Pharm NCLEX study set 2

The nurse is caring for a postrenal transplant client taking cyclosporine (Sandimmune, Gengraf, Neoral). The nurse notes an increase in one of the client's vital signs, and the client is complaining of a headache. What is the vital sign that is most likely increased? 1. Pulse 2. Respirations 3. Blood pressure 4. Pulse oximetry

3. Blood pressure

A nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply area for possible use to reverse this elevation? 1. Calcium gluconate 2. Calcium chloride 3. Calcitonin (Calcimar) 4. Vitamin D

3. Calcitonin (Calcimar)

A nurse is reinforcing dietary instructions to a client who is currently prescribed probenecid (Benemid). Which food should the nurse encourage the client to continue to eat? 1. Spinach 2. Scallops 3. Shrimp 4. Liver

1. Spinach

Etidronate (Didronel), an antihypercalcemic medication, is prescribed for a client. The nurse instructs the client to take the medication: 1. Two hours before meals 2. With meals 3. With milk 4. With an antacid

1. Two hours before meals

The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal obstruction 2. Peptic ulcer with melena 3. Diverticulitis with perforation 4. Vomiting following cancer chemotherapy

4. Vomiting following cancer chemotherapy

A client with dermatitis has been prescribed a topical corticosteroid for use on the affected areas, and the nurse has provided instructions about the use of this medication. Which statement by the client indicates the need for further instructions? 1. "I will apply a bandage over the site after applying the medication." 2. "The medication reduces inflammation and itching." 3. "I will apply the medication in a thin film." 4. "I will massage the medication gently into the skin."

1. "I will apply a bandage over the site after applying the medication."

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1. Alcohol 2. Organ meats 3. Whole-grain cereals 4. Carbonated beverages

1. Alcohol

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin? 1. 3 to 5 ng/mL 2. 0.5 to 2 ng/mL 3. 1.2 to 2.8 ng/mL 4. 3.5 to 5.5 ng/mL

2. 0.5 to 2 ng/mL

Nalidixic acid (NegGram) is prescribed for the client with a urinary tract infection. Reviewing the client's record, the nurse notes that the client is taking warfarin (Coumadin) on a daily basis. Which of the following prescriptions would the nurse anticipate because the client is taking this oral anticoagulant? 1. An increase in the anticoagulation dosage 2. A reduction in the anticoagulation dosage 3. The need to discontinue the warfarin during therapy 4. The need to administer an alternative medication to treat the urinary tract infection

2. A reduction in the anticoagulation dosage

A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate

2. Tremors 3. Drowsiness 4. Hypotension

A client has taken his first dose of lisinopril (Zestril) about 2 hours ago and begins to develop fullness in his face and hoarseness. What should be the nurse's first action? 1. Determine the client's blood pressure to determine effectiveness. 2. Determine the client's ability to breathe effectively. 3. Instruct the client to stay in the resting position to prevent dizziness. 4. Ask the client when the hoarseness first developed.

2. Determine the client's ability to breathe effectively.

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids? 1. "I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress." 2. "I should stop my medication if I begin to experience any unpleasant side effects." 3. "The medication I am taking is very safe and does not cause side effects." 4. "If I'm nauseated and can't take my medicine for a few days, I can do without them."

1. "I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress."

A client with chronic glaucoma is being started on medication therapy with acetazolamide. The nurse teaches the client that which symptoms that can occur early in use subsides or disappears in time? 1. Diuresis 2. Fatigue 3. Headache 4. Loss of libido

1. Diuresis

A client uses the alternative therapy of cascara sagrada known as Californian buckthorn for ongoing management of chronic constipation. The nurse monitors the client's laboratory results for which electrolyte imbalance related to long-term use of this medication? 1. Hypokalemia 2. Hyperkalemia 3. Hyponatremia 4. Hypernatremia

1. Hypokalemia

A client has been given a prescription for trimethoprim (Proloprim). The nurse determines that the client understands how to use the medication properly if the client states an intention to: 1. Restrict fluids while taking the medication. 2. Drink extra fluids while taking the medication. 3. Discontinue the medication once symptoms subside. 4. Call the health care provider if the urine becomes brown.

2. Drink extra fluids while taking the medication.

A client taking theophylline (Theo-24) has a serum theophylline level of 15 mcg/mL. The nurse interprets that this result is: 1. Below the therapeutic range 2. In the middle of the therapeutic range 3. Near the top of the therapeutic range 4. In excess of the therapeutic range

2. In the middle of the therapeutic range

Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication? 1. "I should take the medication with my evening meal." 2. "I should take the medication at noon with an antacid." 3. "I should take the medication in the morning when I first arise." 4. "I should take the medication right before bedtime with a snack."

3. "I should take the medication in the morning when I first arise."

A nurse is caring for a client with myasthenia gravis who has received edrophonium (Enlon) intravenously to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. The nurse's response is based on the understanding that the effects have a duration of approximately: 1. 5 minutes 2. 15 minutes 3. 30 minutes 4. 60 minutes

3. 30 minutes

The nurse is providing education to the client with gestational diabetes who was recently placed on insulin therapy. The nurse tells the client that insulin needs in the second and third trimesters of pregnancy: 1. Increase 2. Decrease 3. Remain unchanged 4. Require both short- and long-term insulin therapy

1. Increase

A child is brought to the emergency department for treatment of an acute asthma attack. The nurse prepares to administer which of the following medications first? 1. Oral corticosteroids 2. A leukotriene modifier 3. A β2 agonist 4. A nonsteroidal anti-inflammatory

3. A β2 agonist

A client is scheduled for an intravenous pyelogram and has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which of the following instructions will the nurse provide to the client? 1. "Take the medication on ice." 2. "Mix the medication with apple juice only." 3. "Mix the medication with a full glass of water." 4. "Drink the medication at room temperature."

1. "Take the medication on ice."

A nurse is assisting in preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate in an extended format by mouth. The nurse suggests including which priority nursing action in the plan of care for this client? 1. Encourage the client to cough and deep breathe. 2. Encourage increased fluids. 3. Monitor the client's temperature. 4. Monitor the urine output.

1. Encourage the client to cough and deep breathe.

A nurse is assisting in caring for a client who is receiving morphine sulfate by continuous intravenous infusion. The nurse ensures that which medication is readily available if a morphine overdose occurs? 1. Nalmefene (Revex) 2. Atropine sulfate (Atropine) 3. Promethazine (Phenergan) 4. Protamine sulfate (Protamine sulfate)

1. Nalmefene (Revex)

A client arrives at the emergency department with an acetaminophen (Tylenol) overdose. Acetylcysteine (Mucomyst) is prescribed to be administered to the client immediately. The nurse prepares to administer the medication by which of the following routes? 1. Orally 2. Nebulizer 3. Intramuscularly 4. Subcutaneously

1. Orally

A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should monitor for which adverse effects of the medication? Select all that apply. 1. Rash 2. Hepatotoxicity 3. Hyperglycemia 4. Peripheral neuropathy 5. Reduced bone mineral density

1. Rash 2. Hepatotoxicity

A nurse is reviewing a health care provider's prescriptions for a client with newly diagnosed, untreated hypothyroidism. Which of the following medications, if prescribed for the client, would the nurse question and verify? 1. Docusate sodium (Colace) 2. Morphine sulfate 3. Levothyroxine (Synthroid) 4. Atenolol (Tenormin)

2. Morphine sulfate

Docetaxel (Taxotere) is prescribed for a client with metastatic breast cancer. In addition, dexamethasone (Decadron) is prescribed to be administered before initiation of the docetaxel. The nurse tells the client that the dexamethasone is prescribed to: 1. Enhance the effects of the docetaxel. 2. Reduce the severity of fluid retention. 3. Prevent thromboembolic disorders. 4. Prevent neutropenia.

2. Reduce the severity of fluid retention.

The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted? 1. Resolved diarrhea 2. Relief of epigastric pain 3. Decreased platelet count 4. Decreased white blood cell count

2. Relief of epigastric pain

A client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution? 1. Let the solution run freely over normal skin tissue. 2. Rinse off immediately following irrigation. 3. Pour onto sterile sponges and pack in the wound. 4. Use each bottle of solution for 1 month before replacing.

2. Rinse off immediately following irrigation.

A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will: 1. Drink at least 2 L of fluid per day. 2. Take the daily dose at bedtime. 3. Avoid changing brands of the medication without health care provider (HCP) approval. 4. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.

2. Take the daily dose at bedtime.

A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

2. The development of audible expiratory wheezes

The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level

2. Uric acid level

A client who will undergo thyroidectomy at a later date has been started on medication therapy with potassium iodide (Lugol solution). As the licensed practical nurse (LPN) prepares to administer a scheduled dose, the client states that there is a burning sensation and a brassy taste in the mouth. The LPN should: 1. Give half the prescribed dose and notify the registered nurse (RN). 2. Withhold the medication and notify the RN. 3. Continue to administer the medication. 4. Stop the medication for 24 hours.

2. Withhold the medication and notify the RN.

Cyclosporine (Sandimmune) is prescribed for a client following an allogenic kidney transplant. The nurse provides instructions to the client regarding the medication and tells the client that: 1. The medication will need to be taken for a period of 6 months. 2. The medication is administered by the intravenous route on a monthly basis. 3. Blood levels of the medication will need to be measured periodically. 4. There are no known adverse effects of the medication.

3. Blood levels of the medication will need to be measured periodically.

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level

3. Liver enzyme levels

Entacapone (Comtan) is prescribed for a client with a diagnosis of Parkinson's disease. The nurse provides medication instructions to the client and tells the client that a frequent side effect is: 1. An elevation in blood pressure 2. Joint pains 3. Urine discoloration to dark yellow or orange 4. Pruritus

3. Urine discoloration to dark yellow or orange

When discussing the rationale for levothyroxine (Synthroid) with a client with hypothyroidism, the nurse should emphasize that the client can anticipate what primary expected outcome? 1. Alleviating depression 2. Increasing energy levels 3. Increasing blood glucose levels 4. Achieving normal thyroid hormone levels

4. Achieving normal thyroid hormone levels

A client recently began medication therapy with propranolol (Inderal-LA). The nurse would be most concerned after noting the presence of which of the following in this client? 1. Blood pressure of 136/84 from 162/90 mm Hg 2. Heart rate of 86 beats per minute decreased to 78 3. Complaints of insomnia 4. Audible expiratory wheezes

4. Audible expiratory wheezes

A client on the nursing unit has a prescription for dextroamphetamine (Dexedrine) orally daily. The nurse collaborates with the dietitian to limit the amount of which of the following items on the client's dietary trays? 1. Fat 2. Protein 3. Starch 4. Caffeine

4. Caffeine

A child is hospitalized with a diagnosis of lead poisoning. The nurse assisting in caring for the child would prepare to assist in administering which of the following medications? 1. Activated charcoal 2. Sodium bicarbonate 3. Syrup of ipecac syrup 4. Dimercaprol (BAL in Oil)

4. Dimercaprol (BAL in Oil)

The nurse should instruct the client taking codeine sulfate to do which of the following? 1. Avoid the use of stool softeners to prevent diarrhea. 2. Avoid exercise to prevent lightheadedness. 3. Maintain a low-fiber diet. 4. Increase fluid intake.

4. Increase fluid intake.

A nurse provides instructions to a pregnant client regarding the administration of iron. The nurse determines that the teaching is effective if the client states that she will take the iron with which of the following food items? 1. Tea 2. Milk 3. Water 4. Tomato juice

4. Tomato juice

The nurse administering medications to a group of clients notes a prescription to give a subcutaneous dose of heparin sodium. The nurse should do which of the following to give this medication safely? 1. Aspirate with the plunger before injecting. 2. Massage the site after injection. 3. Give the injection using a 25- to 27-gauge, ⅝-inch needle. 4. Withdraw medication using a ⅝-inch needle and then change to a 1-inch needle.

3. Give the injection using a 25- to 27-gauge, ⅝-inch needle.

A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question? 1. Cyclobenzaprine (Flexeril) 2. Alendronate (Fosamax) 3. Allopurinol (Zyloprim) 4. Prednisone

4. Prednisone

A female client undergoing chemotherapy with intravenous vincristine sulfate (Oncovin) has been given information about the treatment. The nurse determines that the client has adequate understanding of the side effects of treatment if the client states that her hair: 1. May be lost temporarily but will grow back normally 2. May be lost temporarily but may grow back with a different color and texture 3. Will not be lost with this medication 4. Will permanently be lost with this medication

2. May be lost temporarily but may grow back with a different color and texture

A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication? 1. Nausea 2. Diarrhea 3. Anorexia 4. Cough and chest pain

4. Cough and chest pain

A nurse is collecting data from a client receiving pioglitazone (Actos) 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication? 1. Increased blood pressure and decreased hypoxia 2. Increased urinary output and reduced proteinuria 3. Reduced serum ammonia and improved level of consciousness 4. Decreased fasting blood glucose and reduced hemoglobin A1C (HbA1c)

4. Decreased fasting blood glucose and reduced hemoglobin A1C (HbA1c)

A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs? 1. Vitamin K 2. Atropine sulfate 3. Protamine sulfate 4. Acetylcysteine (Mucomyst)

2. Atropine sulfate

A client admitted to the hospital gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication? 1. Complaints of hunger 2. Complaints of insomnia 3. A pulse rate less than 60 beats per minute 4. Frequent handwashing with hot, soapy water

4. Frequent handwashing with hot, soapy water

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol (Tenormin) for dysrhythmia suppression. The nurse determines that the client needs instruction about this medication if the client states to: 1. Take the dose at the same time each day. 2. Avoid sudden discontinuation of this medication. 3. Take the medication with food if gastrointestinal (GI) upset occurs. 4. Stop taking the prescribed digoxin (Lanoxin) after starting this new medication.

4. Stop taking the prescribed digoxin (Lanoxin) after starting this new medication.