Pharm Questions to study for final (ATI & Evolve Questions)

The client diagnosed with diabetes insipidus is admitted in acute distress. Which interventions should the nurse implement? Select all that apply. 1. Start an IV with lactated Ringer's. 2. Insert an indwelling catheter. 3. Monitor the urine specific gravity. 4. Administer furosemide (Lasix) IVP. 5. Assess the intake and output every shift.

1. Start an IV with lactated Ringer's.

The home health nurse is caring for a client diagnosed with congestive heart failure (CHF) who has been prescribed the cardiac glycoside digoxin (Lanoxin) and the loop diuretic furosemide (Lasix). Which statements by the client indicate the medications are effective? Select all that apply. 1. "I am able to walk next door now without being short of breath." 2. "I keep my feet propped up as much as I can during the day." 3. "I have not gained any weight since my last doctor's visit." 4. "My blood pressure has been within normal limits." 5. "I am staying on my diet, and I don't salt my foods anymore."

1. "I am able to walk next door now without being short of breath." 3. "I have not gained any weight since my last doctor's visit."

The client diagnosed with high blood pressure is ordered the angiotensin-converting enzyme inhibitor captopril (Capoten). Which statements by the client indicate to the nurse the discharge teaching has been effective? Select all that apply. 1. "I should get up slowly when I am getting out of my bed." 2. "I should check and record my blood pressure once a day." 3. "If I get leg cramps, I should increase my potassium supplements." 4. "If I forget to take my medication, I will take two doses the next day." 5. "I can eat anything I want as long as I take my medication every day."

1. "I should get up slowly when I am getting out of my bed." 2. "I should check and record my blood pressure once a day."

The client diagnosed with Addison's disease is being discharged. Which statement indicates the client needs more discharge teaching? 1. "I will be sure to keep my dose of steroid constant and not vary." 2. "I may have to take two forms of steroids to remain healthy." 3. "I will get weak and dizzy if I don't take my medication." 4. "I need to notify any new HCP of the medications I take."

1. "I will be sure to keep my dose of steroid constant and not vary."

The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning the storage of insulin? 1. "I will keep my unopened vials of insulin in the refrigerator." 2. "I can keep my insulin in the trunk of my car so I will have it at all times." 3. "It is all right to put my unopened insulin vials in the freezer." 4. "If I prefill my insulin syringes, I must use them within 1-2 days."

1. "I will keep my unopened vials of insulin in the refrigerator."

The client diagnosed with angina is prescribed nitroglycerin (Nitrobid) and tells the nurse, "I don't understand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurse's best response? 1. "If you take the medications together, you may get very low blood pressure." 2. "You are worried your wife will be concerned if you cannot make love." 3. "If you wait at least 8 hours after taking your nitroglycerin (NTG), you can take your Viagra." 4. "You should get clarification with your HCP about your taking Viagra."

1. "If you take the medications together, you may get very low blood pressure."

The client newly diagnosed with type 1 diabetes asks the nurse, "Why should I get an external portable insulin pump?" Which statement is the nurse's best response? 1. "It will cause you to have fewer hypoglycemic reactions and it will control blood glucose levels better." 2. "Insulin pumps provide an automatic memory of the date and time of the last 24 boluses." 3. "The pump injects intermediate-acting insulin automatically into the vein to maintain a normal blood glucose level." 4. "The portable pump is the easiest way to administer insulin to someone with type 1 diabetes and is highly recommended."

1. "It will cause you to have fewer hypoglycemic reactions and it will control blood glucose levels better."

The nurse determines that the client understands an important principle of chemotherapy when the client makes which statement? 1. "The use of multiple chemotherapy drugs affects different stages of the cancer cell's life cycle." 2. "Staging describes the process of determining how responsive the cancer is to the prescribed chemotherapy." 3. "Antineoplastic drugs kill the entire tumor, including the clones, and prevent repopulation." 4. "Combination chemotherapy requires higher dosages of each individual agent and increases toxicity."

1. "The use of multiple chemotherapy drugs affects different stages of the cancer cell's life cycle."

The client with a seizure disorder who is taking carbamazepine (Tegretol) tells the clinic nurse, "I am taking evening primrose oil for my premenstrual cramps and it is really working." Which statement is the nurse's best response? 1. "You should inform your health-care provider about taking this herb." 2. "It is very dangerous to take both the herb and Tegretol." 3. "Herbs are natural substances and I am glad it is helping your PMS." 4. "Are you sure you should be taking herbs along with Tegretol?"

1. "You should inform your health-care provider about taking this herb."

The client diagnosed with chronic hypertension is prescribed furosemide (Lasix), a loop diuretic, and enalapril (Vasotec), an ACE inhibitor. The client's blood pressures for the last 3 weeks have averaged 178/95, and the HCP has added atenolol (Tenormin), a beta blocker, to the client's current medication regimen. Which statement is the scientific rationale for including this medication in the client's regimen? 1. Achieving a lower average blood pressure will help to prevent a stroke. 2. The other medications are not effective without the addition of atenolol. 3. The atenolol will potentiate the effects of loop diuretics. 4. The HCP will taper off the ACE inhibitor and eventually discontinue it.

1. Achieving a lower average blood pressure will help to prevent a stroke.

The 2-year-old child has just been diagnosed with cystic fibrosis (CF). Which interventions should the nurse discuss with the child's mother? Select all that apply. 1. Administer over-the-counter mucolytic agents. 2. Perform postural drainage and chest percussion. 3. Administer cough suppressants at night only. 4. Check the child's blood glucose level four times a day. 5. Sprinkle pancreatic enzymes on the child's food.

1. Administer over-the-counter mucolytic agents. 2. Perform postural drainage and chest percussion. 5. Sprinkle pancreatic enzymes on the child's food.

The client with coronary artery disease is prescribed cholestyramine, a bile-acid sequestrant. Which intervention should the nurse implement when administering the medication? 1. Administer the medication with fruit juice. 2. Instruct the client to decrease fiber when taking the medication. 3. Monitor the cholesterol level before giving medication. 4. Assess the client for upper-abdominal discomfort.

1. Administer the medication with fruit juice.

The client diagnosed with acute pancreatitis is complaining of severe abdominal pain. Which interventions should the nurse implement? Select all that apply. 1. Ask the client to rate the pain on a 1-10 pain scale. 2. Determine when the client received the last dose of medication. 3. Administer hydrocodone (Vicodin), a narcotic pain medication. 4. Assist the client to a semi-Fowler's position. 5. Apply oxygen at 4 L/minute via nasal cannula.

1. Ask the client to rate the pain on a 1-10 pain scale. 2. Determine when the client received the last dose of medication. 4. Assist the client to a semi-Fowler's position.

Which complication should the nurse assess for in the elderly client newly diagnosed with hypothyroidism who has been prescribed levothyroxine (Synthroid)? 1. Cardiac dysrhythmias. 2. Respiratory depression. 3. Paralytic ileus. 4. Thyroid storm.

1. Cardiac dysrhythmias.

The nurse in the emergency department is preparing to administer the thrombolytic medication alteplase (Activase) to a client whose initial symptoms of a stroke began 2 hours ago. Which interventions should the nurse implement? Select all that apply. 1. Check the client's armband for allergies. 2. Hang the medication via IVPB and infuse over 90 minutes. 3. Check the results of the client's CT scan of the brain. 4. Teach the client this medication dissolves clots. 5. Monitor the client's PTT during drug administration.

1. Check the client's armband for allergies. 2. Hang the medication via IVPB and infuse over 90 minutes. 3. Check the results of the client's CT scan of the brain. 4. Teach the client this medication dissolves clots. 5. Monitor the client's PTT during drug administration.

The nurse is caring for the client diagnosed with type 2 diabetes. The client is complaining of a headache, jitteriness, and nervousness. Which interventions should the nurse implement? Select all that apply. 1. Check the client's serum blood glucose level. 2. Give the client a glass of orange juice. 3. Determine when the last antidiabetic medication was administered. 4. Assess the client's blood pressure and apical pulse. 5. Administer prescribed insulin via sliding scale.

1. Check the client's serum blood glucose level. 2. Give the client a glass of orange juice. 3. Determine when the last antidiabetic medication was administered. 4. Assess the client's blood pressure and apical pulse.

The nurse is preparing to administer an oral medication to a client diagnosed with a stroke. Which interventions should the nurse implement? Select all that apply. 1. Crush all oral medications and place them in pudding. 2. Elevate the head 30 degrees. 3. Ask the client to swallow a drink of water. 4. Have suction equipment at the bedside. 5. Insert a nasogastric tube to administer medications.

1. Crush all oral medications and place them in pudding. 3. Ask the client to swallow a drink of water.

The overweight client diagnosed with type 2 diabetes reports to the clinic nurse that he has lost 35 pounds in the past 4 months. Which intervention should the nurse implement first? 1. Determine if the client has had an increase in hypoglycemic reactions. 2. Instruct the client to make an appointment with the health-care provider. 3. Ask the client if he has been trying to lose weight or has it happened naturally. 4. Check the client's last weight in the chart with the weight obtained in the clinic.

1. Determine if the client has had an increase in hypoglycemic reactions.

Which discharge instructions should the emergency room nurse discuss with the client who has sustained a concussion? Select all that apply. 1. Do not drink any type of alcoholic beverage until allowed by HCP. 2. Take two acetaminophen (Tylenol) up to every 6 hours for a headache. 3. If experiencing a headache, take one hydrocodone (Vicodin) every 8 hours. 4. It is all right to take a couple of aspirin if experiencing a headache. 5. Notify the health-care provider if medication does not relieve headache.

1. Do not drink any type of alcoholic beverage until allowed by HCP. 2. Take two acetaminophen (Tylenol) up to every 6 hours for a headache. 5. Notify the health-care provider if medication does not relieve headache.

The client with type 1 diabetes is diagnosed with diabetic ketoacidosis. The HCP prescribes intravenous regular insulin by continuous infusion. Which intervention should the intensive care nurse implement when administering this medication? 1. Flush the tubing with 50 mL of the insulin drip before administering to the client. 2. Monitor the client's serum glucose level every hour and document it on the MAR. 3. Draw the client's arterial blood gas results daily and document them in the client's chart. 4. Administer the client's regular insulin drip via gravity at the prescribed rate.

1. Flush the tubing with 50 mL of the insulin drip before administering to the client.

The client with Addison's disease is prescribed prednisone. Which laboratory data should the nurse expect this medication to alter? 1. Glucose. 2. Sodium. 3. Calcium. 4. Creatinine.

1. Glucose.

Which medication should the nurse question administering to a client diagnosed with stage C congestive heart failure (CHF)? 1. Ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug (NSAID). 2. Amlodipine (Norvasc), a calcium channel blocker. 3. Spironolactone (Aldactone), a potassium-sparing diuretic. 4. Atenolol (Tenormin), a beta blocker.

1. Ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug (NSAID).

The client is complaining of severe chest pain radiating down the left arm and is nauseated and diaphoretic. The HCP suspects the client is having a myocardial infarction (MI) and has ordered morphine sulfate (MS), a narcotic analgesic, for the pain. Which interventions should the nurse implement? Select all that apply. 1. Instruct the client not to get up out of the bed without notifying the nurse. 2. Administer the morphine sulfate (MS) intramuscularly in the ventral gluteal muscle. 3. Dilute the morphine sulfate (MS) to a 10-mL bolus with normal saline. 4. Administer the morphine sulfate (MS) slowly over 5 minutes. 5. Question the order because morphine sulfate (MS) should not be administered to a client with a myocardial infarction (MI).

1. Instruct the client not to get up out of the bed without notifying the nurse. 3. Dilute the morphine sulfate (MS) to a 10-mL bolus with normal saline. 4. Administer the morphine sulfate (MS) slowly over 5 minutes.

The nurse is discussing the oral hypoglycemic medication Micronase with the client diagnosed with type 2 diabetes. Which information should the nurse discuss with the client? 1. Instruct the client to take the oral hypoglycemic medication with food. 2. Explain that hypoglycemia will not occur with oral medications. 3. Tell the client to notify the HCP if a headache, nervousness, or sweating occurs. 4. Recommend the client check the ketones in the urine every morning.

1. Instruct the client to take the oral hypoglycemic medication with food.

The client diagnosed with acute pancreatitis is placed on total parenteral nutrition (TPN). Which interventions should the nurse implement? Select all that apply. 1. Monitor blood glucose levels every 6 hours. 2. Assess the peripheral intravenous site. 3. Check the client's complete blood count. 4. Check the TPN bag with the client's MAR. 5. Change the tubing with every new bag of TPN.

1. Monitor blood glucose levels every 6 hours. 4. Check the TPN bag with the client's MAR. 5. Change the tubing with every new bag of TPN.

The client diagnosed with hyperthyroidism is prescribed an antithyroid medication. Which interventions should the nurse implement? Select all that apply. 1. Monitor the client's thyroid function tests. 2. Monitor the client's weight weekly. 3. Monitor the client for gastrointestinal distress. 4. Monitor the client's vital signs. 5. Monitor the client for activity intolerance.

1. Monitor the client's thyroid function tests. 2. Monitor the client's weight weekly. 3. Monitor the client for gastrointestinal distress. 4. Monitor the client's vital signs. 5. Monitor the client for activity intolerance.

The nurse is administering medications. Which medication should the nurse question administering? 1. Morphine sulfate, an opioid, to a client diagnosed with pancreatitis. 2. Diphenhydramine (Benadryl), an H1 blocker, to a client with an allergic reaction. 3. Methylprednisolone (Solu-Medrol), a glucocorticoid, to a client with type 2 diabetes. 4. Vasopressin (DDAVP), a hormone, to a client diagnosed with diabetes insipidus.

1. Morphine sulfate, an opioid, to a client diagnosed with pancreatitis.

The client with a head injury is admitted into the intensive care unit (ICU). Which health-care provider medication order should the ICU nurse question? Select all that apply. 1. Morphine, a narcotic analgesic. 2. Osmitrol (mannitol), an osmotic diuretic. 3. Methylprednisolone (Solu-Medrol), a corticosteroid. 4. Phenytoin (Dilantin), an anticonvulsant. 5. Oxygen, 6 L via nasal cannula.

1. Morphine, a narcotic analgesic. 3. Methylprednisolone (Solu-Medrol), a corticosteroid.

A client has been receiving vincristine (Oncovin) as one of the drugs in a chemotherapy regimen. What important findings will the nurse monitor to prevent or limit the main dose-related toxicity for this client? Select all that apply. 1. Numbness of the hands or feet 2. Angina and dysrhythmias 3. Constipation 4. Diminished reflexes 5. Dyspnea and pleuritis

1. Numbness of the hands or feet 3. Constipation 4. Diminished reflexes

The long-term-care facility nurse is caring for a client diagnosed with a cerebrovas- cular accident (CVA) 6 months ago who has residual cognitive deficits. The HCP has ordered alprazolam (Xanax), an antianxiety medication, to be administered at bedtime. Which interventions should the nurse initiate for this client? Select all that apply. 1. Offer toileting every 2 hours. 2. Move the client close to the nurse's station. 3. Administer the medication at 2100. 4. Administer the medication with a full glass of water. 5. Do not administer if the client's apical pulse is less than 60.

1. Offer toileting every 2 hours. 2. Move the client close to the nurse's station. 3. Administer the medication at 2100.

The HCP ordered furosemide (Lasix) for a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory test would be monitored to determine the effectiveness of the medication? 1. Serum sodium levels. 2. Serum potassium levels. 3. Creatinine levels. 4. Serum ACTH levels.

1. Serum sodium levels.

The client diagnosed with Cushing's disease is prescribed alendronate (Fosamax), a biphosphonate regulator, to prevent osteoporosis. Which information should the clinic nurse teach? Select all that apply. 1. Take the medication and sit upright for 30 minutes. 2. Take the medication just before going to bed. 3. Take the medication with an antacid to alleviate gastric disturbances. 4. Take the medication at least 30 minutes before breakfast. 5. Take the medication with a full glass of water.

1. Take the medication and sit upright for 30 minutes. 4. Take the medication at least 30 minutes before breakfast. 5. Take the medication with a full glass of water.

The client is prescribed prednisone, a glucocorticoid, for poison ivy. Which information should the nurse discuss with the client? Select all that apply. 1. Take the medication with food. 2. The medication must be tapered. 3. Avoid going into the sunlight. 4. Monitor the blood glucose level. 5. Do not eat green, leafy vegetables.

1. Take the medication with food. 2. The medication must be tapered.

The nurse is administering 0900 medications to the following clients. Which client should the nurse question administering the medication? 1. The client receiving a calcium channel blocker who drank a glass of grapefruit juice. 2. The client receiving a beta blocker who has an apical pulse of 62 beats per minute. 3. The client receiving a nitroglycerin patch who has a blood pressure of 148/92. 4. The client receiving an antiplatelet medication who has a platelet count of 150,000.

1. The client receiving a calcium channel blocker who drank a glass of grapefruit juice.

The male client diagnosed with pancreatitis is prescribed octreotide (Sandostatin), a hormone. Which data indicates the medication has been effective? 1. The client reports that the diarrhea has subsided. 2. The client states that he has grown 1 inch. 3. The client has no muscle cramping or pain. 4. The client has no complaints of heartburn.

1. The client reports that the diarrhea has subsided.

The client diagnosed with arterial hypertension is receiving furosemide (Lasix), a loop diuretic. Which data indicates the medication is effective? 1. The client's 8-hour intake is 1800 mL and the output is 2300 mL. 2. The client's blood pressure went from 144/88 to 154/96. 3. The client has had a weight loss of 1.3 kg in 7 days. 4. The client reports occasional light-headedness and dizziness.

1. The client's 8-hour intake is 1800 mL and the output is 2300 mL.

The client is diagnosed with hypothyroidism and is taking the thyroid hormone levothyroxine (Synthroid). Which data indicates the medication is effective? 1. The client's apical pulse is 84 and the blood pressure is 134/78. 2. The client's temperature is 96.7°F and respiratory rate is 14. 3. The client reports having a soft, formed stool every 4 days. 4. The client tells the nurse that the client only needs 3 hours of sleep.

1. The client's apical pulse is 84 and the blood pressure is 134/78.

The client is diagnosed with primary hyperaldosteronism and prescribed the aldosterone agonist spironolactone (Aldactone). Which data supports that the medication is effective? 1. The client's potassium level is 4.2 mEq/L. 2. The client's urinary output is 30 mL/hr. 3. The client's blood pressure is 140/96. 4. The client's serum sodium is 137 mEq/L.

1. The client's potassium level is 4.2 mEq/L.

The client newly diagnosed with epilepsy is prescribed an anticonvulsant medication. Which information should the nurse tell the client? 1. The medication dosage will start low and gradually increase over a few weeks. 2. The dosage prescribed initially will be the dosage prescribed for the rest of your life. 3. The health-care provider will prescribe a loading dose and decrease dosage gradually. 4. The dose of medication will be adjusted monthly until a serum drug level is obtained.

1. The medication dosage will start low and gradually increase over a few weeks.

The client with increased intracranial pressure is receiving the osmotic diuretic mannitol (Osmitrol). Which data would cause the nurse to hold the administration of this medication? 1. The serum osmolality is 330 mOsm/kg. 2. The urine osmolality is 550 mOsm/kg. 3. The BUN level is 8 mg/dL. 4. The creatinine level is 1.8 mg/dL.

1. The serum osmolality is 330 mOsm/kg.

The health-care provider prescribed a beta blocker for the client diagnosed with arterial hypertension. Which statement is the scientific rationale for administering this medication? 1. This medication decreases the sympathetic stimulation to the heart, thereby decreasing the client's heart rate and blood pressure. 2. This medication prevents the calcium from entering the cell, which helps decrease the client's blood pressure. 3. This medication prevents the release of aldosterone, which decreases absorption of sodium and water, which, in turn, decreases blood pressure. 4. This medication will cause an increased excretion of water from the vascular system, which will decrease the blood pressure.

1. This medication decreases the sympathetic stimulation to the heart, thereby decreasing the client's heart rate and blood pressure.

A nurse is caring for a client who receives a local anesthetic of lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client? A. Seizures B. Tachycardia C. Hypertension D. Fever

A. Seizure activity is an adverse effect that may occur as a result of local anesthetic injection.

The nurse is giving an intravenous dose of levothyroxine (Synthroid). The order reads: "Give 0.1 mg IV push now." What is the ordered dose in micrograms?

100 mcg

The female client diagnosed with epilepsy tells the nurse, "I am very scared to get pregnant since I am taking medication for my epilepsy." Which statement is the nurse's best response? 1. "You are scared because you take medication for your epilepsy." 2. "Can you tell me more about what is concerning you?" 3. "You should not get pregnant when you are taking anticonvulsants." 4. "Have you discussed your concerns with your health-care provider?"

2. "Can you tell me more about what is concerning you?"

The client with a head injury is ordered a CT scan of the head with contrast dye. Which statements by the client warrant immediate intervention? Select all that apply. 1. "I take Tenormin for my high blood pressure." 2. "I am allergic to many types of fish." 3. "I get nauseated whenever I take aspirin." 4. "I am taking Glucophage for my diabetes." 5. "I had about three beers before I fell and hit my head."

2. "I am allergic to many types of fish." 4. "I am taking Glucophage for my diabetes."

The client diagnosed with hyperthyroidism is prescribed the antithyroid medication propylthiouracil (PTU). Which statement by the client warrants immediate intervention by the nurse? 1. "I seem to be drowsy and sleepy all the time." 2. "I have a sore throat and have had a fever." 3. "I have gained 2 pounds since I started taking PTU." 4. "Since taking PTU I am not as hot as I used to be."

2. "I have a sore throat and have had a fever."

The client diagnosed with congestive heart failure (CHF) is prescribed the angiotensin- converting enzyme (ACE) inhibitor enalapril (Vasotec). Which statement explains scientific rationale for administering this medication? 1. ACE inhibitors increase the levels of angiotensin II in the blood vessels. 2. ACE inhibitors dilate arteries, which reduces the workload of the heart. 3. ACE inhibitors decrease the effects of bradykinin in the body. 4. ACE inhibitors block the intervention of antidiuretic hormone in the kidney.

2. ACE inhibitors dilate arteries, which reduces the workload of the heart.

The nurse is administering digoxin (Lanoxin), a cardiac glycoside, to a client diagnosed with congestive heart failure (CHF). Which interventions should the nurse implement? Select all that apply. 1. Assess the client's carotid pulse for 1 full minute. 2. Check the client's current potassium level. 3. Ask the client if he or she is seeing a yellow haze around objects. 4. Have the client squeeze the nurse's fingers. 5. Teach the client to get up slowly from a sitting position.

2. Check the client's current potassium level. 3. Ask the client if he or she is seeing a yellow haze around objects.

The nurse is administering morning medications. Which medication should the nurse question? 1. Black cohosh, an herb, to a client with dysmenorrhea and cramping. 2. Desmopressin (DDAVP), to a client with diabetes insipidus and angina. 3. Hydrochlorothiazide (Diuril), to a client with SIADH from a head injury. 4. Calcitonin (Cibacalcin), a hormone, to a client with hypercalcemia from lung cancer.

2. Desmopressin (DDAVP), to a client with diabetes insipidus and angina.

Which medication should the nurse administer to the client diagnosed with nephrogenic diabetes insipidus? 1. Clofibrate (Atromid-S), an antilipemic. 2. Ibuprofen (Motrin), a prostaglandin inhibitor. 3. Furosemide (Lasix), a loop diuretic. 4. Desmopressin (DDAVP), a pituitary hormone.

2. Ibuprofen (Motrin), a prostaglandin inhibitor.

The male client diagnosed with iatrogenic Cushing's disease calls the clinic nurse and informs the nurse he has a temperature of 100.1°F. Which intervention should the nurse implement? 1. Tell the client to take acetaminophen and drink liquids. 2. Instruct the client to come to the clinic for an antibiotic. 3. Have the client go to the nearest emergency department. 4. Encourage the client to discuss his feelings about the disease.

2. Instruct the client to come to the clinic for an antibiotic.

The nurse is discussing the thiazide diuretic chlorothiazide (Diuril) with the client diagnosed with essential hypertension. Which discharge instruction should the nurse discuss with the client? 1. Encourage the intake of sodium-rich foods. 2. Instruct the client to drink adequate fluids. 3. Teach the client to keep strict intake and output. 4. Explain taking the medication at night only.

2. Instruct the client to drink adequate fluids.

The female client has secondary adrenal insufficiency and is prescribed adrenocorticotrophic hormone ACTH (Acthar). Which information should the nurse discuss with client? 1. Explain ACTH will increase metabolism. 2. Instruct the client to limit dietary salt. 3. Inform the client that an increase in growth may occur. 4. Tell the client that normal menses is expected.

2. Instruct the client to limit dietary salt.

The HCP prescribed chlordiazepoxide (Librium), a sedative hypnotic, for a 55-year-old male client diagnosed with chronic pancreatitis. Which statement is the scientific rationale for prescribing this medication? 1. Librium acts as an adjunct to pain medication. 2. Librium limits complications related to alcohol withdrawal. 3. Librium prevents the nausea related to pancreatitis. 4. Librium is used as a sleep aid for clients who are NPO.

2. Librium limits complications related to alcohol withdrawal.

The nurse is evaluating the client who is receiving chemotherapy to determine the risk for infection. Which laboratory values would prompt the nurse to implement protective isolation measures for this client? 1. High uric acid level 2. Low neutrophil count 3. High red blood cell count 4. Low platelet count

2. Low neutrophil count

The client has developed severe diarrhea following 4 days of self-administered antacid preparation. The nurse suspects that the diarrhea may be caused by which type of antacid? 1. Aluminum compounds 2. Magnesium compounds 3. Calcium compounds 4. Sodium compounds

2. Magnesium compounds

The HCP prescribed an angiotensin-converting enzyme (ACE) inhibitor for a client diagnosed with congestive heart failure (CHF). Which instruction should the nurse provide? 1. Eat a banana or drink orange juice at least twice a day. 2. Notify the HCP if you develop localized edematous areas that itch. 3. A dry cough is expected early in the morning on arising. 4. The symptoms of CHF should improve rapidly.

2. Notify the HCP if you develop localized edematous areas that itch.

The client diagnosed with Addison's disease tells the clinic nurse that he is taking licorice every day to help the disease process. Which intervention should the nurse implement? 1. Tell the client licorice is a candy and will not help Addison's disease. 2. Praise the client because licorice increases aldosterone production. 3. Ask the client why he thinks licorice will help the disease process. 4. Determine if the licorice has caused any mouth ulcers or sores.

2. Praise the client because licorice increases aldosterone production.

The client diagnosed with type 1 diabetes is complaining of a dry mouth, extreme thirst, and increased urination. Which interventions should the nurse implement? Select all that apply. 1. Administer one amp of intravenous 50% glucose. 2. Prepare to administer intravenous regular insulin. 3. Inject Humulin N subcutaneously in the abdomen. 4. Hang an intravenous infusion of D5W at a keep open rate. 5. Check the client's blood glucose level via a glucometer.

2. Prepare to administer intravenous regular insulin. 5. Check the client's blood glucose level via a glucometer.

The client is scheduled for a bilateral adrenalectomy for Cushing's disease. Which information regarding the prescribed glucocorticoid prednisone (Deltasone) should the nurse teach? Select all that apply. 1. When discontinuing this medication, it must be tapered. 2. Take the medication regularly; do not skip doses. 3. Stop taking the medication if you develop a round face. 4. Notify the HCP if you start feeling thirsty all the time. 5. Wear a MedicAlert bracelet in case of an emergency.

2. Take the medication regularly; do not skip doses. 4. Notify the HCP if you start feeling thirsty all the time. 5. Wear a MedicAlert bracelet in case of an emergency.

Which intervention should be implemented when discharging a client diagnosed with chronic pancreatitis who has been receiving high doses of meperidine (Demerol), an opioid, for the past 4 weeks? 1. Tell the client to monitor his or her stools and to avoid constipation. 2. Taper the medication slowly over several days prior to discharge. 3. Refer the client to a drug withdrawal clinic to stop taking the Demerol. 4. Discuss signs and symptoms of drug dependence to report to the HCP.

2. Taper the medication slowly over several days prior to discharge.

The client diagnosed with hypothyroidism is prescribed levothyroxine (Synthroid). Which assessment data supports the client needs to take more medication? Select all that apply. 1. The client has a 2-kg weight loss. 2. The client complains of being too cold. 3. The client has exophthalmos. 4. The client's radial pulse rate is 90 bpm. 5. The client complains of being constipated.

2. The client complains of being too cold. 5. The client complains of being constipated.

The client has developed Cushing's syndrome as a result of long-term steroid therapy. Which assessment findings support this condition? 1. The client is short of breath on exertion and has pale mucous membranes. 2. The client has a round face and multiple ecchymotic areas on the arms. 3. The client has pink, frothy sputum and jugular vein distention. 4. The client has petechiae on the trunk and sclerosed veins.

2. The client has a round face and multiple ecchymotic areas on the arms.

The client diagnosed with a myocardial infarction is receiving thrombolytic therapy. Which data warrants immediate intervention by the nurse? 1. The client's telemetry has reperfusion dysrhythmias. 2. The client is oozing blood from the intravenous site. 3. The client is alert and oriented to date, time, and place. 4. The client has no signs of infiltration at the insertion site.

2. The client is oozing blood from the intravenous site.

The client on strict bed rest is prescribed subcutaneous heparin. Which data indicates the medication is effective? 1. The client's current PT is 22, the INR is 2.4, and the PTT is 70. 2. The client's calves are normal size, are normal skin color, and are nontender. 3. The client performs active range-of-motion exercises every 4 hours. 4. The client's varicose veins have reduced in size and appearance.

2. The client's calves are normal size, are normal skin color, and are nontender.

Which data indicates to the nurse that simvastatin (Zocor), an HMG-CoA reductase inhibitor, is effective? 1. The client's blood pressure is 132/80. 2. The client's cholesterol level is 180 mg/dL. 3. The client's LDL is 180 mg/dL. 4. The client's HDL is 35 mg/dL.

2. The client's cholesterol level is 180 mg/dL.

The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG), a coronary vasodilator. Which statement indicates the client needs more medication teaching? 1. "I will always carry my nitroglycerin in a dark-colored bottle." 2. "If I have chest pain, I will put a tablet underneath my tongue." 3. "If my pain is not relieved with one tablet, I will get medical help." 4. "I should expect to get a headache after taking my nitroglycerin."

3. "If my pain is not relieved with one tablet, I will get medical help."

The client diagnosed with a pituitary tumor has the pituitary hormone vasopressin (DDAVP) ordered. Which statement by the client indicates the medication is effective? 1. "My headaches are much better since I have been on this medication." 2. "My nasal drainage was initially worse, but now I don't have any." 3. "I am not so thirsty when I take this medication." 4. "My seizures have been eliminated."

3. "I am not so thirsty when I take this medication."

The client diagnosed with type 2 diabetes is prescribed the sulfonylurea glipizide (Glucotrol). Which statement by the client warrants intervention by the nurse? 1. "I have to eat my diabetic diet even if I am taking this medication." 2. "I will need to check my blood glucose level at least once a day." 3. "I usually have one glass of wine with my evening meal." 4. "I do not like to walk every day, but I will if it will help my diabetes."

3. "I usually have one glass of wine with my evening meal."

The nurse is discharging the female client diagnosed with deep vein thrombosis (DVT) who is prescribed the anticoagulant warfarin (Coumadin). Which statement indicates the client needs more teaching concerning this medication? 1. "I should wear a MedicAlert bracelet in case of an emergency." . "If I get cut, I will apply pressure for at least 5 minutes." 3. "I will increase the amount of green, leafy vegetables I eat." 4. "I will have to see my HCP regularly while taking this medication."

3. "I will increase the amount of green, leafy vegetables I eat."

The client diagnosed with hyperthyroidism undergoes a bilateral thyroidectomy. Which statements indicate the client understands the discharge instructions? Select all that apply. 1. "I must take my PTU medication at night only." 2. "I should not take my medication if I am nauseated." 3. "I will take my thyroid hormone pill every day." 4. "I need to check my thyroid level frequently." 5. "If I have diarrhea I should contact my doctor."

3. "I will take my thyroid hormone pill every day." 4. "I need to check my thyroid level frequently." 5. "If I have diarrhea I should contact my doctor."

The male client diagnosed with essential hypertension tells the nurse, "I am not able to make love to my wife since I started my blood pressure medications." Which statement by the nurse is most appropriate? 1. "You are concerned that you cannot make love to your wife." 2. "I will refer you to a psychologist so that you can talk about it." 3. "You need to discuss this with your health-care provider." 4. "Ask your wife to come in and we can discuss it together."

3. "You need to discuss this with your health-care provider."

The nurse is scheduling the client's daily medication. When would be the most appropriate time for the client to receive proton pump inhibitors? 1. At night 2. After fasting at least 2 hours 3. About 1/2 hour before a meal 4. About 2 to 3 hours after eating

3. About 1/2 hour before a meal

The client diagnosed with neurogenic diabetes insipidus is prescribed vasopressin tannate in oil. Which instructions should the nurse teach? 1. Sleep with the head of the bed elevated. 2. Use a tuberculin syringe to administer medication. 3. Administer the medication in the evening. 4. Alternate nares when taking the medication.

3. Administer the medication in the evening.

The nurse who is caring for a client with gastroesophageal reflux disease should question the order for which drug? 1. H2-receptor antagonists 2. Proton pump inhibitors 3. Antibiotics 4. Antacids

3. Antibiotics

The nurse is administering pancreatic secretin, a stimulatory hormone, to a client to rule out chronic pancreatitis. Which procedure should the nurse follow? 1. Have the client lie on the right side during the administration of the medication. 2. Make sure the client has signed a permit for an investigational procedure. 3. Aspirate gastric and duodenal contents before and after the medication. 4. Place the client in the Trendelenburg position before beginning the medication.

3. Aspirate gastric and duodenal contents before and after the medication.

The client with increased intracranial pressure is receiving the osmotic diuretic mannitol (Osmitrol). Which intervention should the nurse implement to evaluate the effectiveness of the medication? 1. Monitor the client's vital signs. 2. Maintain strict intake and output. 3. Assess the client's neurological status. 4. Check the client's serum osmolality level.

3. Assess the client's neurological status.

The nurse is preparing to administer nitroglycerin, a coronary vasodilator transdermal patch, to the client diagnosed with a myocardial infarction. Which intervention should the nurse implement? 1. Question applying the patch if the client's BP is less than 110/70. 2. Use nonsterile gloves when applying the transdermal patch. 3. Date and time the transdermal patch prior to applying to client's skin. 4. Place the transdermal patch on the site where the old patch was removed.

3. Date and time the transdermal patch prior to applying to client's skin.

The client being discharged after sustaining an acute myocardial infarction is prescribed the ACE inhibitor lisinopril (Zestril). Which instruction should the nurse include when teaching about this medication? 1. Instruct the client to monitor the blood pressure weekly. 2. Encourage the client to take medication on an empty stomach. 3. Discuss the need to rise slowly from lying to a standing position. 4. Teach the client to take the medication at night only.

3. Discuss the need to rise slowly from lying to a standing position.

The client with Type 1 diabetes is scheduled for a CT scan of the abdomen with contrast. The client is taking metformin (Glucophage), a biguanide, and 70/30 insulin 24 units at 0700 and 1600. Which instruction should the nurse discuss with the client? 1. Administer the 70/30 insulin the morning of the test. 2. Take half the dose of the morning insulin on the day of the test. 3. Do not take the Glucophage after the procedure until the HCP approves. 4. Take the medications as prescribed because they will not affect the test.

3. Do not take the Glucophage after the procedure until the HCP approves.

The client diagnosed with chronic pancreatitis has a nasogastric tube. The charge nurse observes the primary nurse instill an antacid down the tube and then clamp the tube. Which action should the charge nurse take? 1. Tell the nurse to reconnect the tube to suction. 2. Notify the unit manager of the nurse's actions. 3. Do nothing because this is the correct procedure. 4. Instruct the nurse to administer the medication orally.

3. Do nothing because this is the correct procedure.

The client diagnosed with stage D congestive heart failure (CHF) has a brain natri uretic peptide (BNP) level greater than 1500. Which medication should the nurse anticipate the HCP prescribing? 1. Captopril (Capoten), an angiotensin-converting enzyme inhibitor, orally. 2. Digoxin (Lanoxin), a cardiac glycoside, IVP. 3. Dobutamine (Dobutrex), a synthetic catecholamine, IV. 4. Metoprolol (Lopressor), a beta blocker, orally.

3. Dobutamine (Dobutrex), a synthetic catecholamine, IV.

The client has petechiae on the anterior lateral upper-abdominal wall. The medication administration record (MAR) indicates the client is receiving a daily baby aspirin, an intravenous narcotic, and a low-molecular-weight heparin. Which intervention should the nurse implement? 1. Request an order to discontinue the 81-mg aspirin. 2. Assess the client's pain level on a 1-10 scale. 3. Document the finding and take no intervention. 4. Put cool compresses on the abdominal wall.

3. Document the finding and take no intervention.

Chemotherapy is being initiated for a client with prostate cancer who is experiencing mucositis. Which of the following health teaching would be most appropriate for this drug? 1. Use an over-the-counter mouthwash to eliminate bacteria. 2. Increase intake of citrus-containing foods and beverages. 3. Eat a bland diet and use a soft toothbrush for oral care. 4. This adverse effect is expected and will disappear within a few days.

3. Eat a bland diet and use a soft toothbrush for oral care.

The nurse is providing discharge instructions for a client prescribed the thiazide diuretic hydrochlorothiazide (Diuril). Which instruction should the nurse include? 1. Drink at least 8-10 glasses of water a day. 2. Weigh monthly and report the weight to the HCP. 3. Eat bananas or oranges regularly. 4. Try to sleep in an upright position.

3. Eat bananas or oranges regularly.

The client with hyperthyroidism is prescribed the thioamide propylthiouracil (PTU). Which laboratory data should the nurse monitor? 1. The client's arterial blood gases. 2. The client's serum potassium level. 3. The client's red blood cell (RBC) count. 4. The client's white blood cell (WBC) count.

4. The client's white blood cell (WBC) count.

The client diagnosed with pancreatitis is complaining of polydipsia and polyuria. Which medication should the nurse prepare to administer? 1. Humalog, a fast-acting insulin intravenously, and then monitor glucose levels. 2. Pancrelipase (Cotazym) sprinkled on the client's food with meals. 3. Humulin R subcutaneously after assessing the blood glucose level. 4. Ranitidine (Zantac), a histamine2 receptor blocker, orally.

3. Humulin R subcutaneously after assessing the blood glucose level.

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching? 1. Discuss the importance of not using iodized salt. 2. Explain the importance of not taking medication with grapefruit juice. 3. Instruct the client to take the medication in the morning. 4. Teach the client to monitor daily glucose levels.

3. Instruct the client to take the medication in the morning.

A client receiving carboplatin (Paraplatin) is also receiving filgrastim (Neupogen). The nurse will explain to the client that the filgrastim is used for what effect? 1. It boosts the effects of the carboplatin so a decreased dosage is needed. 2. It prevents the development of secondary cancers related to the carboplatin. 3. It shortens the duration of neutropenia and associated infection risk related to the carboplatin. 4. It prevents bone loss and osteoporosis.

3. It shortens the duration of neutropenia and associated infection risk related to the carboplatin.

Which data should the nurse assess for the client with a seizure disorder who is taking valproate (Depakote)? 1. Creatinine and BUN. 2. White blood cell count. 3. Liver enzymes. 4. Red blood cell count.

3. Liver enzymes.

The nurse is preparing to administer the following anticonvulsant medications. Which medication should the nurse question administering? 1. Carbamazepine (Tegretol) to the client who has a Tegretol serum level of 8 μg/mL. 2. Clonazepam (Klonopin) to the client who has a Klonopin serum level of 60 ng/mL. 3. Phenytoin (Dilantin) to the client who has a Dilantin serum level of 26 μg/mL. 4. Ethosuximide (Zarontin) to the client who has a Zarontin serum level of 45 μg/mL.

3. Phenytoin (Dilantin) to the client who has a Dilantin serum level of 26 μg/mL.

The client diagnosed with diabetes insipidus is prescribed desmopressin (DDAVP). Which comorbid condition warrants a change in medication? 1. Renal calculi. 2. Diabetes mellitus type 2. 3. Sinusitis. 4. Hyperthyroidism.

3. Sinusitis.

The emergency department nurse is caring for a client in an addisonian crisis. Which intervention should the nurse implement first? 1. Draw serum electrolyte levels. 2. Administer methylprednisolone (Solu-Medrol) IV. 3. Start an 18-gauge catheter with normal saline. 4. Ask the client what medications he or she is taking.

3. Start an 18-gauge catheter with normal saline.

The following clients have a head injury. Which clients should the nurse question administering the osmotic diuretic mannitol (Osmitrol)? Select all that apply. 1. The 34-year-old client who is HIV-positive. 2. The 84-year-old client who has glaucoma. 3. The 68-year-old client who has cor pulmonale. 4. The 16-year-old client who has cystic fibrosis. 5. The 58-year-old with congestive heart failure.

3. The 68-year-old client who has cor pulmonale. 5. The 58-year-old with congestive heart failure.

The nurse is preparing to administer medications to the following clients. Which medication should the nurse question administering? 1. The loop diuretic furosemide (Lasix) to a client with a serum potassium level of 4.2 mEq/L. 2. The osmotic diuretic mannitol (Osmitrol) to a client with a serum osmolality of 280 mOsm/kg. 3. The cardiac glycoside digoxin (Lanoxin) to a client with a digoxin level of 2.4 mg/dL. 4. The anticonvulsant phenytoin (Dilantin) to a client with a Dilantin level of 14 μg/mL.

3. The cardiac glycoside digoxin (Lanoxin) to a client with a digoxin level of 2.4 mg/dL.

The nurse in the HCP's office is completing an assessment on a client who has been prescribed the cardiac glycoside digoxin (Lanoxin) for congestive heart failure (CHF). Which data indicates the medication has been effective? 1. The client's sputum is pink and frothy. 2. The client has 2+ pitting edema of the sacrum. 3. The client has clear breath sounds bilaterally. 4. The client's heart rate is 78 beats per minute.

3. The client has clear breath sounds bilaterally.

The client diagnosed with diabetes insipidus (DI) is receiving desmopressin (DDAVP), a pituitary hormone, intranasally. Which assessment data warrants the client notifying the health-care provider? Select all that apply. 1. The client does not feel thirsty all the time. 2. The client is able to sleep throughout the night. 3. The client has gained 2 kg in the past 24 hours. 4. The client has to urinate 20-30 times daily. 5. The client has elastic skin turgor and moist mucosa.

3. The client has gained 2 kg in the past 24 hours. 4. The client has to urinate 20-30 times daily.

Which assessment data best indicates the client with type 1 diabetes is adhering to the medical treatment regimen? 1. The client's fasting blood glucose is 100 mg/dL. 2. The client's urine specimen has no ketones. 3. The client's glycosylated hemoglobin is 5.8%. 4. The client's glucometer reading is 120 mg/dL.

3. The client's glycosylated hemoglobin is 5.8%.

The client diagnosed with type 2 diabetes is receiving the combination oral antidiabetic medication glyburide/metformin (Glucovance). Which data indicates the medication is effective? 1. The client's skin turgor is elastic. 2. The client's urine ketones are negative. 3. The serum blood glucose level is 118 mg/dL. 4. The client's glucometer level is 170 mg/dL.

3. The serum blood glucose level is 118 mg/dL.

The school nurse is teaching a class about type 2 diabetes in children to elementary school teachers. Which information is most important for the nurse to discuss with the teachers? 1. The importance of not allowing students to eat candy in the classroom. 2. The increase in the number of students developing type 2 diabetes. 3. The signs and symptoms of hypoglycemia and the immediate treatment. 4. The need to have the students run or walk for 20 minutes during the recess period.

3. The signs and symptoms of hypoglycemia and the immediate treatment.

Which statement best describes the scientific rationale for prescribing the biguanide metformin (Glucophage)? 1. This medication decreases insulin resistance, improving blood glucose control. 2. This medication allows the carbohydrates to pass slowly through the large intestine. 3. This medication will decrease the hepatic production of glucose from stored glycogen. 4. This medication stimulates the beta cells to release more insulin into the bloodstream.

3. This medication will decrease the hepatic production of glucose from stored glycogen.

The client diagnosed with coronary artery disease is instructed to take 81 mg of aspirin ("baby aspirin," "children's aspirin" or "adult low-dose aspirin") daily. Which statement best describes the scientific rationale for prescribing this medication? 1. This medication will help thin the client's blood. 2. Daily aspirin will decrease the incidence of angina. 3. This medication will prevent platelet aggregation. 4. Baby aspirin will not cause gastric distress.

3. This medication will prevent platelet aggregation.

A client with acute lymphoblastic leukemia has started therapy with doxorubicin (Adriamycin). The nurse will assist the client with what important intervention during the course of this treatment? 1. Perform active or assisted range-of-motion (ROM) exercises to maintain strength. 2. Participate in relaxation therapy to control pain. 3. Use daily mouth rinses as prescribed. 4. Maintain bed rest during treatment.

3. Use daily mouth rinses as prescribed.

The client with type 2 diabetes is admitted into the medical department with a wound on the left leg that will not heal. The HCP prescribes sliding-scale insulin. The client tells the nurse, "I don't want to have to take shots. I take pills at home." Which statement is the nurse's best response? 1. "If you can't keep your glucose under control with pills, you must take insulin." 2. "You should discuss the insulin order with your HCP because you don't want to take it." 3. "You are worried about having to take insulin. I will sit down and we can talk." 4. "During illness you may need to take insulin to keep your blood glucose level down."

4. "During illness you may need to take insulin to keep your blood glucose level down."

The 55-year-old African American male client presents to the emergency department with blurred vision, slurred speech, and left-sided weakness. The client has a history of hypertension (HTN) and benign prostatic hypertrophy (BPH). Which statement regarding the client's medications should the nurse ask at this time? 1. "Have you been taking over-the-counter herbs to treat the BPH?" 2. "Do you take an aspirin every day to prevent heart attacks and strokes?" 3. "Do you eat green, leafy vegetables frequently?" 4. "Have you been taking medications routinely to control the HTN?"

4. "Have you been taking medications routinely to control the HTN?"

The female client diagnosed with congestive heart failure (CHF) tells the nurse that she has been taking hawthorn extract, an over-the-counter medication, since the HCP told her that she had heart problems. Which statement by the nurse is most appropriate? 1. "You need to take garlic supplements with hawthorn for it to be effective." 2. "You should stop taking this herb immediately because it can cause more problems." 3. "This herb can cause bleeding if you take it with your other medications." 4. "Some clients find this is helpful, but make sure your HCP is aware of the medication."

4. "Some clients find this is helpful, but make sure your HCP is aware of the medication."

The client diagnosed with a deep vein thrombosis (DVT) asks the nurse, "Why do I have to take my Coumadin in the evening?" Which statement is the nurse's best response? 1. "The medication works more effectively while you are sleeping." 2. "The medicine should be given with the largest meal of the day." 3. "The side effects of the Coumadin are less if you take it in the evening." 4. "This allows for a more accurate INR level when we draw your morning labs."

4. "This allows for a more accurate INR level when we draw your morning labs."

The nurse is completing A.M. care with a client diagnosed with angina when the client complains of chest pain. The client has a saline lock in the right forearm. Which intervention should the nurse at the bedside implement first? 1. Assess the client's vital signs. 2. Administer sublingual nitroglycerin (NTG). 3. Administer intravenous morphine sulfate (MS) via saline lock. 4. Administer oxygen via nasal cannula.

4. Administer oxygen via nasal cannula.

The client has an open laceration on the right temporal lobe secondary to being hit on the head with a baseball bat. The emergency department HCP sutures the laceration and the CT scan is negative. Which instruction should the nurse discuss with the client? 1. Do not put anything on the laceration for 72 hours. 2. Use hydrocortisone cream 0.5% on the laceration. 3. Cleanse the area with alcohol three times a day. 4. Apply Neosporin ointment to the sutured area.

4. Apply Neosporin ointment to the sutured area.

The client calls the clinic and says, "I am having chest pain. I think I am having another heart attack." Which intervention should the nurse implement first? 1. Call 911 emergency medical services. 2. Instruct the client to take an aspirin. 3. Determine if the client is at home alone. 4. Ask if the client has any sublingual nitroglycerin.

4. Ask if the client has any sublingual nitroglycerin.

The female client diagnosed with type 2 diabetes tells the clinic nurse she started taking ginseng to help increase her memory. Which intervention should the clinic nurse implement? 1. Take no action because ginseng does not affect type 2 diabetes. 2. Determine what type of memory deficits the client is experiencing. 3. Explain that herbs are dangerous and she should not be taking them. 4. Determine if the client is currently taking any type of antidiabetic medication.

4. Determine if the client is currently taking any type of antidiabetic medication.

The client newly diagnosed with coronary artery disease is being prescribed a daily aspirin. The client tells the nurse, "I had a bad case of gastritis last year." Which intervention should the nurse implement first? 1. Ask the client if he or she informed the HCP of the gastritis. 2. Explain that regular aspirin could cause gastric upset. 3. Instruct the client to take an enteric-coated aspirin. 4. Determine if the client is taking any antiulcer medication.

4. Determine if the client is taking any antiulcer medication.

The elderly client diagnosed with a stroke is being discharged. When preparing the discharge instructions, the nurse notes many medications that are ordered to be taken at different times of the day. Which intervention should the nurse implement first? 1. Complete a comprehensive chart for the client to use. 2. Refer the client to a home health-care agency for follow-up. 3. Teach the client to return to the HCP office for follow-up. 4. Discuss the multiple medications and times with the HCP.

4. Discuss the multiple medications and times with the HCP.

Which medication should the nurse question administering? 1. Lisinopril (Zestril), an ACE inhibitor, to a client with a BP of 118/84. 2. Carvedilol (Coreg), a beta blocker, to a client with an apical pulse of 62. 3. Verapamil (Calan), a calcium channel blocker, to a client with angina. 4. Furosemide (Lasix), a loop diuretic, to a client complaining of leg cramps.

4. Furosemide (Lasix), a loop diuretic, to a client complaining of leg cramps.

A client with cancer is started on a chemotherapeutic agent that is a known vesicant. The nurse performs which priority activity related to this drug? Monitor the client's: 1. Response to antinausea drugs. 2. Intake of calcium-rich foods. 3. Respiratory status for cough. 4. IV site for swelling and pain.

4. IV site for swelling and pain.

The unlicensed assistive personnel (UAP) notifies the nurse that the client is complaining of being jittery and nervous and is diaphoretic. The client is diagnosed with diabetes mellitus. Which interventions should the nurse implement? Rank in order of performance. 1. Have the UAP check the client's glucose level. 2. Tell the UAP to get the client some orange juice. 3. Check the client's medication administration record. 4. Immediately go to the room and assess the client. 5. Assist the UAP in changing the client's bed linens.

4. Immediately go to the room and assess the client. 1. Have the UAP check the client's glucose level. 2. Tell the UAP to get the client some orange juice. 3. Check the client's medication administration record. 5. Assist the UAP in changing the client's bed linens.

The client is having status epilepticus and is prescribed intravenous diazepam (Valium). The client has an IV of D5W 75 mL/hr in the right arm and a saline lock in the left arm. Which intervention should the nurse implement? 1. Dilute the Valium and administer over 5 minutes via the existing IV. 2. Do not dilute the medication and administer at the port closest to the client. 3. Question the order because Valium cannot be administered with D5W. 4. Inject 3 mL of normal saline in the saline lock and administer Valium undiluted.

4. Inject 3 mL of normal saline in the saline lock and administer Valium undiluted.

The nurse is discussing the thyroid hormone levothyroxine (Synthroid) with the client diagnosed with hypothyroidism. Which intervention should the nurse discuss with the client? 1. Encourage the client to decrease the fiber in the diet. 2. Discuss the need to monitor the T3, T4 levels daily. 3. Tell the client to take the medication with food only. 4. Instruct the client to report any significant weight changes.

4. Instruct the client to report any significant weight changes.

Which statement best describes the pharmacodynamics of insulin? 1. Insulin causes the pancreas to secrete glucose into the bloodstream. 2. Insulin is metabolized by the liver and muscle and excreted in the urine. 3. Insulin is needed to maintain colloidal osmotic pressure in the bloodstream. 4. Insulin lowers blood glucose by promoting use of glucose in the body cells.

4. Insulin lowers blood glucose by promoting use of glucose in the body cells.

The client newly diagnosed with type 2 diabetes who has been prescribed an oral hy- poglycemic medication calls the clinic and tells the nurse that the sclera has a yellow color. Which intervention should the clinic nurse implement? 1. Ask the client if he or she has been exposed to someone with hepatitis. 2. Determine if the client has a history of alcohol use or is currently drinking alcohol. 3. Check to see if the client is taking the cardiac glycoside digoxin. 4. Make an appointment for the client to come to the health-care provider's office.

4. Make an appointment for the client to come to the health-care provider's office.

The nurse in the medical department is preparing to administer Humalog, a rapid-acting insulin, to a client diagnosed with type 1 diabetes. Which intervention should the nurse implement? 1. Ensure the client is wearing a MedicAlert bracelet. 2. Administer the dose according to the regular insulin sliding scale. 3. Assess the client for hyperosmolar, hyperglycemic, nonketotic coma. 4. Make sure the client eats the food on the meal tray that is at the bedside.

4. Make sure the client eats the food on the meal tray that is at the bedside.

The nurse in the intensive care unit is caring for a client diagnosed with a left cere bral artery thrombotic stroke who received a thrombolytic medication in the emer gency department. Which intervention should be implemented? 1. Administer the antiplatelet medication ticlopidine (Ticlid) po. 2. Place the client in the Trendelenburg position. 3. Keep the client turned to the right side and high Fowler's position. 4. Monitor the anticoagulant heparin infusion.

4. Monitor the anticoagulant heparin infusion.

The elderly client diagnosed with coronary artery disease has been taking aspirin daily for more than a year. Which data warrant notifying the health-care provider? 1. The client has lost 5 pounds in the last month. 2. The client has trouble hearing low tones. 3. The client reports having a funny taste in the mouth. 4. The client has hard, dark, tarry stools.

4. The client has hard, dark, tarry stools.

Which assessment data should the nurse obtain prior to administering a calcium channel blocker? 1. The serum calcium level. 2. The client's radial pulse. 3. The current telemetry reading. 4. The client's blood pressure.

4. The client's blood pressure.

The nurse is preparing to administer the following medications. Which medication should the nurse question administering? 1. The vasodilator hydralazine (Apresoline) to the client with a blood pressure of 168/94. 2. The alpha blocker prazosin (Minipress) to the client with a serum sodium level of 137 mEq/L. 3. The calcium channel blocker diltiazem (Cardizem) to the client with a glucose level of 280 mg/dL. 4. The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1 mEq/L.

4. The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1 mEq/L.

The client has had a total right hip replacement. Which medication should the nurse anticipate the HCP prescribing? 1. The oral anticoagulant warfarin (Coumadin). 2. The intravenous anticoagulant heparin. 3. The thrombolytic alteplase (Activase). 4. The low-molecular-weight heparin enoxaparin (Lovenox).

4. The low-molecular-weight heparin enoxaparin (Lovenox).

The client with a head injury is experiencing increased intracranial pressure. The neurosurgeon prescribes the osmotic diuretic mannitol (Osmitrol). Which intervention should the nurse implement when administering this medication? 1. Monitor the client's arterial blood gases during administration. 2. Do not administer if the client's blood pressure is less than 90/60. 3. Ensure that the client's cardiac status is monitored by telemetry. 4. Use a filter needle when administering the medication.

4. Use a filter needle when administering the medication.

The female client diagnosed with Hodgkin's disease is prescribed vincristine (Oncovin), a vinca alkaloid. Since the last treatment the client complains that she cannot wear her rings or most of her shoes because of weight gain. Which intervention should the nurse implement first? 1. Administer a diuretic before the Oncovin to prevent fluid overload. 2. Monitor the client for signs of infection. 3. Discuss a low-sodium diet with the client. 4. Weigh the client and report the findings to the oncologist.

4. Weigh the client and report the findings to the oncologist.

The client who is having a scalp laceration sutured will be receiving local anesthesia with lidocaine (Xylocaine) that contains epinephrine. The nurse knows that the purpose of this drug combination is to: A. Decrease bleeding at the site of trauma. B. Increase vasodilation at the site of the laceration. C. Decrease blood pressure in individuals who are hypertensive. D. Ensure that infection at the wound site will not occur.

A. Decrease bleeding at the site of trauma.

The nurse is preparing to administer a nitroglycerin patch to a client diagnosed with coronary artery disease. Which interventions should the nurse implement? Rank in order of performance. 1. Date and time the nitroglycerin patch. 2. Remove the old patch. 3. Clean the site of the old patch. 4. Apply the nitroglycerin patch. 5. Check the patch against the MAR.

5. Check the patch against the MAR. 1. Date and time the nitroglycerin patch. 2. Remove the old patch. 4. Apply the nitroglycerin patch. 2. Remove the old patch.

Which statement made by the client who is taking lithium carbonate (Eskalith) indicates that further teaching is necessary? A. "I will be sure to remain on a low sodium diet." B. "I will have blood levels drawn every 2 to 3 months, even when I have no symptoms." C. "Lithium has a narrow margin of safety, so toxicity is a very real concern." D. "I will not be able to breastfeed my baby."

A. "I will be sure to remain on a low sodium diet."

A nurse is admitting a client to an acute care facility for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following the priority nursing action? A. Administering a supplemental dose of hydrocortisone B. Instructing the client about coughing and deep breathing C. Collecting addition information from the client about his history of Addison's disease D. Inserting an indwelling urinary catheter

A. Administering a supplemental dose of hydrocortisone

A nurse is caring for a client who is taking propylthiouracil (PTU). For which of the following adverse effects of this medication should the nurse monitor? A. Bradycardia B. Insomnia C. Heat intolerance D. Weight loss

A. Bradycardia

A nurse is providing discharge teaching to a client who is to begin taking fluoxetine (Prozac) for posttraumatic stress disorder. Which of the following statements is appropriate for the nurse to include in the teaching? A. "You may have a decreased desire for intimacy while taking this medication." B. "You should take this medication at bedtime to help promote sleep." C. "You will have fewer urinary adverse effects if you urinate just before taking this medication." D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication."

A. Decreased libido is a potential adverse effect of fluoxetine and other SSRIs.

A nurse is planning care for a client who has brain cancer and experiences headache caused by cerebral edema. Which of the following adjuvant medications may be indicated for this client? A. Dexamethasone (Decadron) B. Methylphenidate (Ritalin) C. Hydroxyzine (Vistaril) D. Amitriptyline (Elavil)

A. Dexamethasone, a glucocorticoid, decreases inflammation and swelling. It is used to reduce cerebral edema and relieve pressure from the tumor.

A nurse is caring for a client who takes oral morphine and carbamazepine (Tegretol) for cancer pain. Which of the following effects may occur when both medications are administered to this client? (Select all that apply.) A. Dosage of the opioid is reduced. B. Adverse effects of the opioid are reduced. C. Analgesic effects are increased. D. CNS stimulation is enhanced. E. Opioid tolerance is increased.

A. Dosage of the opioid may be reduced when adjuvant medications are added for pain. B. Adverse effects of the opioid may be reduced when adjuvant medications are added for pain. C. Analgesic effects are increased when adjuvant medications are added for pain.

An adult client is taking diphenhydramine (Benadryl) for symptoms of allergic rhinitis. For which of the following adverse reactions should the nurse teach the client to watch? (Select all that apply.) A. Dry mouth B. Nonproductive cough C. Skin rash D. Diarrhea E. Urinary hesitation

A. Dry mouth E. Urinary hesitation

A nurse is caring for a client who has a local anesthetic of lidocaine with epinephrine for the removal of a skin lesion. Epinephrine is used with the lidocaine for which of the following reasons? A. Reduce risk of systemic toxicity B. Reduce the occurrence of tachycardia C. Produce localized vasodilation D. Speed absorption of anesthesia

A. Epinephrine added to the local anesthetic reduces the risk of systemic toxicity because a reduced amount of anesthetic may be used.

A nurse is caring for a client who has a new prescription for valproic acid (Depakote). The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.) A. Thrombocyte count B. Hematocrit C. Amylase D. Liver function tests E. Potassium

A. For thrombocytopenia; the client's thrombocyte count should be monitored periodically. C. For pancreatitis; the client's amylase should be monitored periodically. D. For hepatotoxicity; the client's liver function should be monitored periodically.

A nurse is reviewing laboratory findings and notes that a client's plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse? A. Perform immediate gastric lavage. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test.

A. Gastric lavage is appropriate for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. This action will lower the client's lithium level.

A nurse is caring for a client who has a prescription for metformin (Glucophage). The nurse should monitor the client for which of the following adverse effects? A. Lactic acidosis B. Hypoglycemia C. Hyperlipidemia D. Respiratory alkalosis

A. Lactic acidosis

A nurse is caring for a client who has breast cancer and asks why she is receiving a combination therapy of cyclophosphamide, methotrexate, and fluorouracil. The appropriate response by the nurse is that combination chemotherapy is used to do which of the following? (Select all that apply.) A. Decrease medication resistance. B. Attack cancer cells at different stages of cell growth. C. Block chemotherapy agent from entering healthy cells. D. Stimulate immune system. E. Decrease injury to normal body cells.

A. Medication resistance is decreased with combination therapy because the chance of developing resistance to several medication is less than development of resistance to only one medication. B. Each medication kills cancer cells at a different stage of growth. A combination of medications can kill more cancer cells than only one medication. E. Injury to normal body cells can be decreased by combination therapy because the medications used have different toxicities.

A nurse is caring for a client who has a new prescription for phenelzine (Nardil) for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss

A. Orthostatic hypotension is an adverse of effect of MAOIs, including phenelzine.

A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client he should avoid which of the following laxatives? A. Sodium phosphate (Fleet Phospho-Soda) B. Psyllium (Metamucil) C. Bisacodyl (Dulcolax) D. Polyethylene glycol (MiraLAX)

A. Typically, clients who have heart failure are on a sodium-restricted diet. Absorption of sodium from sodium phosphate causes fluid retention and is contraindicated for clients who have heart failure.

A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine (Prozac). The nurse is concerned that the client is developing serotonin syndrome. Assessment: Objective and Subjective - Identify at least six expected findings.

Agitation Confusion Disorientation Difficulty concentrating Anxiety Hallucinations Hyperreflexia Incoordination Tremors Fever Diaphoresis

A nurse is providing teaching to a client prescribed tetracycline (Sumycin) to treat a GI infection caused by Helicobacter pylori. Which of the following statements by the client indicates understanding of the teaching? A. "I will take this medication with a full glass of milk." B. "I will let my doctor know if I start having diarrhea." C. "I can stop taking this medication when I feel completely well." D. "I can take this medication just before bedtime."

B. "I will let my doctor know if I start having diarrhea."

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide (Prandin). Which of the following statements made by the client indicates understanding of the administration of this medication? A. "I'll take this medicine with my meals." B. "I'll take this medicine 30 minutes before I eat." C. "I'll take this medicine just before I go to bed." D. "I'll take this medicine as soon as I wake up in the morning."

B. "I'll take this medicine 30 minutes before I eat."

A nurse is evaluating a client's understanding of the teaching about the use of fluticasone (Flonase) to treat perennial rhinitis. Which of the following statements by the client indicate he understands the teaching? A. "I should use the spray every 4 hours while I am awake." B. "It may take as long as 3 weeks before the medication takes a maximum effect." C. "This medication can also be used to treat motion sickness." D. "I can use this medication when my nasal passages are blocked."

B. "It may take as long as 3 weeks before the medication takes a maximum effect."

A nurse is administering gentamicin by IV infusion at 0900. The gentamicin will take 1 hr to infuse. When should the nurse plan for a peak serum level of gentamicin to be drawn? A. 1000 B. 1030 C. 1100 D. 1130

B. 1030

A nurse is providing follow-up dietary teaching for a client who recently was prescribed phenelzine (Nardil). When reviewing the client's dietary log, which of the following foods requires a need for further teaching? A. Cottage cheese B. Banana bread C. Apple pie D. Grilled steak

B. Clients taking phenelzine, an MAOI, should avoid foods containing tyramine. Bananas and yeast products contain tyramine. Therefore, the selection of banana bread requires the need for further teaching.

A nurse in a primary care clinic is assessing a client who takes lithium carbonate (Lithotabs) for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? A. Severe hypertension B. Coarse tremors C. Constipation D. Urinary retention

B. Coarse tremors are an indication of toxicity.

A nurse is caring for a client who has been taking Fluxetine (Prozac) for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. Bruising B. Fever C. Abdominal pain D. Rash

B. Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline.

A nurse is providing instructions to a client who has a prescription for metronidazole (Flagyl) to treat peptic ulcer. The client asks the nurse why this medication has been prescribed. Which of the following responses by the nurse is correct? A. "The purpose of this medication is to get rid of the infection from giardiasis." B. "The purpose of this medication is to get rid of the infection from H. pylori." C. "The purpose of this medication is to increase the pH of gastric juices in the stomach." D. "The purpose of this medication is to decrease the pH of gastric juices in the stomach."

B. H. pylori is a gram-negative organism can reside in the client's stomach and duodenum. Metronidazole and other antibiotics are used to eradicate H. pylori, which greatly reduces the recurrence of peptic ulcer disease.

A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory infection. For which of the following adverse effects should the nurse monitor? (Select all that apply.) A. Drowsiness B. Hematuria C. Muscle weakness D. Difficulty swallowing E. Vertigo

B. Hematuria C. Muscle weakness E. Vertigo

A nurse is caring for a client who has cancer and is taking a glucocorticoid as an adjuvant for pain control. The nurse should plan to perform which of the following interventions? (Select all that apply.) A. Monitor for urinary retention. B. Monitor serum glucose. C. Monitor serum potassium level. D. Monitor for gastric bleeding. E. Monitor for respiratory depression.

B. Monitoring serum glucose is important because glucocorticoids raise the glucose level, especially in clients who have diabetes mellitus. C. Monitoring serum potassium level is important because glucocorticoids may cause hypokalemia. D. Monitoring for gastric bleeding is important because glucocorticoids irritate the gastric mucosa and put the client at risk for a peptic ulcer.

A nurse is caring for a client who states she has been taking phenylephrine (Neo-Synephrine) nasal drops for the past 10 days for her upper respiratory symptoms. For which of the following adverse effects should the nurse assess? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B. Nasal congestion

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following is the priority nursing action? A. Administer flumazenil (Romazicon). B. Identify the client's level of orientation. C. Infuse IV fluids. D. Prepare the client for gastric lavage

B. When taking the nursing process approach to client care, the initial step is assessment. Therefore, identifying the client's level of orientation is the priority action.

Which of these statements, if made by a client, would indicate that further instruction is needed about alprazolam (Xanax)? A. "I will stop smoking by undergoing hypnosis." B. "I will not drive immediately after I take this medication." C. "I will stop taking the medicine when I feel less anxious." D. "I will take my medication with food if my stomach feels upset."

C. "I will stop taking the medicine when I feel less anxious."

Which statement, if made by the client, would alert the nurse that the antiparkinson medication is effective? A. "I'm sleeping a lot more, especially during the day." B. "My appetite has improved." C. "I'm able to shower by myself." D. "My skin doesn't itch anymore."

C. "I'm able to shower by myself."

A nurse is caring for a client in an acute care setting who was admitted with a cerebral spinal fluid (CSF) infection caused by a highly gram-negative bacteria. Which of the following cephalosporin IV antibiotics should the nurse expect to be effective in treating this infection? A. Cefaclor (Ceclor) B. Cefazolin (Ancef) C. Cefepime (Maxipime) D. Cephalexin (Keflex)

C. Cefepime (Maxipime)

The nurse determines that the client understands an important principle in self-administration of fluoxetine (Prozac) when the client makes which of the following statements? A. "I should not decrease my sodium or water intake." B. "This drug can be taken concurrently with an MAOI." C. "It may take up to 1 month to reach full therapeutic effects." D. "There are no problems associated with concurrent use of other depressants."

C. "It may take up to 1 month to reach full therapeutic effects."

A nurse should advise a client who is receiving lorazepam (Ativan) about the adverse effects of this medication, which include: A. Tachypnea B. Astigmatism C. Ataxia D. Euphoria

C. Ataxia

A nurse is providing teaching to a client who has a new prescription for amitriptyline (Elavil) for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Expect therapeutic effects in 24 to 48 hr. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth.

C. Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline. E. Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline.

A nurse is teaching a client to self-administer nasal drops for allergic rhinitis symptoms. The nurse should teach the client to lie in which of the following positions to obtain the best effect of the medication? A. Supine with head flexed B. Sitting with head in neutral position C. Lateral with head in low position D. Prone with head extended

C. Lateral with head in low position

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration? A. Insulin glargine (Lantus) B. NPH insulin (Humulin N) C. Regular insulin (Humulin R) D. Insulin lispro (Humalog)

C. Regular insulin (Humulin R)

The nurse is caring for a client receiving a sedative-hypnotic. Which of the following adverse effects associated with this drug therapy is the highest priority for the nurse? A. Urinary incontinence B. Activity intolerance C. Risk for falls D. Poor nutritional intake

C. Risk for falls

A nurse is teaching a female client who has bipolar disorder about her new prescription for lithium carbonate (Lithobid). Which of the following is appropriate for the nurse to include in the teaching? (Select all that apply.) A. An adverse effect of this medication is amenorrhea. B. An antidepressant is combined with lithium therapy during phases of mania. C. Take this medication with food or a glass of milk. D. Avoid pregnancy while taking this medication. E. Thyroid function is assessed prior to lithium therapy.

C. Taking lithium with food or a glass of milk can help reduce gastrointestinal distress. D. Lithium is a Pregnancy Risk Category D medication that is teratogenic, especially during the first trimester. Therefore, the client should avoid pregnancy while taking this medication. E. Because lithium can cause goiter and hypothyroidism, the client's thyroid function is assessed prior to lithium therapy.

A nurse is administering amitriptyline (Elavil) to a client who has pain caused by a malignant tumor. Which of the following is an adverse effect of amitriptyline that should be monitored by the nurse? A. Decreased appetite B. Explosive diarrhea C. Decreased pulse rate D. Orthostatic hypotension

D. Amitriptyline may cause orthostatic hypotension. The nurse should assess the client for this effect and should instruct the client to move slowly from lying down or sitting after taking this medication.

The nurse is caring for several clients who are receiving opioids for pain relief. Which client is at the highest risk of developing hypotension, respiratory depression, and mental confusion? A. A 23-year-old female, post delivery of a 6-lb baby. B. A 16-year-old male, post motorcycle injury with lacerations C. A 54-year-old female, post myocardial infarction D. An 86-year-old male postoperative femur fracture

D. An 86-year-old male postoperative femur fracture

A nurse is providing discharge teaching for a client who has a new prescription for clozapine (Clozaril). Which of the following statements is appropriate for the nurse to include in the teaching? A. "You should have a high-carbohydrate snack between meals and at bedtime." B. "You are likely to develop hand tremors if you take this medication for a long period of time." C. "You may experience temporary numbness of your mouth after each dose." D. "You should have your white blood cell count monitored every week."

D. Due to the risk for fatal agranulocytosis weekly monitoring of the client's WBC count is recommended while taking clozapine.

A nurse is assessing a client who takes vasopressin (Pitressin) for diabetes insipidus. For which of the following adverse effects should the nurse monitor? A. Hypovolemia B. Hypercalcemia C. Hypoglycemia D. Hypertension

D. Hypertension

A nurse is providing a client who has peptic ulcer disease with instructions about managing his condition. Which of the following instructions should the nurse include? (Select all that apply.) A. "Eat six small meals a day." B. "Drink milk to aid in healing your ulcer." C. "Low-dose aspirin therapy should be avoided." D. "Seek measures to reduce stress." E. "Avoid smoking."

D. Reducing stress is beneficial for healing of the ulcer and prevention of complications. E. Smoking inhibits healing of the ulcer.

The client states that he has not taken his antipsychotic drug for the past 2 weeks because it was causing sexual dysfunction. The nurse is aware that the name antipsychotic indicates that continuing the medication as prescribed is important because: A. Hypertensive crisis may occur with abrupt withdrawal. B. Muscle twitching may occur with abrupt withdrawal. C. Parkinson-like symptoms will occur with withdrawal. D. Symptoms of psychosis are likely to return if the medication is withdrawn.

D. Symptoms of psychosis are likely to return if the medication is withdrawn.

A nurse is caring for a client who has a new prescription for lithium carbonate (Lithobid). When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B. Restrict intake of foods rich in sodium. C. Decrease fluid intake to less than 1,500 mL daily D. Limit aerobic activity in hot weather.

D. The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity.

A nurse is caring for an older adult client in a long-term care facility who has hypothyroidism and is beginning levothyroxine (Synthroid). Which of the following dosage schedules should the nurse expect for this client? A. The client will start at a high dose, and the dose will be tapered down as needed. B. The client will remain on the initial dosage during the course of treatment. C. The clients dosage will be adjusted daily based on blood levels. D. The client will start on a low dose, which will be gradually increased.

D. The client will start on a low dose, which will be gradually increased.

A nurse is reviewing discharge instructions with a client who has a new diagnosis of bipolar disorder. The client has a new prescription for lithium carbonate (Eskalith) 600 mg PO three times a day. Medication to complete this item to include three side/adverse effects the nurse should include in the teaching.

GI distress: nausea, diarrhea, abdominal pain Fine hand tremors Polyuria Mild thirst Weight gain Renal toxicity Goiter and hypothyroidism Bradydysrhythmias Hypotension Electrolyte imbalances

A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine (Prozac). The nurse is concerned that the client is developing serotonin syndrome. Description of Disorder/Disease Process

Serotonin syndrome is a potentially lethal complication that usually begins 2 to 72 hr after initiation of treatment with an SSRI. The syndrome resolves when the medication is discontinued.

When assessing the elderly patient, the nurse keeps in mind that certain nonspecific symptoms may represent hypothyroidism in these patients, such as: a leukopenia, anemia b loss of appetite, polyuria c weight loss, dry cough d cold intolerance, depression

d cold intolerance, depression

A patient is taking metformin for new-onset type 2 diabetes mellitus. When reviewing potential adverse effects, the nurse will include information about: (Select all that apply.) a Abdominal bloating b Nausea c Diarrhea d Headache e Weight gain f Metallic taste

a Abdominal bloating b Nausea c Diarrhea f Metallic taste

Which is the most appropriate timing regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient? a Give it 15 minutes before the patient begins a meal. b Give it ½ hour before a meal. c Give it 1 hour after a meal. d The timing of the insulin injection does not matter with insulin lispro.

a Give it 15 minutes before the patient begins a meal.

When teaching a patient who has a new prescription for thyroid hormone, the nurse will instruct the patient to notify the physician if which adverse effects are noted? (Select all that apply.) a Palpitations b Weight gain c Angina d Fatigue e Cold intolerance

a Palpitations c Angina

The nurse is teaching a patient who has a new prescription for the antithyroid drug propylthiouracil (PTU). Which statement by the nurse is correct? a "There are no food restrictions while on this drug." b "You need to avoid foods high in iodine, such as iodized salt, seafood, and soy products." c "This drug is given to raise the thyroid hormone levels in your blood." d "Take this drug in the morning on an empty stomach."

b "You need to avoid foods high in iodine, such as iodized salt, seafood, and soy products."

When checking a patient's fingerstick blood glucose level, the nurse obtains a reading of 42 mg/dL. The patient is awake but states he feels a bit "cloudy-headed." After double-checking the patient's glucose level and getting the same reading, which action by the nurse is most appropriate? a Administer two packets of table sugar. b Administer oral glucose in the form of a semisolid gel. c Administer 50% dextrose IV push. d Administer the morning dose of lispro insulin.

b Administer oral glucose in the form of a semisolid gel.

When monitoring the laboratory values of a patient who is taking antithyroid drugs, the nurse knows to watch for a increased platelet counts. b decreased white blood cell counts. c decreased blood urea nitrogen level. d increased blood glucose levels.

b decreased white blood cell counts.

Which statement is appropriate for the nurse to include in patient teaching regarding type 2 diabetes? a "Insulin injections are never used with type 2 diabetes." b "You don't need to measure your blood glucose levels because you are not taking insulin injections." c "A person with type 2 diabetes still has functioning beta cells in his or her pancreas." d "Patients with type 2 diabetes usually have better control over their diabetes than those with type 1 diabetes."

c "A person with type 2 diabetes still has functioning beta cells in his or her pancreas."

A patient with type 2 diabetes is scheduled for magnetic resonance imaging (MRI) with contrast dye. The nurse reviews the orders and notices that the patient is receiving metformin (Glucophage). Which action by the nurse is appropriate? a Proceed with the MRI as scheduled. b Notify the radiology department that the patient is receiving metformin. c Expect to hold the metformin the day of the test and for 48 hours after the test is performed. d Call the prescriber regarding holding the metformin for 2 days before the MRI is performed.

c Expect to hold the metformin the day of the test and for 48 hours after the test is performed.

The nurse monitoring a patient for a therapeutic response to oral antidiabetic drugs will look for a fewer episodes of diabetic ketoacidosis (DKA). b weight loss of 5 pounds. c hemoglobin A1C levels of less than 7%. d glucose levels of 150 mg/dL.

c hemoglobin A1C levels of less than 7%.

To help with the insomnia associated with thyroid hormone replacement therapy, the nurse will teach the patient to a take half the dose at lunchtime and the other half 2 hours later. b use a sedative to assist with falling asleep. c take the dose upon awakening in the morning. d reduce the dosage as needed if sleep is impaired.

c take the dose upon awakening in the morning.

The pharmacy has called a patient to notify her that the current brand of thyroid replacement hormone is on back order. The patient calls the clinic to ask what to do. Which is the best response by the nurse? a "Go ahead and take the other brand that the pharmacy has available for now." b "You can stop the medication until your current brand is available." c "You can split the thyroid pills that you have left so that they will last longer." d "Let me ask your physician what needs to be done; we will need to watch how you do if you switch brands."

d "Let me ask your physician what needs to be done; we will need to watch how you do if you switch brands."

A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine (Prozac). The nurse is concerned that the client is developing serotonin syndrome. Assessment: Risk Factors - Describe at least one risk factor.

• Onset of treatment with an SSRI within the last 2 to 72 hr • Concurrent use of an SSRI with an MAOI • Concurrent use of an SSRI with a TCA