Pharm Test 2 Nclex Questions
The client with deep vein thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following? 1. Activated partial thromboplastin time (aPTT) 2. Prothrombin time (PT) 3. Platelet counts 4. International normalized ratio (INR)
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A nurse is teaching a patient about their prescription for potassium chloride. The nurse knows the teaching was successful when the patient states all of the following except. (Select all that apply) 1. I should dilute this oral medication with at least 4 ounces of water, juice, or carbonated beverage. 2. I should take this medication with a banana every morning 3. I will notify my HCP if experience unexplained muscle weakness, shortness of breath 4. I should not use salt substitutes. 5. I should store this medication in the refrigerator.
1,3 and 4 are the answers. Reason: Mix oral doses with at least 120 mL (4 ouces) to disguise the taste. Eating a banana every day with the medication isn't indicated, adding unnecessary potassium, possibly risking induction of hyperkalemia. Some signs of hyperkalemia are unexplained muscle weakness, shortness of breath, as well as palpitations, slow pulse and fatigue. Using salt substitutes also risks hyperkalemia because salt substitutes contain potassium. Storing the medication in the refrigerator is not proper. It should be stored at room temperatures away from moisture, heat and light.
The nurse is administering a continuous IV infusion of calcium properly diluted in a compatible IV fluid. Which one of the following would it be most important for the nurse to monitor? A. cardiac rhythm B. urine output C. hearing changes D. musculoskeletal pain
Answer is A. It is essential to monitor patients receiving calcium intravenously for cardiac dysrhythmias
A patient taking Propylthiouracil should be instructed to reduce dietary sources of A) Iodine B) Iron C) Potassium D) Vitamin K
Answer. A)Iodine Rationale: Prophylthiouracil (PTU) is used to treat hyperthyroidism and blocks the synthesis of thyroid hormones. Iodine is utilized in the synthesis of thyroid hormones and will interfere with the action of propylthiouracil; therefore it should be reduced or eliminated.
Why would a patient be taking propranolol with hyperthyroidism? Increases T4 conversion to T3 in the hypothalamus Controls symptoms of hyperthyroidism due to excessive stimulation of SNS Enhances acidity buffer in the jejunum Decreases metabolic rate and increases O2 consumption by the CNS
Answer 2: Propranolol blocks beta-adrenergic receptors in various organs and thereby controls symptoms of hyperthyroidism from excessive stimulation of the SNS. These symptoms include tachycardia, palpitations, excessive sweating, tremors, and nervousness.
Which medication can potentiate a fluid volume deficit? A. Insulin B. Inderal (propanolol) C. Lasix (furosemide) D. Valium (diazepam)
Answer C is correct. Lasix is a non-potassium-sparing diuretic. This drug can potentiate fluid volume deficit. Answer A is incorrect because insulin will force fluid back into the cell and will not increase fluid volume deficit. Answer B is incorrect because Inderal (propanolol) is a beta blocker used for the treatment of hypertension and cardiac disease. Inderal does not potentiate diuresis. Answer D is incorrect because is a phenothiazine used as an anti-anxiety medication. This drug does not potentiate fluid volume deficit.
A patient is going to begin taking Propylthiouracil. The nurse is responsible for educating the patient on the newly prescribed medication. What should the nurse include in his/her teaching? Select all that apply. A. This medication affects the metabolism of other drugs. B. This medication may decrease the effects of anticoagulants. C. Weight loss is an expected therapeutic effect. D. Therapeutic effects will take several days or weeks to present. E. You will receive routine liver function testing.
A, D, E. This medication will affect the metabolism of other drugs. Also, when the patient becomes euthyroid, it is necessary to evaluate and to reduce doses of all medications. Therapeutic effects do not occur for several days or weeks until the stored hormones in the body have been used. This medication has a Black Box Warning stating that severe liver injury or acute liver failure may occur within 6 months of treatment. Patients should receive routine liver function testing to assess for liver failure. This medication may increase the effects of anticoagulants. Weight gain is an expected therapeutic effect.
What nursing intervention is essential for the client receiving alteplase [thombolytic]? A) a. Assess for reperfusion dysrhythmias. B) b. Monitor liver enzymes. C) c. Administer vitamin K if bruising is observed. D) d. Monitor blood pressure and stop the medication if blood pressure drops below 110 systolic.
A. Alteplase (Activase) can cause bleeding as well as reperfusion dysrhythmias. Alteplase does not directly affect liver enzymes. Vitamin K will not reverse the effects of Activase. Vital sign changes can alert the nurse to complications; however, a blood pressure below 110 systolic is not, in itself, cause for alarm.
A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich food B. Expect muscle twitching to occur C. Take this medication with food D. Anticipate relief of manifestations in 24 hours.
ANSWER: C. Take this medication with food. A. Protein-rich food should be avoided as they decrease the therapeutic effects of the drug. B. Muscle twitching can indicate toxicity. Monitor & report. D. Relief may take several weeks.
A patient is admitted for a routine colonoscopy and Propofol is the drug of choice for sedation. Which of the following allergies should nurse report to the anesthesia provider? a. eggs b. peanuts c. shrimp d. strawberries
ANSWER: a. eggs Rationale: A patient that is allergic to eggs or soy should not receive Propofol. The nurse should communicate this to the anesthesia provider
A client with chest pain is prescribed intravenous nitroglycerin. Which assessment is of greatest concern for the nurse initiating the nitroglycerin drip? a.) serum potassium is 3.5 mEq/L (3.5 mmol/L) b.) blood pressure is 88/46 mmHg c.) ST elevation is present on the electrocardiogram d.) heart rate is 61 bpm
ANSWER: b.) RATIONALE: Nitroglycerin is a vasodilator that will lower blood pressure. The client is having chest pain, and the ST elevation indicates an injury to the myocardium, which may benefit from nitroglycerin. The potassium and heart rate are WNL.
A nurse is administering Levothyroxine (Syndthroid) to a patient with hypothyroidism. When should the nurse not administer this medication? 1. If the patient is dehydrated 2. If the patient has a BP of 100/50 3. If the patients resting heart rate is more than 100 bpm 4. none of the above
Answer 3. The nurse should hold the med if resting HR is above 100 because it increases the body's metabolic rate which would just increase the HR more
The nurse is educating the patient on the proper way to administer the medication Foasamax at home to help the patient manage Osteoporosis. What is most important to include in the teaching? A. Take with food B. Take medication 30 minutes before other medications and sit up for 30 minutes after medication C. Crush the pill before taking it D. Take in the middle of the day to allow food to be absorbed and cause less GI upset
Answer & rationale: B. Take the medication 30 minutes before other medications and sit up for 30 minutes after medication Fosamax should be taken with an empty stomach because food can significantly decrease the absorption and it can be very difficult to swallow so that is why the patient should sit up 30 minutes after. A full glass of water is also really important when taking this medication due to it being hard to swallow (not part of the question, but an extra hint :) ) Lastly, never crush this pill.
A patient who has recently inhaled succinylcholine (a neuromuscular blocking agent) begins to sweat and exhibits jaw and body rigidity. The nurse takes a set of vital signs and finds most are abnormal, including: Temp: 106.0 Pulse: 136 Given these symptoms, the nurse realizes that the patient is probably experiencing_______ a Portal Hypertension b Malignant Hyperthermia c Ventricular Tachycardia d Pulmonary Embolism
Answer: B. Malignant Hyperthermia is a potentially fatal hypermetabolic response after exposure to volatile inhalation anesthetics or neuromuscular blocking agent succinylcholine. This reaction can be delayed or occur immediately after taking the medication. For this reason, it is important for the nurse to assess the patient's family and medical history thoroughly prior to administration.
Ciprofloxacin is prescribed for a client to treat a urinary tract infection. Which point should a nurse stress when teaching the client about the medication? 1. Avoid taking ciprofloxacin with milk or yogurt 2. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate 3. Avoid fennel because it will increase the absorption of the ciprofloxacin 4. Take dietary calcium tablets 1 hour before or 2 hours after ciprofloxacin
Answer: 1 Ciprofloxacin is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided. Bismuth subsalicylate also decreases the absorption of ciprofloxacin and should be avoided. Extended release ciprofloxacin significantly reduces the frequency of nausea and diarrhea. Fennel will decrease the absorption of the ciprofloxacin. Dietary calcium can be taken at any ttime; it is unaffected by ciprofloxacin.
The nurse is caring for a client who is taking propylthiouracil, which of the following side effects should the nurse monitor for? 1. Insomnia 2. Bradycardia 3. Heat Intolerance 4. Weight Loss
Answer: 2 Rationale: PTU is used to treat Hyperthyroidism, side effects of this medication include bradycardia, drowsiness (not insomnia), weight gain (not weight loss), and cold intolerance (not heat intolerance)
The nurse has been administering Gentamicin IV to a 65-year-old patient. The most current lab results indicate a peak serum drug concentration of 14 mcg/mL. What is the nurse's priority based on this result? 1 Prepare the next dose of Gentamicin 2 Notify the provider of the lab results 3 Monitor patient's vital signs 4 Measure patient's urine output
Answer: 2, notify the provider of the lab results. Rationale: A serum drug concentration greater than 12 mcg/mL is toxic to the kidneys, and the provider needs to be notified of this result so the dose and/or frequency of administration of the medication can be adjusted. Although it might be appropriate to monitor the patient's vital signs and urine output, it is not the priority action in this situation. It would be inappropriate for the nurse to prepare the next dose of Gentamicin before consulting the provider.
A client is taking enoxaparin (Lovenox) daily. Which client statement requires additional monitoring? A. "I take aspirin daily for headaches." B. "I take ibuprofen (Motrin) at least once a week for joint pain." C. "Whenever I have a fever, I take acetaminophen (Tylenol)." D. "I take my medicine first thing in the morning."
Answer: A Rationale: Aspirin is an antiplatelet medication. A client taking both aspirin and Lovenox could cause excessive bleeding.
The nurse understands that a patient with a coagulant disorder is strongly against the consumption of pork. which of these medications will the nurse not recommend? A. Heparin b. Lovenox c. Coumadin d. Argatroban
Answer: A & B, both is derived from porcine
A patient recently diagnosed with hypothyroidism is prescribed levothyroxine. The nurse should include which of the following in his teaching plan? select all that apply. A. Do not take with antacid. B. Take at bedtime. C. Take at meal time. D Take early in the morning on an empty stomach.
Answer: A & D Levothyroxine should be taken early in the morning to avoid interfering with sleep (side effects: insomnia, anxiety and nervousness) Levothyroxine should not be taken with food to increase absorption. Also, levothyroxine should not be taken within 4hrs of using multivitamins, antacids or iron supplements. It is chelated with certain elements.
A patient is being seen for care after developing abdominal distention, cramping, and hypotension. He is diagnosed with hypokalemia secondary to excessive use of diuretics. Which of the following nursing interventions is most appropriate for this patient? A) Arrange for an ECG and report the findings to the physician B) Administer sodium bicarbonate as ordered C) Administer an IV bolus of potassium as ordered D) Prepare to set up for dialysis treatment
Answer: A) Arrange for an ECG and report the findings to the physician Rationale: A patient who has developed hypokalemia is at risk of cardiac dysrhythmias that can be harmful. If the patient is experiencing symptoms of hypokalemia, the nurse should set up for an ECG to assess the patient's heart rhythm and ensure he is not experiencing dysthymias as a result of electrolyte imbalance. Potassium chloride is never to be given as a bolus or IV push.
A nurse is caring for a client who receives a local injection of anesthetic lidocaine during the repair a skin laceration. For which of the following adverse effects should the nurse monitor the client? A) Seizures B) Tachycardia C) Hypertension D) Fever
Answer: A, Seizures. Rational: Seizure activity is an adverse effect that can occur as a result of a local anesthetic injection. Bradycardia, not tachycardia can result, hypotension can occur, fever is not an adverse effect of local anesthetic injections.
A nurse caring for a mechanically ventilated patient who is sedated for a prolonged time with a high dose of propofol knows to monitor for what adverse effect(s)? Select all that apply. A. Arrhythmias B. Hyperkalemia C. Hypokalemia D. Metabolic acidosis E. Respiratory acidosis
Answer: A,B,D Rationale: Propofol infusion syndrome (PRIS) is a rare but extremely dangerous complication associated with prolonged, high-dose infusions. Manifestations have a sudden onset and include severe metabolic acidosis, cardiac arrhythmias, hyperkalemia, lipemia, hepatomegaly, and acute kidney injury.
After administering Activase to a patient, the nurse knows to monitor the patient for: A.) Skin irritation B.) Signs and symptoms of HIT C.) Tachycardia D.) Decreased LOC, dilated pupils
Answer: D Rationale:Before giving this medication, the patients INR, aPTT and platelet baseline should be established (and checked again, 2-3 hours after administration). There is a serious risk for brain hemorrhage with this drug; the patients pupils, LOC and signs of IICP should be monitored. This medication is administered IV only. Signs and symptoms of HIT (Heparin Induced Thrombocytopenia) are associated with Heparin.
The nurse is educating a client who has been taking baclofen (Lioresal) for several weeks for back pain but would like to stop taking it because his back pain is now resolved. Which of the following should the nurse include in her teaching? A) "You must continue taking the medication until all the pills are gone." B) "You can stop taking the medication by decreasing the dosage gradually over 2 weeks." C) "You can stop taking the medication as long as you take an opiate pain reliever instead." D) "We will have to do follow up x-rays before you can stop taking the medication."
Answer: B Rationale: Stopping the medication abruptly can cause withdrawal symptoms, including rebound seizures. It is important for patients to finish the entire course of antibiotics, not muscle relaxers. If the patient is not in pain, opiates aren't necessary. Baclofen is a muscle relaxant so it most likely won't make changes to the patient's x-rays.
A patient was just prescribed Plavix. What information should be included in the teaching? A. This medication can cause hypotension. B. Plavix increases the risk of bleeding. C. Plavix can cause constipation. D. It's okay to double the dose if a dose is missed.
Answer: B. Plavix increases the risk of bleeding because it is an antiplatelet agent. Plavix may cause hypertension, not hypotension. Plavix may cause diarrhea, not constipation. It is never okay to double the dose. If a dose is missed, take it as soon as possible, unless it is almost time for the next dose.
When preparing to administer an antibiotic to a client, the nurse understands it will be effective in the treatment of an infectious disease process primarily because antibiotics: A. Reduce the inflammatory response B. Enhance the body's natural immune function C. Block growth of essential components of the bacterial cell D. Immobilize bacteria and allow them to be eliminated from the body
Answer: C Antibiotics block the growth of essential components of an organism by inhibiting or interfering with protein synthesis, thus leading to cell death or dysfunction, rendering it unable to reproduce.
The most important instructions a nurse can give a patient regarding the use of the antibiotic ampicillin prescribed for her are to a.) call the physician if she has any breathing difficulties b.) take it with meals so it doesn't cause an upset stomach c.) take all of the medication prescribed even if the symptoms stop sooner d.) not share the pills with anyone else
Answer: C It is important to take all of the ampicillin that is prescribed because even if symptoms stop occurring, the bacteria that were causing the symptoms may not be fully destroyed.
A nurse is caring for a client who has had a valve replacement to treat aortiac stenosis. They have prescriptions for warfarin and spironolactone and they are on a low sodium vegetarian diet. Which food choices below would be appropriate for this client? (Choose all) A-spinach salad with cranberries B- baked potato with sour cream and green onions C- Baked eggplant with cauliflower and mushrooms D-Baked chicken breast with iceberg salad E-roasted pepper and onion pita with cucumber salad
Answer: C and E spinach is high in vitamin K which could interfere with warfarin, cranberries and potatoes are high in potassium which can cause hyperkalemia when consumed while taking potassium sparing diuretics, the client is vegetarian for chicken would be inappropriate. Peppers, Onions, Cucumbers, Pita, eggplant, cauliflower and mushrooms are low in Vitamin K, sodium, Potassium and are appropriate for vegetarian diets.
The nurse is caring for a client receiving Warfarin (Coumadin). The morning INR value is 7. The priority nursing interventions are: A) Administer protamine sulfate and hold the next dose of Warfarin (Coumadin) B) Hold the next dose of Warfarin (Coumadin) and contact the physician immediately C) Administer vitamin K and hold the next dose of Warfarin (Coumadin) D) Hold the next dose of Warfarin (Coumadin) and request a repeat INR
Answer: C) Rational: Vitamin K is the antidote for Coumadin overdose and an INR of 7 warrants this action. Protamine sulfate is the antidote for heparin, not Coumadin Contacting the physician and requesting another INR are appropriate actions, but not until Vitamin K has been administered
he nurse is assessing a patient receiving epidural analgesia after a total knee replacement. Which of the following is the priority assessment? A. assessing peripheral pulses B. assessing the epidural dressing every shift C. Assessing the patient's legs for sensation D. keeping the patient supine on bed rest
Answer: C. assessing the patients legs for sensation rational: A. apart of the routine assessment, but not the highest priority B. dressing should be assessed every 4 hours D. the patient does not need to be on a flat bed rest and may ambulate, also not a assessment.
Mannitol (Osmitrol) is administered intravenously to a client admitted to the hospital with loss of consciousness and a closed head injury. The nurse determines that the medication achieved its priority effect if which of the following outcomes was noted? a) weight loss of 1 kg and a serum creatinine of 0.8 mg/dL b) serum creatinine of 1.2 mg/dL and normal intracranial pressure c) improved level of consciousness and normal intracranial pressure d) diuresis of 500mL in 2 hours and a blood urea nitrogen (BUN) of 15 mg/dL
Answer: C; - Mannitol (Osmitrol) is an osmotic diuretic that can be administered parenterally to treat cerebral edema. Lowering of intracranial pressure occurs within 15 minutes of administration, and diuresis occurs within 1 to 3 hours. Expected effects of the medication include rapid diuresis and fluid loss. For the client with cerebral edema (as in closed head injury), effectiveness is measured by assessing neurological status and intracranial pressure readings.
An elderly patient is prescribed ciprofloxacin for the treatment of a Urinary Tract Infection (UTI). The nurse should inform the patient of which potential most serious side effect? A) Atrial Fibrillation B) Constipation C) Ototoxicity D) Tendon Rupture
Answer: D Rationale: Ciprofloxacin and other fluoroquinolone antibiotics have a black box warning for the increased risk for tendon rupture. Patients usually experience pain and edema around tendons that may eventually lead to rupture. Patients should be instructed to rest if they experience tendon pain or edema while taking antibiotics in this class.
The patient is newly admitted with acute coronary syndrome and he has history of HIT. What treatment will the nurse expect the order from the provider? A. Heparin B. Levenox C. Coumadin D. Lipirudin
Answer: D Rationale: Lepirudin (Refludan) is used with acute coronary syndrome and HIT only. It does not use for all patients needing anticoagulant therapy. This drug and other DTIs are less suitable for long-term treatment because administration by injection only, therapeutic drug monitoring is not widely available, and no pharmacologic antidote to reverse the effects is available.
A 73-year-old man has been admitted to the emergency department with severe chest pain. Onset of symptoms is within the last 60 minutes. What medication would you expect the physician to order for his acute disorder? A) Anticoagulant drugs B) Direct thrombin inhibitor drugs C) Antiplatelet drugs D) Thrombolytic drugs
Answer: D The main use of a Thrombolytic agents is for management of acute, severe thromboembolic disease, such as myocardial infarction or pulmonary embolism.
A patient receives a lidocaine injection prior to having a laceration sutured. The nurse notices the patient becoming agitated and complaining of a ringing in their ear. The patient then beings having a seizure. The nurse knows that this patient is likely experiencing: A. Malignant hyperthermia B. HIT C. Anaphylaxis D. LAST
Answer: D "LAST (local anesthetic systemic toxicity) is a life-threatening effect associated with the use of lidocaine or any local anesthetic. This occurs when the drug is absorbed systemically. Symptoms begin with numbness, metallic taste, tinnitus or auditory changes, and agitation. These may progress to seizure activity and then lead to symptoms of CNS depression including coma, respiratory arrest, and cardiovascular depression" Nursing: a concept-based approach to learning, 2015.
Why can't Heparin be administered orally? A) It is large B) It contains too much magnesium C) It is negatively charged D) A and C E) All of the above
Answer: D) It is large and negatively charged and cannot cross the membrane to be absorbed
The nurse is preparing to administer calcium to a patient experiencing hypocalcemia. Which of the following actions should the nurse take? Select all that apply. A.) Ensure the calcium IV solution is diluted B.) Advise the patient they are unable to eat solid food for 12 hours after administration C.) Advise the provider the patient is taking Digoxin prior to administration D.) Prepare to monitor the patient's heart rate and ECG after administration
Answers: A, C, D Rationale: A is correct because calcium is irritating to tissue and needs to be diluted prior to administration to prevent tissue damage B is incorrect because calcium should be taken with food, and there is no need to restrict food after C is correct because calcium increases the risk for Digoxin toxicity D is correct because hypercalcemia can cause dysrhythmias
What statement by the patient tells the nurse that more teaching is necessary about Propylthiouracil (PTU)? A) I am going to take it with food every day B) It does not matter if I take it with or without food, so some days I will take it with food, and some days I won't C) I am going to take it on an empty stomach every day D) It does not matter if I take it with or without food, but I have to do it the same way every day.
B (The key with Propylthiouracil (PTU) is consistency)
The nurse is evaluating a client with hyperthyroidism who is taking Propylthiouracil (PTU) 100 mg/day in three divided doses for maintenance therapy. Which statement by the client indicates the drug has been effective? A. "I have excess energy throughout the day." B. "I am able to sleep and rest at night." C. "I have lost weight since taking this medication." D. "I do perspire throughout the entire day."
B. PTU inhibits production of thyroid hormones. A client taking an anti-thyroid drug should be able to sleep well at night since the thyroid hormone is reduced. Excess energy, loss of weight, and perspiring throughout the day are symptoms of hyperthyroidism indicating the drug has not been effective.
he nurse is assisting with the preparation of a surgical patient with a history of malignant hyperthermia. Which of the following anesthetic's does the nurse advocate the use for? A. Propofol (Diprivan) B. Vecuronium C. Succinycholine D. Isoflurane (Forane)
CORRECT: A - Propofol (Diprivan) is the only anesthetic that does not trigger malignant hyperthermia reactions.
A nurse is administering medication to a client who has impaired swallowing. There nurse understands that which of the following medications may be crushed? A. Nifedipine (Procardia XL) B. Levothyroxine (Synthroid) C. Venlafaxine (Effexor XL) D. Glipizide (Glucotrol XL) eleased over a period of time and should not be crushed
Correct answer B. A. extended-release medications are meant to be released over a period of time and should not be crushed B. Levothyroxine can be crushed because it is neither extended-release nor enteric-coated C. extended-release medications are meant to be released over a period of time and should not be crushed D. extended-release medications are meant to be r
A patient diagnosed with a pulmonary embolism is receiving an IV Heparin infusion. Which of the following indicates a complication of therapy for which the nurse should monitor? Lethargy Shortness of breath Hyperglycemia Tarry stools
Correct answer D Rationale: Patients on Heparin are at an increased risk for bleeding and tarry stools is a sign of bleeding.
A patient with hyperthyroidism is placed on Propylthiouracil to reduce thyroid hormone synthesis. The patient asks the nurse when the drug will start working. What should be the nurse's response? A. 1-3 weeks B. 1-5 days C. 2-3 months D. 4-6 weeks
Correct answer is A. 1-3 weeks. The therapeutic effect of PTU has an onset of 10-21 days and a peak of 6-10 weeks
When administering IV midazolam (Versed), the nurse should: 1. Obtain serial electrocardiograms (ECG) every hour until the client goes to surgery 2. Continuously monitor the patient's respiration after administration 3. Encourage the client to take quick, shallow breaths 4. Explain what will occur in the recovery room when the client awakens from anesthesia
Correct answer: 2 Versed is a respiratory depressant which requires constant respiratory monitoring; instructing the client to take quick, shallow breaths is ill advised due to the potential for respiratory depression. Serial ECGs are not necessary. Versed causes amnesia, so the client is unlikely to remember explanations that occur around the same time as admin.
A nurse is administering IV vancomycin to a patient. The nurse knows a side effect that is unique to vancomycin is: 1. Retinal toxicity 2. Neurotoxicity 3. Respiration depression 4. Red man syndrome
Correct answer: 4 Rationale: When administered too quickly through an IV, vancomycin is known to cause red man syndrome. Red man syndrome is characterized by flushing, hypotension, and rash on face, neck, back, and arm
Which of the following medications may cause malignant hyperthermia and require the antidote dantrolene to be on hand? (Select all that apply) A. Propofol (Diprivan) B. Isoflurane (Forane) C. Alteplase (Activase) D. Midazolam (Versed) E. Succinylcholine (Anectine)
Correct answers: B & E - No specific antidote is indicated to have ready for Propofol - Alteplase and Midazolam require antidotes to be on hand, but not for the treatment or prevention of malignant hyperthermia.
A nurse is caring for a client who is being discharged home on alendronate sodium (Fosamax). When planning client teaching for this medication, which of the following should the nurse include? A. Alendronate sodium is used to reduce bleeding in women experiencing menopause. B. Take Fosamax with a full glass of water on an empty stomach C. Side effects of Fosamax include flu-like symptoms and leukopenia D. Fosamax should be taken with calcium containing foods to increase absorption
Rationale: A: Fosamax is a bisphosphonate that inhibits osteoclast mediated bone resorption. B: CORRECT ANSWER: Fosamax should be taken with at least 8oz of water 30 minutes before ingesting foods. An upright position is recommended after taking Fosamax to decrease GI upset. c: Common side effects include hypocalcemia, esophageal irritation, GI upset, headache, joint and muscle pain. D: After taking Fosamax the client should not eat or drink anything but plain water for at least 30 minutes and not take calcium or antacids.
The most dangerous metabolic side effect of general anesthesia that can occur during surgery is: a. hyperglycemia b. hyperthermia c. hypoglycemia d. hypothermia
The answer is B. Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia.
A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to administer this medication: a) in the morning to prevent insomnia b) only when the client complains of fatigue and cold intolerance c) at various times during the day to prevent tolerance from occurring d) three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels
a) in the morning to prevent insomnia Levothyroxine (Synthroid) is a synthetic thyroid hormone that increases cellular metabolism. Levothyroxine should be given in the morning in a single dose to prevent insomnia and should be given at the same time each day to maintain an adequate drug level. Therefore, options B, C, and D are incorrect.
he patient's daughter is concerned that the newly prescribed Levodopa has not improved her 89 year old father's shuffling gait after 4 days. What is the nurses' best response? 1. "A shuffling gait is inevitable at his age." 2. "Signs of improvement may take 2-3 weeks, possibly up to 6 months to appear." 3. "Let me call the provider to get the order changed." 4. "Parkinson's is very hard to treat."
answer: 2- this is the correct time line for therapeutic effects and you are giving the family factual information while asking them to be patient 1-this is not true 3-this is not needed 4- this may be true, but does not address the daughter's concern about the drug or give her more useful information
Once daily dosing is recommended with gentamicin for what reason? (select all that apply) A) A potential increase in efficacy B) with once daily dosing you have to check peak and trough every two hours C) decrease chance of nephropathy D) You only need to check gentamicin levels every 12 hours E) Giving only one dose a day makes the workload less for the nurse
answer: A,C,D. When using once daily dosing there is a potential increase in efficacy and decreased chance for nephropathy which is a major side effect of gentamicin. when you use once daily dosing the nurse has to check levels 12 hours after administration, instead of checking peak and trough levels with multiple doses per day.
The nurse is going to administer the patients warfarin (Coumadin). Prior to administration the lab comes back with an INR of 4.1. The nurse should? A) Give warfarin as scheduled. B) Call Doctor to decrease the dose. C) Call Doctor to increase the dose. D) Hold the warfarin.
answer: D rationale: Hold warfarin with an INR>3.6
A client is to receive enoxaparin (Lovenox) 6 hours before the scheduled time of laparoscopic hysterectomy. Which of the following effects does the nurse recognize as an intended therapeutic action of the enoxaparin? a. increase in red blood cell production b. reduction of postoperative thrombi c. decrease in postoperative bleeding d. promotion of tissue healing
b. enoxaparin and low-dose heparin given 6-12 hours preoperatively reduce the incidence of DVT and pulmonary emboli by 60% in clients who are at risk for DVT, such as those who are placed in the lithotomy position.
A patient being treated for a DVT is receiving IV Heparin and they begin to vomit blood. After stopping the IV Heparin, the nurse knows to administer which of the following medications? a. Vitamin K b. Atropine c. Protamine Sulfate d. Calcium Guconate
c. Protamine Sulfate Rationale: The antidote for Heparin is Protamine Sulfate
A client with a potassium level of 5.5 mEq/L is to receive Kayexalate. After administering the drug, the priority nursing action is to monitor Urine output. Blood pressure. Bowel movements. ECG for tall, peaked T waves. Bowel movements.
kayexalate causes potassium to be exchanged for sodium in the intestines and excreted through bowel movements. If client does not have stools, the drug cannot work properly. Blood pressure and urine output are not of primary importance. The nurse would already expect changes in t waves with hyperkalemia. Normal serum potassium is 3.5 to 5.3 meq/l.
