during intercourse."

A patient prescribed phenytoin reports using over-the-counter medications to treat acid reflux. Which response by the nurse is correct? "You should take a lower dose of phenytoin while using antacids." "Use an antacid that does not contain calcium." "Stop taking the phenytoin immediately if increased acid reflux occurs." "This combination may lead to increased central nervous system depression."

"Use an antacid that does not contain calcium." Calcium binds with phenytoin to decrease absorption and will alter the therapeutic effects. Patients should be instructed to use antacids that do not contain calcium.

Directions: Calculate the dose, use label provided. Round answer to the nearest hundredth. Do not include units. Order: Heparin 4,400 units subcut daily Available: 10,000units/ml How many milliliters will you administer? _____mL

0.44 ml

Levothyroxine 25 mcg daily is prescribed for a client with hypothyroidism. The pharmacy dispensed levothyroxine 12.5 mcg per tablet. How many tablets will the nurse instruct the client to take daily? Record your answer using a whole number. __ tablets

2 tablets

A child weighs 10 kg and is to receive 0.5 g of Nafcillin in 100 mL D5W q6h. The safe dosage range is 100 to 200 mg/kg/day. Is this order safe? Yes(True)/ No (False) Do not forget to show your calculations on the calculations sheet.

true

Order: Heparin 25,000 units in 500 mL D5W to infuse at 15 mL/hr.Calculate the hourly heparin dosage in units/hr. Round your answer to the nearest whole number and include units.

750 units/hr

Directions: Round dosage and weight to the nearest tenth as indicated. Use labels where provided.Order: Albuterol 1.2 mg p.o. t.i.d. is ordered for a child weighing 27 lb. The recommended dosage is 0.3 mg/kg/24 hr divided q8h. Available: 2mg/5ml a. What is the safe 24-hr dosage for this child? Enter the numeric portion only, no units, rounded to the nearest tenth.

3.7

Directions: Determine the following in drops per minute using the drop factor provided.2,500 mL RL in 12 hr Drop factor 10 gtt/mL will have ______ gtt/min. Enter the numeric portion only, no units. Enter the whole number only, no decimals.

35gtt/hr

Directions: Calculate the following children's dose. Order: Amoxil 75 mg p.o. q8h Available: 125mg/5ml How many milliliters will you administer? _____ mL. Round your answer to the nearest tenth. Do not include units in your answer.

3ml

Which lab result is a priority for the nurse to assess for a client who is prescribed dantrolene (Dantrium)? Hemoglobin and hematocrit. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) BUN and creatinine, Serum amylase and lipase.

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

8. The nurse knows that intranasal corticosteroids are used to treat seasonal allergies and explains to the patient that which of the following needs to be done before application? Rinse mouth before application Blow nose before application Suck on hard candy or ice chips before application Drink 8 ounces of water before application

Blow nose before application

Directions: Determine the flow rate for the following IV being administered by infusion pump. Round your answer to the nearest tenth and include units.500 mL of Intralipid in 6 hr: _____

83.3 ml/hr

Directions: Use the label to answer the question. Order: Zithromax 250 mg p.o. daily Available: 200mg/5ml How many milliliters of diluent must be added to the bottle? Do not include units.

9 ml

The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient? Obtain blood glucose Assess the heart rate Apply a pulse oximeter Observe for lower leg edema

Assess the heart rate

Which condition in a postoperative patient is treated with bethanechol? Atonic bladder Post operative ischemic colitis Respiratory atelectasis Post operative hypotension

Atonic bladder

Which ophthalmic solution is contraindicated for clients with glaucoma? Atropine Pilocarpine Timolol Epinephrine

Atropine

Through which action does phenytoin exert its effects? - By eliminating the underlying causes of seizure disorders - By increasing the action of gamma-aminobutyric acid (GABA), which inhibits neurotransmitters throughout the brain - By suppressing sodium influx and prolonging the channel inactivation to prevent neuron firing - By suppressing the calcium influx to prevent the electric current generated by the calcium ions to the T-type calcium channel

By suppressing sodium influx and prolonging the channel inactivation to prevent neuron firing

Which medication would be used to treat hypertension and diabetic nephropathy? Peridopril Trandolapril Captoril Quinapril

Captoril

Which describes the primary goal of pharmacotherapy for the treatment of hyperthyroidism (Graves' disease)? Suppress TSH. Increase synthesis of thyroid hormones. Decreasing the production of thyroid hormones Decrease the metabolic processes

Decreasing the production of thyroid hormones

From a pharmacology standpoint, which statement best explains why levodopa is superior to dopamine? Dopamine is a controlled substance, so it is more difficult to prescribe it. Dopamine does not cross blood brain barrier, where as Levodopa does Dopamine is an animal based product. Dopamine can cause neurogenic shock.

Dopamine does not cross blood brain barrier, where as Levodopa does

Which is progestin primarily prescribed to treat? Dysfunctional uterine bleeding. Breast cancer Amenorrhea Menopause

Dysfunctional uterine bleeding.

A middle-aged woman was just diagnosed with hypothyroidism due to Hashimoto's thyroiditis. What findings a nurse expects to see in her chart? Elevated TSH and decreased free T4. Decreased TSH and elevated ACTH . Decreased TSH and decreased TRH. Elevated TSH and elevated total T3.

Elevated TSH and decreased free T4

Which adverse effect would a nurse monitor for in a client taking clopidogrel? Chest pain Epistaxis Nausea Elevated temperature

Epistaxis (nose bleed)

Which symptom is common for a client with untreated type 1 diabetes mellitus? Increased energy. Fatigue. Weight gain. Decreased hunger.

Fatigue.

A nurse would instruct patients taking phenytoin to report which side effects? Fever Gastrointestinal (GI) upset Dizziness Bleeding gums Reddish-brown urine

Fever Dizziness Bleeding gums

Which insulin selection indicates patient understanding of teachings received from the nurse about the use of basal insulin for glucose stabilization? Aspart Lispro Glargine Glulisine

Glargine

The nurse is preparing to administer a dose of intravenous phenytoin to a patient and notes that the patient's serum phenytoin level is 25 mcg/mL. Which action would the nurse take? Request a prescription for oral phenytoin. Hold the dose and notify the health care provider. Give the dose and observe closely for central nervous system (CNS) side effects. Notify the health care provider to discuss increasing the phenytoin dose.

Hold the dose and notify the health care provider.The therapeutic serum level of phenytoin is 10 to 20 mcg/mL. The nurse would hold the dose and notify the health care provider that the patient has a toxic drug level.

The nurse is caring for a patient who sustained a myocardial infarction and is prescribed metoprolol before discharge. Which information would the nurse provide? Monitor for decreased urination Notify the health care provider of bruising Hold the medication if the pulse is less than 55 beats/min Report continued dry coughing

Hold the medication if the pulse is less than 55 beats/min

Which effect would a nurse anticipate might occur in a patient receiving inhaled fluticasone who is also prescribed hydrochlorothiazide for hypertension? Increased risk for hypokalemia Increased risk for immunosuppression Increased clearance of fluticasone, decreasing risk for side effects Reduced clearance of fluticasone, increasing risk for side effects

Increased risk for hypokalemia

Which statement is correct regarding the effect of Atropine on the heart? Increases heart rate Decreases heart rate Causes heart block Induces cardiac arrest

Increases heart rate

The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education on the safety of this drug? Potassium function needs to be monitored when a patient is taking Metformin. Kidney function needs to be monitored when a patient is taking Metformin. Calcium needs to be monitored when a patient is taking Metformin. Liver function needs to be monitored when a patient is taking Metformin.

Kidney function needs to be monitored when a patient is taking Metformin.

What is a rare but potentially fatal complication of metformin use in the management of type 2 diabetes? Renal Failure Lactic acidosis Hypoglycemia Liver disease

Lactic acidosis

Which of the following diabetic medications does not put a patient at risk for hypoglycemia? Insulin regular (Humulin R). Metformin (Glucophage). Glipizide (Glucotrol). Repaglinide (Prandin).

Metformin (Glucophage).

Which drug does the nurse anticipate will be prescribed to a pregnant patient who developed hypertension at 28 weeks' gestational age? Valsartan Propranolol Methyldopa Captopril

Methyldopa

The nurse would suspect that a female patient is experiencing phenytoin toxicity if which manifestation is noted? Select all that apply. One, some, or all responses may be correct. Nystagmus Staggering gait Excessive facial hair growth Swollen, tender gums that bleed easily Double vision

Nystagmus Staggering gait Double vision

Which is responsible for the secretion of estrogen? Ovarian follicles. Anterior pituitary. Endometrium. Corpus luteum.

Ovarian follicles.

Which rationale differentiates type 1 diabetes from type 2 diabetes? Most people with type 1 diabetes are born with it. People with type 2 diabetes make insulin, but in inadequate amounts. People with typee 2 diabetes do not develop typical diabetic complications. People with type 1 diabetes are often obese.

People with type 2 diabetes make insulin, but in inadequate amounts.

The nurse notices significant edema surrounding and proximal to the peripheral intravenous (IV) site where epinephrine is being infused. Which action would the nurse anticipate first? Ensure that naloxone [Narcan] is available. Prepare to administer phentolamine [Regitine]. Institute the protocol for congestive heart failure (CHF). Monitor the blood urea nitrogen (BUN), creatinine, and potassium levels.

Prepare to administer phentolamine [Regitine].

Which laboratory test should the nurse monitor the client for who is receiving insulin? Serum Calcium. Serum Potassium. Platelets. AST.

Serum Potassium.

A patient who has a seizure disorder has begun taking phenytoin. To ensure effectiveness of the drug, which laboratory value will the nurse monitor? Correct Serum drug levels Liver function tests Renal function tests Complete blood count (CBC)

Serum drug levels Serum drug levels are necessary to ensure that therapeutic drug levels are maintained. The normal range of phenytoin is 10 to 20 mcg/mL. Levels lower than 10 mcg/mL are too low to control seizures, and levels above 20 mcg/mL may result in toxicity.

A patient who has been taking phenytoin for several years reports stopping the drug the day before admission to the hospital. Which condition is most important for the nurse to monitor for in this patient? Fever or bruising Status epilepticus Ataxia and nystagmus Increased serum glucose

Status epilepticus Abrupt withdrawal of phenytoin may precipitate status epilepticus, so this patient should be monitored closely for seizures. Seizure precautions should be maintained and medications should be prescribed to treat any seizure activity that occurs, such as intravenous benzodiazepine and/or phenobarbital.

The nurse is teaching a medication regimen to a patient who has been prescribed an oral daily dose of prednisone. Which instructions would the nurse provide the patient to take this medication to ensure safe administration? Take with non-steroidal anti-inflammatory drugs Take with aspirin Take late in the evening Take in the early morning

Take in the early morning

A patient who is taking oral phenytoin reports experiencing heartburn and gastrointestinal (GI) upset. Which recommendation will the nurse provide to the patient? Take the medication with food. Take with a calcium-containing antacid. Take the medication on an empty stomach. Stop taking the medication and notify the health care provider.

Take the medication with food. Patients who experience GI distress should be counseled to take the drug with food to reduce these symptoms.

Thyroxine has recently been added to the routine medications for a patient who also uses insulin, warfarin, cholestyramine, and antacids daily. Which statement by the nurse would be included in medication education? Take your cholestyramine at least 4 hours apart from the levothyroxine Your dose of warfarin will have to be increased while you are taking this medication The dose of insulin that you take may need to be decreased You will need to avoid aluminum-containing antacids such as Maalox and Mylanta

Take your cholestyramine at least 4 hours apart from the levothyroxine

The client injects his insulin as prescribed but then gets busy and forgets to eat. What is the nurse's most likely assessment finding? The client will need to urinate. The client will be very hungry. The client will be sweating. The client will be very thirsty.

The client will be sweating.

The patient receives heparin. During the morning assessment of the patient, the nurse notes that the patient's blood pressure and red blood cell (RBC) count are low. There is no evidence of bleeding on the bed linen or the patient's gown. What will the best assessment of this patient reveal? The patient has probably formed some clots. The patient is dehydrated. The patient's activated partial thromboplastin time (aPTT) is too low. The patient may be bleeding internally.

The patient may be bleeding internally.

The nurse is preparing to educate a client prescribed levothyroxine (Synthroid). Which information should the nurse include in the teaching? Serum blood levels of TSH needs to be checked weekly. This medication needs to be taken on empty stomach. This medication can cause decreased appetite. Serum blood levels of levothyroxine needs to be checked monthly.

This medication needs to be taken on empty stomach.

Which of the following surgical procedures will most likely cause severe hypocalcemia? Nephrectomy. Thyroidectomy. Gastrectomy. Lobotomy.

Thyroidectomy.

Order: Gentamicin 45 mg IV q8h for a child weighing 45 lb. The recommended dosage is 6 to 7.5 mg/kg/day in three to four divided dosages.Round weight and doses to nearest tenth. Is the dosage ordered safe? Answer Yes (true) or No (false).

true

A transgender female patient is receiving estrogen therapy. This therapy puts her at risk of what complication? Pulmonary embolism. Anorexia. Prostate cancer. Hirsutism.

Pulmonary embolism.

The nurse is preparing to provide education for a client prescribed Clopidogrel (Plavix) after a stent placement. Which statements should the nurse use to explain the action of Clopidogrel? "Clopidogrel will make the platelets in your blood less sticky." "Clopidogrel will dissolve any clots that might form in your stent." "Clopidogrel works just like the heparin you were prescribed when in the hospital." "Clopidogrel will decrease the vitamin K level in your blood."

"Clopidogrel will make the platelets in your blood less sticky."

Which information should the nurse include in the teaching of a client with type 1 diabetes mellitus that would like to participate in sports? "Take an oral hypoglycemic agent on game days rather than insulin." "Eat a large meal after your game." "Eat a meal 1 hour before the game and consume a carbohydrate snack and fluids during the game." "Lower your dose of insulin."

"Eat a meal 1 hour before the game and consume a carbohydrate snack and fluids during the game."

The nurse has provided a client education about enoxaparin (Lovenox). Which statement made by a client indicates an understanding of the information? "Enoxaparin dissolves small clots but not big ones." "Enoxaparin increases the flexibility of my platelets" "Enoxaparin inhibits the synthesis of platelets." "Enoxaparin interferes with my body's ability to form a clot."

"Enoxaparin interferes with my body's ability to form a clot."

A nursing student asks the nurse why epinephrine, and not other adrenergic agonists, is used to treat anaphylactic shock. What will the nurse tell the student? "Epinephrine is the only adrenergic agonist that may be given parenterally." "Epinephrine has the ability to activate multiple types of adrenergic receptors." "Other adrenergic agonists have more severe adverse effects and are not safe in the doses needed to treat anaphylaxis." "Other adrenergic agonists have little or no effects on beta2-adrenergic receptors."

"Epinephrine has the ability to activate multiple types of adrenergic receptors."

The nursing instructor teaches student nurses about male reproductive function and the role of follicle-stimulating hormone (FSH). The instructor evaluates learning has occurred when the students make which statement? "Follicle-stimulating hormone (FSH) regulates male progesterone." "Follicle-stimulating hormone (FSH) regulates sperm production." "Follicle-stimulating hormone (FSH) regulates male androgen production." "Follicle-stimulating hormone (FSH) regulates production of testosterone."

"Follicle-stimulating hormone (FSH) regulates sperm production."

A client comes to the women's center and tells the nurse she has had unprotected sex. She asks for emergency contraception. What is the best assessment question for the nurse to ask? "Did you use a condom during intercourse?" "What kind of birth control have you used in the past?" "How long ago did you have unprotected sex?" "Where are you in your monthly cycle?"

"How long ago did you have unprotected sex?"

Which patient statement indicates understanding of the nurse's teachings related to a newly prescribed medication, insulin glargine (Lantus)? Select all that apply. One, some, or all responses may be correct. "I cannot mix this with other insulins." "I will take this before meals and at bedtime." "I will administer it subcutaneously." "The insulin will start working in one and a half hours." "If I am in hospital, I can get this medication IV."

"I cannot mix this with other insulins." "I will administer it subcutaneously." "The insulin will start working in one and a half hours."

The nurse is taking the initial history of a patient admitted to the hospital for hypertension. The physician has ordered a beta-adrenergic blocker. Which statement by the patient does the nurse recognize as most significant? "My father died of a heart attack when he was 48-years-old." "When I have a migraine headache, I need to have the room darkened." "I don't handle stress well; I have a lot of diarrhea." "I have always had problems with my asthma."

"I have always had problems with my asthma."

Which statement should concern the nurse the most concerned in the 38 year old woman who reports using an estrogen/progestin oral contraceptive? "I have been under a lot of stress lately and I started running 5 miles a day again." "I have been under a lot of stress lately and I started smoking cigarettes again." "I have been under a lot of stress lately and I started drinking alcohol again." "I have been under a lot of stress lately and I started taking SSRI medications again."

"I have been under a lot of stress lately and I started smoking cigarettes again."

The nurse has provided discharge education for a client prescribed an anticoagulant. Which statement made by the client indicates an understanding of the information? "I should consult with my prescribing provider before having any surgery." "I need to have a medical bracelet with the dose of insulin that I am taking." "I need to eat more protein while I am taking this medication." "I need to have my potassium level checked every 3 months."

"I should consult with my prescribing provider before having any surgery."

Which statement made by a client indicates an understanding of the education about insulin administration? "I should only use an appropriate calibrated insulin syringe for the injections." "I should provide direct pressure over the site following the injection." "I should use the abdominal area only for insulin injections." "I should check my blood sugar immediately prior to the administration."

"I should only use an appropriate calibrated insulin syringe for the injections."

7. The nurse is teaching the patient in the scenario who recently started an antihistamine. Which statement by the patient indicates that further teaching is needed? "I will be able to drive without any problem because I will know when I am impaired." "I should drink 8 to 10 glasses of water every day while taking this medication." "I can suck on candy or chew gum when my mouth gets dry from this drug." "If my vision starts to blur, I will need to call my doctor."

"I will be able to drive without any problem because I will know when I am impaired."

The nurse is teaching the patient about atenolol [Tenormin]. Which statement by the patient indicates a correct understanding of the nurse's instruction? "I will need to wait for 6 months and then stop this medication." "I will not stop taking this drug without the approval of my healthcare provider." "I may experience occasional chest pain and discomfort." "One missed dose will not affect my blood pressure."

"I will not stop taking this drug without the approval of my healthcare provider."

Questions 5-10 relate to the following scenario A patient came into the clinic with complaints of worsening nasal congestion after starting on oxymetazoline (Afrin) for seasonal allergies. 5. The patient in the scenario who has been taking Afrin for allergies, asks the nurse about the frequent upper respiratory symptoms that have been experienced lately. The nurse responds with which appropriate statement? "I will let your healthcare provider know about this adverse effect that we may have to hospitalize you for." "The medications that you are taking can cause a worsening of your symptoms before it will start to improve them." "Apparently, you are not taking your medication the proper way or your symptoms would be improving." "If you use that medication for longer than a few days you may get a rebound of the symptoms that you are using it for."

"If you use that medication for longer than a few days you may get a rebound of the symptoms that you are using it for."

Which instruction will the nurse provide a patient with type 1 diabetes mellitus who has been prescribed insulin lispro? "The duration of action for this insulin is about 8 to 10 hours, so you will need a snack." "To achieve tight glycemic control, this is the only type of insulin you will need." "Inject this insulin with meals because it is very fast acting." "This insulin needs to be mixed with regular insulin to enhance the effects."

"Inject this insulin with meals because it is very fast acting."

Which information should the nurse include in education for a client prescribed methimazole (Tapazole)? "Instruct the patient to notify their health care provider if they develop a fever and sore throat" "Occasionally you may feel your heart beating fast." "You may experience a weight loss while taking this prescription." "Call the clinic if you are having trouble sleeping."

"Instruct the patient to notify their health care provider if they develop a fever and sore throat"

Which information should the nurse include in the education for a client prescribed sildenafil (Viagra)? "This medication can cause you to have dangerously high blood pressure." "Taking it with grapefruit juice can decrease side effects of this medication." "It is best to take this medication on empty stomach." "You can take up to 2 pills in a 12 hour period."

"It is best to take this medication on empty stomach."

Which information should the nurse include in the teaching for a client prescribed a progestin only oral contraceptive? "It is important to take progestin only contraception in the morning on empty stomach." "It is important to take the progestin only pill at the same time every day." "Progestin only contraception is more effective than combined contraception but has more systemic side effects." "Progestin only contraception puts you at increased risk of blood clots."

"It is important to take the progestin only pill at the same time every day."

A male client prescribed estrogen for prostate cancer asks the nurse why they are receiving a female hormone. Which response should the nurse provide? "It keeps the cancer cells from receiving nutrients." "It suppresses secretion of the androgens that make your cancer grow." "It shrinks your cancer by causing the cells to die at a faster rate." "It eliminates the testosterone that encourages the growth of the cancer cells"

"It suppresses secretion of the androgens that make your cancer grow."

Which education should the nurse include in the teaching for a client prescribed a NuvaRing? "This ring should be inserted into your uterus." "The ring will be inserted by your healthcare provider." "Once inserted the ring provides contraceptive protection for 3 weeks." "Once inserted, this ring provides contraception for 6 months."

"Once inserted the ring provides contraceptive protection for 3 weeks."

A patient with newly diagnosed type 1 diabetes mellitus asks the nurse why they must take insulin and cannot take a pill like their friend does. Which answer would the nurse provide? "Oral hypoglycemics only work when the pancreas still produces insulin." "Insulin is more effective in controlling blood glucose levels." "Calorie reduction along with insulin can prevent long term complications." "Let me check with your healthcare provider to see if this is possible."

"Oral hypoglycemics only work when the pancreas still produces insulin."

10. The patient in the scenario is inquiring about decongestants and asks the nurse to explain the common and serious adverse effects. Which statement by the nurse is correct? "This drug will not stop the nasal congestion but will reduce the runny nose and runny eyes and itching that you have. These types of drugs may cause drowsiness, so do not drive or operate heavy equipment while taking this." "Rebound congestion is common if decongestants are used for longer than 3-5 days." "Topical aerosol products are highly effective in reducing sneezing and nasal itching, but just remember they are for a long period of time only." "This drug prevents histamine from being released so you will not have allergic rhinitis, make sure to blow your nose before spraying the med in your nose and watch for coughing."

"Rebound congestion is common if decongestants are used for longer than 3-5 days."

A client with Parkinson's disease asks the nurse about the effect of medications that he is going to take. Which response should the nurse provide? "The prescriptions will help prevent muscle wasting." "The prescriptions will increase your appetite." "The prescriptions will increase your energy." "The prescriptions will help you to feed yourself."

"The prescriptions will help you to feed yourself."

4. The nurse instructing the patient in the scenario on the drug tiotropium bromide (Spiriva), which was being started instead of continuing ipratropium bromide (Atrovent), realized further teaching was needed after the patient made which statement? "As I understand it, the effects of Spiriva last much longer than Atrovent so I only have to take it once a day." "I can follow the instructions on the package for how to use this drug." "When I take this drug, I should notice a reduced amount of wheezing and easier breathing." "This drug is used to treat an acute attack, like a rescue drug."

"This drug is used to treat an acute attack, like a rescue drug."

2. During the evaluation of the patient in the scenario who was admitted to the hospital complaining of shortness of breath and increased sputum production, the nurse asks the patient for further information by which of the following statements? (Select all that apply.) "Is there anyone at home to help you?" "Have you had any constipation or diarrhea recently?" "What activities would you say make you short of breath?" "Tell me about your cough. Does it wake you at night?" "When you cough up sputum, what color is it?"

"What activities would you say make you short of breath?" "Tell me about your cough. Does it wake you at night?" "When you cough up sputum, what color is it?"

Which statement by the nurse about insulin glargine (U-100) is accurate? "The duration of action of this insulin is about 8 to 10 hours." "You cannot mix this insulin in the same syringe with regular insulin." "This insulin is injected just before meals because it is very fast acting." "You can mix this insulin with regular insulin to enhance its effects."

"You cannot mix this insulin in the same syringe with regular insulin."

Which statement is appropriate to include in the teaching plan for a patient with new prescription for phenytoin? Select all that apply. One, some, or all responses may be correct. "This drug may cause easy bruising. If you notice this, call the clinic immediately." "You may have some mild sedation. Do not drive until you know how this drug will affect you." "You may continue to have wine with evening meals but only in moderation." "Be sure to call the clinic if you or your family notice thay you are experiencing increased anxiety or agitation." "It is very important to have good oral hygiene and visit your dentist regularly."

"You may have some mild sedation. Do not drive until you know how this drug will affect you." "Be sure to call the clinic if you or your family notice thay you are experiencing increased anxiety or agitation." "It is very important to have good oral hygiene and visit your dentist regularly."

Through which mechanisms can antiseizure drugs decrease seizure activities? Select all that apply. - Diminishing calcium influx - Suppressing sodium influx - Increasing sodium channel activation - Increasing the action of gamma-aminobutyric acid (GABA) - Increasing the calcium ion current through the T-type channel

- Diminishing calcium influx - Suppressing sodium influx - Increasing the action of gamma-aminobutyric acid (GABA)

Directions: Calculate the dosage, using the label provided. Round answers to the nearest tenth. Order: Terbutaline 300 mcg subcut stat Available: 1mg/ml How many milliliters will you administer? _____ mL. Do not include units in your answer.

0.3 ml

Directions: Calculate the following hourly dosage of heparin Order: Heparin 4,600 units subcut 2 hours before surgery Available: 5,000 units/ml How many milliliters will you administer? Round to the nearest hundredth and include units.

0.92ml

The nurse educator is reviewing the process of regulation of the female reproductive system. The nurse would arrange these steps in which order beginning with the initial step?

1. Secretion of gonadotropin-releasing hormone (GnRH)2. Secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).3. Ovarian follicles mature4.A surge of luteinizing hormone (LH) occurs5. The corpus luteum is formed

Directions: Use the label provided to obtain the necessary information. Round answers to the nearest tenth. Order: Cefazolin (Ancef) 0.375 g IM q6h Available: 1g - add 2.5ml of sterile water: provides 3ml How many milliliters will you administer? _____ mL. Do not include units in your answer.

1.1ml

Directions: Round dosage and weight to the nearest hundredth as indicated. Use labels where provided.Order: Albuterol 1.2 mg p.o. t.i.d. is ordered for a child weighing 27 lb. The recommended dosage is 0.3 mg/kg/24 hr divided q8h. Available: 2mg/5ml What is the safe divided dosage (the medication is ordered t.i.d) _____ mg . Rounded to hundredth. enter numeric portion only. no units

1.25 ml

Directions: Calculate the dosage, use label provided. Round answers to the nearest hundredth. Order: Atropine 0.5 mg IM stat Available: 0.4mg/ml How many milliliters will you administer? _____ mL. Do not include units in your answer.

1.25ml

Directions: Calculate the dosages, use labels where provided, and shade in the dosages on the syringe where provided. Round answers to the nearest tenth. Do not include units. Order: Furosemide 15 mg IM every day Available: 40mg/4ml

1.5ml

100 units of regular Humulin insulin in 250 mL 0.9% NS were to infuse at 4 mL/hr. How many units per hour will be delivered? Round your answer to the nearest tenth. Input numeric portion only, no units.

1.6 units/hr

Directions: Determine the infusion time in minutes for the following IV . Round minutes to the nearest whole number.60 mL of IV fluid with medication infusing at 50 gtt/min. Drop factor is 10 gtt/mL. Calculate the infusion time: _____ minutes. Enter the numeric portion only, no units.

12 minutes

A client using Depo-Provera as a method of birth control asks the nurse how long the medication will be effective. Which response should the nurse provide the client? 12 weeks. 1 months. 4 months. 6 weeks.

12 weeks.

Order: Cardizem 0.25 mg/kg IV bolus. Infuse over 2 min. Client weighs 50 kg.Available: Cardizem 25 mg (5 mg/mL)a. How many milligrams should the client receive? Round your answer to the nearest tenth and include units.

12.5mg

Directions: Determine the flow rate for the following IV being administered by infusion pump. Round your answer to the nearest tenth and include units.Ampicillin 1.5 g in 100 mL 0.9% NS over 45 min: _____

133.3 mL/hr

Which blood pressure would be expected in a patient with stage I hypertension? 98/65 mmHg 119/84 mmHg 159/92 mmHg 135/84 mmHg

135/84 mmHg

Order: Cardizem 0.25 mg/kg IV bolus. Infuse over 2 min. Client weighs 50 kg.Available: Cardizem 25 mg (5 mg/mL)b. How many milliliters will you give? Round your answer to the nearest tenth and include units.

2.5ml

Directions: Determine the infusion time in minutes for the following IV. Round minutes to the nearest whole number of minutes.1,000 mL D5W infusing at 250 mL/hrDetermine the infusion time: _____minutes. Enter the numeric portion only, no units.

240 minutes

An IV medication of 50 mcg in 200 mL is ordered to infuse over 2 hr. The safe therapeutic dosage range is 1.5 to 3 mcg/kg/hr. The child weighs 5.7 kg. In this order how many mcg of medication the child will be receiving per hour? Enter numeric portion only.

25 mcg/hr

Order: regular Humulin insulin 10 units/hr IVAvailable: 40 units of insulin in 100 mL 0.9% NSWhat rate in mL/hr will infuse 10 units/hr? Round your answer to the nearest tenth and include units.

25ml/hr

Directions: Round dosage and weight to the nearest tenth as indicated. Use labels where provided.Order: Albuterol 1.2 mg p.o. t.i.d. is ordered for a child weighing 27 lb. The recommended dosage is 0.3 mg/kg/24 hr divided q8h. Available: 2mg/5ml e. How many milliliters of albuterol are needed to administer the dosage? Include units.

3ml

Directions: Calculate the dosage.A client is on a sliding scale for insulin q6h. The order is for Humulin Regular U-100 subcut q6h as follows: Blood Glucose Level(mg per dL) Regular Insulin Less than 70 Call MD 201-250 4 units 251-300 6 units 301-350 8 units 351-400 10 units Greater than 400 Call MD At 8:00 AM the client's blood sugar is 284 mg/dL. How many units of insulin will you administer? Record your answer with a whole number. Do not include units.

6 units

Directions: Calculate the dose, use label provided. Round answer to the nearest tenth. Do not include units. Order: Zithromax 250 mg p.o. daily Available: 200mg/5ml How many milliliters will you administer? Do not include units, round your answer to nearest tenth.

6.3 ml

Directions: Calculate the following hourly dosage of heparin (units/hr).A client weighs 165 lb. Order: Administer a bolus of heparin sodium IV. The hospital protocol is 80 units/kg. How many units will you administer? Include units.

6000 units

Directions: Determine the flow rate for the following IV being administered by infusion pump. Round your answer to the nearest tenth and include units.Clindamycin 600 mg in 100 mL D5W over hr: _____

66.7 mL/hr

For which client experiencing muscle spasms is direct-acting antispasmodic medication dantrolene sodium (Dantrium) contraindicated? A 65-year-old with a cerebral vascular accident A 20-year-old with a spinal cord injury A 40-year-old with multiple sclerosis A 57-year-old with congestive heart failure

A 57-year-old with congestive heart failure

The physician writes orders for the client with diabetes mellitus. Which order would the nurse question and validate with the physician before proceeding? Administer Lantus insulin 20U BID. Administering regular insulin 30 minutes prior to meals. Administer 5 units of Humalog and 10 units NPH daily in the same syringe. Administer Metformin (Glucophage) 1000 mg per day divided in two doses.

Administer Lantus insulin 20U BID.

Which intervention would the nurse perform for a patient suspected of anticholinergic toxicity? Administer intramuscular haloperidol Initiate rapid intravenous fluids Administer rapid intravenous atropine sulfate Administer slow intravenous push physostigmine

Administer slow intravenous push physostigmine (antidote for atropine)

A client with Addison's disease is experiencing nausea, vomiting, and confusion. Which priority intervention should the nurse anticipate to be included in the plan of care? Administration of intravenous diuretic. Administration of intravenous hydrocortisone. Placement of a nasogastric tube Immediate endotracheal intubation

Administration of intravenous hydrocortisone.

A patient who recently had a surgery was diagnosed with Deep Venous Thrombosis and is starting heparin therapy. Which medication order would the nurse expect to be changed now that the patient is on heparin. Norco 325/5 p. o. every 4 hours for pain. Advil 800mg p. o. every 8 hours for pain. Cephalexin 500mg p. o. every 6 hours for wound infection. Labetalol 200mg p. o. b. i. d. for hypertension.

Advil 800mg p. o. every 8 hours for pain.

6. The nurse researched the causes of upper respiratory symptoms and learned their diagnoses. Match the causes for allergic rhinitis, nasal congestion, and rhinitis medicamentosa. Allergic rhinitis Nasal congestion Rhinitis medicamentosa match the causes: a. Cholinergic stimulation causes vasodilation of the blood - vessels lining the nasal mucosa b. Excessive blood flow to nasal passages causing swelling and more congestion c. Inflammation of the nasal mucosa from exposure to an allergen

Allergic rhinitis c. Inflammation of the nasal mucosa from exposure to an allergen Nasal congestion a. Cholinergic stimulation causes vasodilation of the blood - vessels lining the nasal mucosa Rhinitis medicamentosa b. excessive blood flow to nasal passages causing swelling and more congestion

Which medication would the nurse anticipate administering to a patient in cholinergic crisis? Pralidoxime Atropine Dobutamine Neostigmine

Atropine

A patient who takes rivastigmine develops complete heart block. Which medication would the nurse administer to improve the patient's condition? Dopamine Epinephrine Atropine Lidocaine

Atropine (antidote for cholinergic toxicity ie bethanechol toxicity)

Which statement describes a pharmacodynamic difference between albuterol and salmeterol? Albuterol is considered "long-acting" and salmeterol is considered "short-acting." Salmeterol's effects last for 3 to 4 hours, and albuterol has an extended duration of action up to 12 hours. Because of the onset of action, albuterol should not be used during an acute attack of asthma, but instead, salmeterol should be used. Based on pharmacodynamics, albuterol is typically dosed as needed based on symptoms whereas salmeterol is dosed twice daily.

Based on pharmacodynamics, albuterol is typically dosed as needed based on symptoms whereas salmeterol is dosed twice daily. rationale: Because of its longer duration of action (i.e., 12 hours),salmeterol is typically dosed twice daily. Because albuterol has a shorter duration of action (i.e., 3 to 4 hours), it is generally dosed on an as-needed basis for an acute attack of asthma or exacerbation of chronic obstructive pulmonary disease (COPD).

Which drug class is prescribed as initial therapy for hypertension after myocardial infarction (MI)? Select all that apply. One, some, or all responses may be correct. Calcium Channel Blockers Beta blockers Angiotensin- converting enzyme inhibitors Aldosterone antagonists Diuretics

Beta blockers Angiotensin- converting enzyme inhibitors Aldosterone antagonists

Which drug increases the risk for unrecognized hypoglycemia in a patient receiving insulin? Aspirin Beta-adrenergic blockers Codeine Thiazide diuretics

Beta-adrenergic blockers

Which drug will the nurse anticipate administering for postoperative abdominal distention and urinary retention in a patient who had an appendectomy? Promethazine Droperidol Ondansetron Bethanechol

Bethanechol

Which medications are useful to relieve pain associated with muscle spasms? Select all that apply. One, some, or all responses may be correct. Fondaparinux Carisoprodol Cyclobenzaprine Methocarbamol Cefazolin

Carisoprodol Cyclobenzaprine Methocarbamol

A patient who has type 2 diabetes mellitus (DM) will begin taking phenytoin to treat seizures. Which ongoing assessment will the nurse complete on this patient? Close monitoring of serum glucose Close monitoring for adverse central nervous system (CNS) effects More frequent assessment of oxygen saturation levels Monitor for subtherapeutic serum drug levels

Close monitoring of serum glucose Phenytoin can lead to increased serum glucose levels; this needs to be monitored closely in patients with type 2 DM. For patients with type 2 DM taking phenytoin, the diabetes medication regimen may need to be altered to prevent prolonged hyperglycemia.

The nurse is reviewing the health record for a patient with type 2 diabetes mellitus. Which finding in the health record would cause the nurse to withhold the dose of metformin and contact the healthcare provider? 2-lb weight gain in 1 week Fasting blood glucose 100 mg/dL Blood pressure 142/90 mmHg Computed tomography scan with contrast scheduled for this morning

Computed tomography scan with contrast scheduled for this morning

Which is responsible for the secretion of progestins? Corpus luteum. Anterior pituitary. Hypothalamus. Ovarian follicles.

Corpus luteum.

A client with type 2 diabetes reports that he is allergic to sulfamethoxazole. A nurse knows that this patient might also be allergic to which diabetic medication. Metformin (Glucophage). Glipizide (Glucotrol). Exenatide (Byetta). Sitagliptin (Januvia).

Glipizide (Glucotrol).

A patient with complex partial seizures is prescribed phenytoin to control recurrent seizures, but the patient reports being reluctant to take the drug long term because of its side effects. Which information would the nurse provide this patient? "Tolerance to most phenytoin side effects will develop over time." "Ask your health care provider about reducing your phenytoin dosage to minimize side effects." "Ask your health care provider about stopping your phenytoin if the side effects become troublesome." "Ask your health care provider about the possibility of using a different class of antiseizure medication."

Correct "Ask your health care provider about the possibility of using a different class of antiseizure medication."Because phenytoin side effects may decrease adherence to the drug regimen, another drug class may be considered to improve the chances that the patient will continue to take the drug.

Which statements made about salmeterol by a patient with asthma would alert the nurse that further intervention is warranted? "I should use this when I feel an asthma attack is coming on." "I will make sure to also use my steroid inhaler and will never use salmeterol by itself." "I should only take the amount of salmeterol the health care provider prescribed." "I will follow up with my health care provider to have my liver tested after starting salmeterol." "I should rinse my mouth after I inhale salmeterol because I might develop a yeast infection."

Correct "I should use this when I feel an asthma attack is coming on."Salmeterol is a long-acting beta2-adrenergic agonist that is used in the maintenance of asthma control. It should not be used during an acute attack of asthma. Incorrect "I will make sure to also use my steroid inhaler and will never use salmeterol by itself."Long-acting beta2 agonists (LABAs) such as salmeterol may increase the risk of severe asthma attacks and asthma-related deaths when received as monotherapy. To minimize the risk, these drugs should be combined with an inhaled glucocorticoid, preferably in the same device. Incorrect "I should only take the amount of salmeterol the health care provider prescribed." Salmeterol is a maintenance medication that should only be taken as prescribed. Overuse can lead to the development of side effects and adverse effects. Correct "I will follow up with my health care provider to have my liver tested after starting salmeterol." Although follow-up is important for a patient receiving salmeterol, liver function tests are not warranted for patients receiving this drug. Liver function should be monitored for patients receiving leukotriene modifiers. Patients receiving salmeterol would have forced expiratory volume, peak expiratory flow, nighttime awakenings, symptom frequency and severity, and short-acting beta2-adrenergic agonist use assessed. Correct "I should rinse my mouth after I inhale salmeterol because I might develop a yeast infection."Rinsing the mouth with water after inhalation of glucocorticoids, not LABAs such as salmeterol, is important to prevent oropharyngeal candidiasis.

Which drug has a quick onset of action and is recommended for use during an acute asthma attack or chronic obstructive pulmonary disease (COPD) exacerbation? Albuterol Fluticasone propionate Salmeterol

Correct AlbuterolAlbuterol has a quick onset of action of 10 to 25 minutes and is considered a "rescue" drug used in patients suffering from an acute asthma attack or COPD exacerbation. Incorrect Fluticasone propionate - Fluticasone propionate is a glucocorticoid with an unknown onset of action; however, glucocorticoids should not be used for acute asthma attacks but instead in the chronic management of pulmonary diseases. Salmeterol - Salmeterol is considered a long-acting beta2-adrenergic agonist and should not be used in the management of an acute asthma attack or COPD exacerbation.

A patient with asthma has been prescribed salmeterol. The patient also takes aspirin, atenolol, furosemide, and phenobarbital. Which drug would be expected to decrease bronchodilation when given with salmeterol? Aspirin Atenolol Furosemide Phenobarbital

Correct Atenolol - Atenolol is a beta blocker. When a beta blocker is given with a beta agonist, there may be a reduction in bronchodilation.

A patient has been prescribed fluticasone propionate for asthma management. The patient also has type 2 diabetes mellitus and dyslipidemia, which are medically managed. Which effect and action does the nurse anticipate may occur when fluticasone propionate is started for this patient? Increased lipids; adjustment of cholesterol medications Decreased lipids; discontinuation of cholesterol medications Increased blood glucose; adjustment of diabetes medications Decreased blood glucose; discontinuation of diabetes medications

Correct Increased blood glucose; adjustment of diabetes medicationsGlucocorticoids such as fluticasone can increase blood glucose levels, even in patients without diagnosed diabetes mellitus. Therefore a dosage increase in diabetes medications may be warranted.

The nurse is performing an admission assessment on a patient who will receive intravenous phenytoin. The patient reports a history of a "slow heart rate." Which action by the nurse is appropriate? - Administer the medication as prescribed. - Request an electrocardiogram (ECG). - Count the apical pulse for 1 minute before giving the drug. - Request an oral form of the drug to minimize cardiovascular side effects.

Correct Request an electrocardiogram (ECG). Phenytoin is contraindicated in patients with second- and third-degree heart block, sinoatrial block, sinus bradycardia, and Adams-Stokes syndrome, so this patient should have an ECG to rule out these conditions before administration of the drug.

Which action is an appropriate nursing intervention for a patient who is taking hydrochlorothiazide? Take the radial pulse for 1 full minute before administering the drug. Schedule the dose to be taken in the evening Monitor serum calcium and sodium levels daily Encourage the intake of foods rich in potassium

Encourage the intake of foods rich in potassium

The nurse is caring for a pregnant patient with a history of thrombosis. Which prophylactic treatment does the nurse anticipate the healthcare provider will prescribe for this patient? Warfarin Clopidogrel Alteplase Enoxaparin

Enoxaparin

3. The nurse explained to the patient in the scenario how the various medications worked to provide symptomatic relief of COPD. Match the mechanism of action for each type of medication. Expectorant Antitussive Mucolytic mechanism of action (match): Suppresses the cough center in the brain Dissolves thick, sticky mucus Stimulates an increase in bronchial gland secretions

Expectorant Stimulates an increase in bronchial gland secretions Antitussive Suppresses the cough center in the brain Mucolytic Dissolves thick, sticky mucus

Which class of drugs used in the management of pulmonary diseases decreases the production of and inhibits the release of leukotrienes, histamine, and prostaglandins; inhibits the activity of eosinophils and leukocytes; and decreases vascular permeability to decrease airway edema? Anticholinergics Beta2-adrenergic agonists Glucocorticoids Leukotriene modifiers

Glucocorticoids

The nurse is teaching the patient why hypertension must be treated. Which complication would be included in the teaching plan? Select all that apply. One, some, or all responses may be correct. Heart failure Kidney Disease Stroke Emphysema Heart Disease Diabetes

Heart failure Kidney Disease Stroke Heart Disease

The nurse educator is reviewing the process of hemostasis. Please put the steps of homeostasis in order.

Hemostasis: the physiologic process by which bleeding is stopped - step1: vasoconstriction (vascular spasm) - step2: damage to endothelium and exposure of connective tissue, resulting in formation of a platelet plug (platelets sticky) - step3: activation of the clotting cascade - step4: formation of a blood clot (reinforcement of the platelet plug with fibrin (coagulation)) - step5: activation of fibrinolysis for clot retraction and clot dissolution Coagulation: defined as the production of fibrin, a threadlike protein that reinforces the platelet plug

The patient has a deep vein thrombosis (DVT) and is admitted for initial heparin therapy. What complication the nurse needs to be aware of? Acne. Hirsutism. Heparin induced polycythemia. Heparin induced thrombocytopenia.

Heparin induced thrombocytopenia.

Which condition is most likely to require lower dosing and closer monitoring to prevent drug toxicity in a patient taking phenytoin? Hepatitis. Pneumonia Anemia Gastroesophageal reflux.

Hepatitis The liver metabolizes the drug to inactive metabolites, so alterations in liver function can decrease metabolism of the drug, leading to toxicity.

Which patient assessment finding contraindicates the use of bethanechol? Blood pressure 140/83 mmHg Use of an antihypertensive drug History of Asthma Tachycardia

History of Asthma

The nurse would teach a patient with diabetes who is taking phenytoin to monitor for which condition? Incorrect Hypoglycemia Hyperglycemia Decreased drug effects Increased drug effects

Hyperglycemia Phenytoin can cause increased serum glucose, so this patient should monitor for hyperglycemia.

Which electrolyte disturbance should the nurse is concerned about in a client who is receiving hydrocortisone therapy? Hypoglycemia and hypokalemia. Hypernatremia and hyperkalemia. Hypernatremia and hyperglycemia. Hypercalcemia and hypoglycemia

Hypernatremia and hyperglycemia.

Which assessment findings should the nurse anticipate for the client with Cushing's syndrome? Tachycardia. Shortness of breath. Thin, gaunt appearance of the face. Hypertension.

Hypertension.

The nurse would monitor for which adverse effect in a patient who takes amiodarone? Select all that apply. One, some, or all responses may be correct. Hyperthroidism Light sensitivity Elevated liver enzymes Hypertension Dyspnea

Hyperthroidism Light sensitivity Elevated liver enzymes Dyspnea

The healthcare provider has prescribed amiodarone for a patient with ventricular dysrhythmias. Upon reviewing the patient's medical history, which statement by the patient would lead the nurse to notify the healthcare provider? I break out in a rash when I take antibiotics. I take a blood thinner so I don't get clots I get faint when I see needles I wear eyeglasses to read print up close

I take a blood thinner so I don't get clots

Which finding for a patient on Coumadin (warfarin sodium) puts this patient at risk for severe bleeding? aPTT of 60 seconds. Platelet count of 120,000/ml. INR of 6. Hemoglobin of 10 mg/dL.

INR of 6.

Which counseling points would a nurse provide in patient teaching regarding the use of an inhaled glucocorticoid for asthma? Palpitations and tremors are expected side effects associated with inhaled glucocorticoid therapy. Rinse the mouth and gargle with water after using an inhaled corticosteroid to minimize the risk for an oral fungal infection. Glucocorticoids are indicated for the acute treatment of symptoms and should be used on an "as-needed" basis for symptoms. Drug levels should be routinely assessed to ensure the patient is not receiving too much or too little of the inhaled glucocorticoid. Because long-term use of inhaled glucocorticoids may cause potential bone loss, adequate vitamin D and calcium intake, along with weight-bearing exercises, is recommended.

Incorrect Palpitations and tremors are expected side effects associated with inhaled glucocorticoid therapy.Palpitations/accelerated heart rate and tremors are more likely to occur with beta2-adrenergic agonists, not inhaled corticosteroids. Correct Rinse the mouth and gargle with water after using an inhaled corticosteroid to minimize the risk for an oral fungal infection.Patients receiving an inhaled glucocorticoid should rinse and gargle with water after administration of the drug to prevent the development of an oral fungal infection (oropharyngeal candidiasis). The use of a spacer (if using a metered-dose inhaler) can also help to reduce the risk of an oral fungal infection. Glucocorticoids are indicated for the acute treatment of symptoms and should be used on an "as-needed" basis for symptoms. Incorrect Glucocorticoids are used in the chronic management of pulmonary diseases and should not be used on an "as-needed" basis during an acute exacerbation. Drug levels should be routinely assessed to ensure the patient is not receiving too much or too little of the inhaled glucocorticoid. Incorrect Glucocorticoids are not assessed with drug levels. This is necessary with theophylline therapy to ensure the patient is effectively and safely receiving the drug. Correct Because long-term use of inhaled glucocorticoids may cause potential bone loss, adequate vitamin D and calcium intake, along with weight-bearing exercises, is recommended. Although minimal systemic absorption is expected with inhaled glucocorticoids, chronic use can lead to bone loss. Therefore ensuring the patient receives adequate calcium and vitamin D, along with weight-bearing exercises, is important to prevent osteoporosis.

Which instruction would the nurse give a patient receiving verapamil to help prevent a common adverse effect of this drug? Use sunscreen Increase calorie intake Increase fluid and fiber intake Use a skin barrier cream

Increase fluid and fiber intake

Which is the action of the pharmacotherapy used to treat Parkinson's disease? Reduce the amount of dopamine and increase the amount of acetylcholine. Reduce the amount of dopamine and acetylcholine. Increase the amount of dopamine and reduce the amount of acetylcholine. Increase the amount of dopamine and acetylcholine.

Increase the amount of dopamine and reduce the amount of acetylcholine.

Which assessment finding indicates that a muscarinic agonist is having the anticipated effect? Vasconstriction Mydriasis Urinary retention Increased gastrointestinal motility

Increased gastrointestinal motility

The nurse makes a home visit to a client with diabetes mellitus. During the visit, the nurse notes that the client's 3-month supply of insulin vials that were delivered a week ago are not refrigerated. What is the best action by the nurse at this time? Instruct the client to discard the vials. Instruct the client that the insulin should be stored away from direct sunlight or excessive heat. Instruct the client that opened vials can be stored out of refrigerator for up to 3 months Instruct the client that unopened vials of insulin can be stored at room temperature until expiration day.

Instruct the client that the insulin should be stored away from direct sunlight or excessive heat.

A patient calls the clinic and tells the nurse that she has missed taking contraceptive pills today, yesterday and the day before yesterday. What is the best action for the nurse? Schedule the patient for an IUD insertion in 2 weeks. Instruct the patient to take 2 pills today, 2 pills tomorrow, then continue your pack while also using condoms for the next 14 days. Assess whether oral contraceptives are the best contraception option for this patient. Advise the patient to do a urinary pregnancy test today and in a week.

Instruct the patient to take 2 pills today, 2 pills tomorrow, then continue your pack while also using condoms for the next 14 days.

Match the peak times for different insulins: Insulin detemir (Levemir) Insulin isophane (NPH) Insulin lispro (Humalog) Insulin regular (Humulin R). 0.5-1 hours No peak 2-4 hours 4-12 hours

Insulin detemir (Levemir) No peak Insulin isophane (NPH) 4-12 hours Insulin lispro (Humalog) 0.5-1 hours Insulin regular (Humulin R). 2-4 hours

Which long-acting insulin mimics natural, basal insulin with its duration of 18 to 24 hours? Insulin glargine Regular insulin Insulin aspart Insulin glulisine

Insulin glargine

Which type of insulin should the nurse anticipate to administer intravenously to a client with a blood glucose of 563? Insulin glargine (Lantus). Insulin aspart (NovoLog). Insulin regular (Humulin R). Insulin isophane (NPH).

Insulin regular (Humulin R)

A patient on warfarin (Coumadin) is scheduled to have a test to check if the blood level of Coumadin is in therapeutic range. Which test will be ordered? aPTT Complete blood count. Platelet count. International normalized ratio (INR).

International normalized ratio (INR).

The administration of which anticoagulant is an error by the nurse? Intramuscular enoxaparin Oral warfarin Oral dabigatran Subcutaneous heparin

Intramuscular enoxaparin

The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest? Intravenous epinephrine Inhaled albuterol Subcutaneous terbutaline Topical phenylephrine

Intravenous epinephrine

The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest? Topical phenylephrine Intravenous epinephrine Subcutaneous terbutaline Inhaled albuterol

Intravenous epinephrine

The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education on the action of this drug? It increases energy use. It reduces insulin resistance. It inhibits absorption of carbohydrates. It stimulates the pancreas to produce more insulin.

It reduces insulin resistance.

In which way would the nurse evaluate the therapeutic effectiveness of a class IV antidysrhythmic drug? Select all that apply. One, some, or all responses may be correct. Monitor cardiac function Count ventricular rate Listen to breath sounds Check pipil constriction Check blood pressure Assess for chest pain

Monitor cardiac function Count ventricular rate Check blood pressure Assess for chest pain

A patient who is taking a beta blocker for hypertension reports being dizzy when first getting out of bed in the morning. The nurse should advise the patient to: Avoid sleeping in a prone position. Drink a full glass of water before rising to increase vascular circulatory volume. Move slowly from the recumbent to the upright position. Stop taking the medication.

Move slowly from the recumbent to the upright position.

A patient has started clopidogrel (Plavix) after experiencing a transient ischemic attack. What is the desired therapeutic effect of this drug? To reduce the risk of a stroke from a blood clot Analgesic as well as clot-dissolving effects To stop clots from becoming emboli Anti-inflammatory and antipyretic effects

To reduce the risk of a stroke from a blood clot

Which assessment finding in an older adult prescribed levodopa-carbidopa (Sinemet) should the nurse be most concerned with? Diarrhea. Hypertension. Muscle twitching. Dark urine.

Muscle twitching.

Questions 1-4 relate to this patient scenario A patient with severe COPD arrived at the flu clinic to receive the annual influenza vaccination. The nurse noted that the patient had difficulty talking with frequent pauses between words to take a breath, was difficult to understand and appeared dyspneic and uncomfortable. 1. During the respiratory assessment of the patient in the scenario who was admitted to the hospital, the nurse noted the patient was coughing frequently and appeared to have difficulty breathing. Which of the following should be included in the respiratory assessment? (Select all that apply.) Observe the patient's degree of respiratory impairment Determine the nutrition status of the patient Observe the patient's general appearance Auscultate the patient's lung fields Determine whether there is any loss of hearing Take and record pulse oximetry level Take and record baseline vital signs

Observe the patient's degree of respiratory impairment Observe the patient's general appearance Auscultate the patient's lung fields Take and record pulse oximetry level Take and record baseline vital signs

The nurse knows that certain foods may interact with the Coumadin (warfarin) that the client is taking. Which meal can interfere with therapeutic effect of this medication? Soy milk latte. Poke bowl with spinach/kale mix instead of rice, Cereal with almond milk. Gluten free bread grilled cheese .sandwich

Poke bowl with spinach/kale mix instead of rice,

Diagnosis of diabetes can be made based on the results of the following tests except for which one? Fasting glucose test. Hemoglobin A1C. Post prandial glucose test. Oral glucose tolerance test.

Post prandial glucose test.

The nurse notices significant edema surrounding and proximal to the peripheral intravenous (IV) site where epinephrine is being infused. Which action would the nurse anticipate first? Institute the protocol for congestive heart failure (CHF). Ensure that naloxone [Narcan] is available. Prepare to administer phentolamine [Regitine]. Monitor the blood urea nitrogen (BUN), creatinine, and potassium levels.

Prepare to administer phentolamine [Regitine].

Which describes the primary action of anticoagulant therapy? Decrease the prothrombin time. Dissolve blood clots. Prevent formation and growth of blood clots. Increase the number of platelets.

Prevent formation and growth of blood clots.

Which describes the mechanism of action of regular insulin? Stimulate the pancreas to produce insulin. Promote entry of glucose into the cells. Delays stomach emptying. Facilitate the entry of glucose into the bloodstream.

Promote entry of glucose into the cells.

Why does the nurse anticipate administering metoprolol [Lopressor] rather than propranolol [Inderal] for diabetic patients who need a beta-blocking agent? Propranolol causes both beta1 and beta2 blockade. Propranolol is associated with a higher incidence of foot ulcers. Metoprolol helps prevent retinopathy in individuals with diabetes. Metoprolol is less likely to cause diabetic nephropathy.

Propranolol causes both beta1 and beta2 blockade.

9. Before initiating antihistamine medications, the nurse knows that the patient's history should be checked for which of the following? (Select all that apply.) Hypothyroidism Hypertension Prostatic hyperplasia Asthma Glaucoma

Prostatic hyperplasia Asthma Glaucoma

A patient calls the clinic 1 week after beginning therapy with phenytoin to report urine that is pinkish red. How would the nurse respond? Have the patient come to the clinic for a dipstick urinalysis. Reassure the patient that this is a harmless side effect of phenytoin. Contact the health care provider and request a prescription for a blood urea nitrogen (BUN) and creatinine. Tell the patient to stop the drug immediately and contact the health care provider.

Reassure the patient that this is a harmless side effect of phenytoin. A pinkish-red or reddish-brown color to the urine is a harmless side effect of phenytoin. The patient should continue the medication as prescribed.

The nurse is providing care for a patient in diabetic ketoacidosis with a blood glucose level of 723 mg/dL. Which insulin would the nurse expect the healthcare provider to prescribe via a continuous infusion? NPH insulin Insulin glargine Regular insulin Afrezza

Regular insulin

A patient asks the nurse about ways to prevent gingival symptoms while taking phenytoin. Which activity will the nurse recommend? Use a soft-bristled toothbrush. Floss the teeth three times daily. Brush the teeth and gums vigorously. Use toothpicks to clean under the gums.

Use a soft-bristled toothbrush.

Which observation supports an effective response to a patient with hypotonic bladder who received bethanechol 45 minutes ago? The patient voided The patient's respiratory rate increased The patient's blood pressure is reduced The patient has decreased bowel sounds

The patient voided

The nurse is managing care for a patient with a DVT (deep vein thrombosis) of the right calf. The patient receives heparin intravenously (IV). What is the priority outcome for this patient? The patient will not experience bleeding. The patient will not disturb the intravenous infusion. The patient will keep the right leg elevated on two pillows. The patient will comply with dietary restrictions.

The patient will not experience bleeding.

Through which mechanism of action do antiseizure drugs work? - They decrease the inhibitory neurotransmitter system in the brain called the gamma-aminobutyric acid (GABA) system. - They increase calcium influx in the brain, causing a decrease in electrical current flow. - They stabilize nerve cell membranes and suppress the abnormal electrical impulses in the cerebral cortex. - They bind to opioid receptors, and molecular signaling activates the receptors to mediate certain actions.

They stabilize nerve cell membranes and suppress the abnormal electrical impulses in the cerebral cortex.

For which purpose would the nurse administer atropine solution sublingually to a dying patient with dyspnea? To decrease fluid overload To treat respiratory infection To dry up respiratory secretions To treat bronchospasms

To dry up respiratory secretions

Which medication should the nurse prepare to administer for a client experiencing a warfarin sodium overdose? Vitamin K. Protamine sulfate. Heparin. Aspirin.

Vitamin K.

A patient on heparin therapy is asking what laboratory test is used to adjust heparin dose. What is the nurse's best understanding that will help her to answer the question? Complete blood count is used to make sure that heparin level is in therapeutic range. aPTT is used to make sure that heparin level is in therapeutic range. Platelet count is used to make sure that heparin level is in therapeutic range. Serum heparin test is used to make sure that heparin level is in therapeutic range.

aPTT is used to make sure that heparin level is in therapeutic range.

A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, what should the nurse do: call the healthcare provider and request an order to decrease the dose. call the healthcare provider and request an order to give vitamin K (phytonadione). administer the dose as ordered. call the healthcare provider and request an order to increase the dose.

administer the dose as ordered.

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics? a. Centrally acting agents stimulate neurons of the central nervous system, while direct-acting agents stimulate neurons of the peripheral nervous system. b. Centrally acting agents stimulate the central nervous system, while direct-acting agents inhibit neuronal conduction of the central nervous system. c. Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles. d. Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents stimulate neurons of the central nervous system.

c. Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.

Directions: Round dosage and weight to the nearest tenth as indicated. Use labels where provided.Order: Albuterol 1.2 mg p.o. t.i.d. is ordered for a child weighing 27 lb. The recommended dosage is 0.3 mg/kg/24 hr divided q8h. Available: 2mg/5ml Is the dosage ordered safe? Yes (True) or No (False) Explain on the calculation paper. ______________________________

true