Pharm Test 4 Chp 16-18, 40, 41, & 52

A group of nursing students are presenting information on the hepatitis B vaccine. What would the students prepare to tell others about the recommended population?

Infants and people at high risk for contracting the disease

When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?

it is administered at 12-15 months

A client with mild low back pain has been advised to take acetaminophen. The nurse teaching the client about this medication would include that excessive intake of acetaminophen may result in which?

liver damage.

Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider?

pain in one leg

When reviewing the history of a patient, which would the nurse identify as a contraindication for the use of progestins?

pelvic inflammatory disease

A 70-year-old woman on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. The client states that in the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to which?

peptic ulcer disease or gastritis.

A client cannot recall the name of the medication prescribed to help manage the pain associated with a urinary tract infection (UTI). What medication was likely prescribed?

phenazopyridine

A nurse is reviewing the laboratory values of a client admitted for gastrointestinal bleed. Which cells control bleeding?

platelets

A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?

practice frequent and thorough skin cleansing

What is a contraindication to an MMR booster for an adolescent female?

pregnancy

A 30-year-old debilitated client is receiving anabolic steroids. Which might the client experience?

priapism

The nurse knows that for a client who still has her ovaries intact, estrogen must be paired with what other drug when used to treat menopausal symptoms?

progestins

What would be most important to monitor in a client receiving an agent for BPH?

prostate-specific antigen level

A group of students are reviewing class material about immunizations and vaccines. The students demonstrate understanding of the topic when they state that immunizations and vaccines:

provide the person with active immunity.

For which disorder would treatment with an anti-infective be appropriate?

pyelonephritis

The clinic nurse admitting a 39-year-old female who reports left-sided tenderness, fever, chills, and flank pain. What does the nurse suspect the patient has?

pyelonephritis

The nurse knows that urinary anti-infectives are chosen to treat bladder infections because of what property?

rapid excretion rate

A client has been prescribed a transdermal patch of estrogen. Which adverse effect should be included in the teaching plan about the medication?

redness at the application site

The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of:

release of antidiuretic hormone.

A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of:

renal dysfunction

A nurse is caring for a client with irritation of the lower genitourinary tract. The client is administered phenazopyridine. Which condition in clients contraindicates the use of the drug?

renal impairment

A client presents at the emergency department reporting dizziness, mental confusion, and difficulty hearing. What should the nurse suspect is the client's issue?

salicylism

A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately?

SOB

A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition?

Salicylate intoxication

A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?

The hormonal contraceptives will stimulate tumor growth.

A female client reports a mild headache and is prescribed acetaminophen 325 mg, two tablets by mouth every 4 to 6 hours. The client states that she usually takes ibuprofen for her headaches and asks why the health care provider ordered acetaminophen. Which explanation would the nurse give?

"Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."

A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response?

"Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

A client has returned to the health care provider's office for follow up after receiving estrogen for symptoms of menopause. Which question should be included in the follow up?

"Can you describe in detail the difference in how you are feeling today and the last visit?"

The parents of an infant are skeptical of immunizing their child, stating, "I've heard a lot about the risks of autism, and I'm not comfortable with increasing that risk." What is the nurse's best response?

"Could we talk about some of the risks that you heard about?"

A female client has been admitted to the emergency department in distress and the nurse's review of the client's medication administration record reveals that the client takes cyclosporine and mycophenolate. What is the nurse's most appropriate assessment question for the client's family members?

"Has she ever been the recipient of a tissue transplant?"

A mother asks the nurse what she can do to help with the discomforts that her child may experience due to an immunization. What would be most appropriate?

"Have him take some time to rest throughout the day."

A nurse is assessing a client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for many months. What statement by the client indicates to the nurse that the client has a good understanding of the use of this therapy?

"I asked my doctor to check for blood in my stool regularly."

After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:

"I need to take the pill about an hour before any sexual stimulation."

A home care nurse is caring for a client who has received a liver transplant. The nurse is reinforcing earlier teaching about the client's immunosuppressant therapy and the need for appropriate self-care. Which client statement suggests that the client understands?

"I will always be at risk for serious infection."

On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate?

"It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke"

A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client?

"Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision."

The nurse is preparing to administer oprelvekin to a client diagnosed with a chemotherapy-induced bleeding disorder. The nurse is explaining to the client the reason for administering this drug? Which explanation is best?

"The drug is used to increase platelet count during chemotherapy."

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs?

"The labs will identify your body's ability to filter and excrete medications."

A nurse is precepting a nursing student, and together they are caring for a patient who is to receive interleukins. The student nurse asks what happens physiologically when a patient receives interleukins. What would be the nurse's best response?

"The patient has increases in the number of natural killer cells."

A client is administered mycophenolate to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. What is the nurse's best response?

"The weekly CBC assesses for the development of infection."

The parents of a two month-old infant have brought their child in to the clinic for the first scheduled immunizations. The parents appear anxious and the child's father says, "We keep hearing about the link between vaccinations and autism. Is there a risk that it could happen to our child?"

"There's been shown to be no genuine link between children receiving vaccinations and developing autism."

A client is alarmed to be prescribed celecoxib (Celebrex), stating, "I heard on TV that Celebrex causes heart attacks." How should the nurse best respond?

"This drug hasn't been definitively proven to be unsafe, so it's still available."

A male client who takes dutasteride for benign prostatic hypertrophy calls the clinic. He says he tried to donate blood and was denied because of his medication. The client is very concerned about this and wants to know why this happened. What is the nurse's best response to the client?

"This medication can harm a developing fetus so your blood could be harmful if given to a pregnant woman."

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response?

"What are some of the safety risks that most concern you?"

The nurse is preparing to administer a dose of the human papillomavirus vaccine to a middle school student. What assessment question should the nurse prioritize when interacting with the student?

"What's your understanding of why you're getting this vaccination?"

The nurse is teaching the client, who has been newly prescribed etanercept, how to administer the medication. What statement is accurate?

"You can rotate subcutaneous injection sites to avoid tissue damage."

The nurse is working with an 18-year-old client who recently immigrated and who did not receive childhood immunizations. The client is "catching up" on immunizations and is scheduled to receive a measles, mumps and rubella (MMR) vaccine today. What should the nurse teach the client about potential adverse effects?

"You might feel a bit unwell or get a slight fever after receiving your immunization."

For the first time, a 10 year-old female has received an IM injection of Gardasil. What follow-up education should the nurse provide?

"You'll have to get another shot in around 2 months."

A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?

"my sperm count should increase"

Which are patients the nurse would be concerned about regarding the adverse effects of immune suppressants? Select all that apply.

-A 22-year-old diagnosed with breast cancer -A 56-year-old with a history of cirrhosis -A 66-year-old patient with diabetes -A 76-year-old with a history of CHF

What immunizations are recommended for older adults? (Select all that apply.)

-A tetanus-diphtheria (Td) booster every 10 years -An annual influenza vaccine -A one-time administration of pneumococcal vaccine at 65 years of age

Which is an example of artificially acquired active immunity? (Select all that apply.)

-Administration of the varicella vaccine to an individual who has no immunity to the disease. -Administration of the influenza vaccine to an individual who has no immunity to the disease. -Administration of the rubella vaccine to an individual who has no immunity to the disease.

Which is an example of naturally acquired active immunity? (Select all that apply.)

-An individual who is exposed to chickenpox for the first time and has no immunity to the disease. -An individual who is exposed to pertussis for the first time and has no immunity to the disease.

The school nurse is interviewing the family of a 5 year-old who is beginning kindergarten. The parents state that the child's immunizations are all "up to date." The nurse recognizes that the child has immunity to what illnesses? Select all that apply.

-Diphtheria -Varicella -Tetanus -Hepatitis B -Poliovirus

A client is to receive oxytocin by IV infusion to promote labor. What would be most important to assess before initiating the therapy? (Select all that apply.)

-Fetal position -Uterine tone -Fetal heart rate -Maternal blood pressure

The nurse is taking the medical history of a female client who is scheduled to begin estrogen therapy. It is most important for the nurse to determine if the client has a history of what condition? Select all that apply.

-Thrombophlebitis -Liver disease -Hypertension

A nurse monitoring a client receiving methylergonovine (Methergine) might suspect ergotism if what symptom develops? (Select all that apply.)

-Tingling of the extremities -Increase in blood pressure -Abdominal pain

Antibodies that attach to specific receptor sites are being developed to respond to very specific situations. Every year, several new monoclonal antibodies are marketed. What are some examples of these antibodies? Select all that apply.

-adalimumab (Humira) -alemtuzumab (Campath) -basiliximab (Simulect) -bevacizumab (Avastin)

After administering the prescribed trimethoprim/sulfamethoxazole to a client, the nurse would assess the client for which adverse reactions? Select all that apply.

-anorexia -glossitis -allergic skin reaction

Which are the LEAST serious adverse effects associated with the use of monoclonal antibodies? Select all that apply.

-fever -malaise -diarrhea

A neonate who weighs 7 lbs, 8 oz kg is prescribed the hepatitis B immune globulin at a dose of 0.06 mL/kg IM. To one decimal place, what dose should the nurse administer?

0.2mL explanation- 7lb 8oz = 7.5lb = 3.41kg*0.06=0.2mL

A mother brings her 18-month-old into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the 18-month-old. What dosage will the nurse administer?

0.5mL

The contractions of a client who is receiving tocolytic therapy stop at 4 pm. The nurse would expect to continue to administer the drug infusion for at least which time frame?

12 hours

The nurse is explaining a schedule for vaccinations to the parents of a new client. When would the nurse explain that the measles, mumps, and rubella (MMR) vaccine is initially administered?

15 months

The nurse should be prepared to administer an infant's first dose of polio vaccine at what age?

2 months

The client has been on a systemic corticosteroid for the last 3 weeks. How long should the client wait before receiving a live virus vaccine?

3 months

Testosterone therapy would be recommended for all these patients except for a:

35-year-old male with erectile dysfunction due to diabetes mellitus.

A 7-year-old child with juvenile arthritis has been prescribed auranofin 0.125 mg/kg/day PO. The client weighs 88 lbs. How many mg of auranofin should the nurse administer each day?

5

A client began taking acetylsalicylic acid several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is the client most likely taking daily?

81mg

What client would be most likely to benefit from treatment with filgrastim (Neupogen)?

A client who has recently undergone bone marrow transplant to treat leukemia

Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen?

A male 30 years of age who drinks four beers per day

Which statements best indicates the client understands recommended vaccines following the 65th birthday?

A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

The nurse will appraise the success or failure of treatment of filgrastim therapy by regularly monitoring the results of what diagnostic test?

Absolute neutrophil count

A hospitalized client is about to receive immunological therapy and asks the nurse to explain the difference between passive and active immunity. In order to provide complete information, the nurse knows to include which information during the teaching session?

Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine).

A client has presented to the emergency department with a puncture wound suffered a few hours ago while demolishing an old house. The nurse's assessment reveals that the client is not in acute distress. The client's immunization status is unknown. What intervention should the nurse prioritize?

Administering tetanus immune globulin as prescribed

The nurse knows, that as a COX-1 inhibitor, indomethacin inhibits prostaglandins associated with which tissues?

All tissues and cell types

A client has been prescribed a PDE5 inhibitor for penile erectile dysfunction. Medication education should strongly discourage the use of what drug classification while on this medication?

Alpha blockers

A nurse should advise a female client beginning therapy with methyltestosterone for the treatment of inoperable advanced breast carcinoma of which of the following adverse reactions? Select all that apply:

Amenorrhea Acne Facial hair growth

A 17-year-old boy has been admitted to the emergency department after suffering a knee sprain during a football practice. The nurse notes that the client has exceptional muscle mass, and the boy quietly admits that this is mostly attributable to the use of steroids, which he obtains from a teammate. What should the nurse teach the boy about anabolic steroid abuse?

Anabolic steroids are universally dangerous but are especially harmful to adolescents.

An adult client is suspected of having an androgen deficiency and has spoken with his primary care provider about the possibility of treatment with testosterone. The use of testosterone would be most complicated by the presence of what preexisting health problem?

BPH

A nurse is caring for a hospitalized client with a urinary tract infection (UTI). The nurse is preparing to administer nitrofurantoin, which is a bacteriostatic antibiotic. Which statement best differentiates bacteriostatic and bactericidal medications?

Bacteriostatic medications slow or retard the multiplication of bacteria.

A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?

Better Mobility

A client is receiving anakinra as treatment for arthritis. The nurse understands that this drug acts in which manner?

Blocks interleukin-1

A client has a sulfonamide allergy. Which drug would the nurse identify as being contraindicated?

Celcoxib

A client's history reveals an allergy to sulfonamides. The nurse understands that which drug would be contraindicated?

Celecoxib

The nurse educator is teaching a class of students about the actions and uses of colony stimulating factor. The nurse should inform students CSF is indicated for what secondary problem related to cancer treatment?

Chemotherapy-induced neutropenia

A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?

Cipro

A client is started on trimethoprim and sulfamethoxazole for a urinary tract infection. The client reports nausea, anorexia, and abdominal pain. What intervention does the nurse discuss with the client?

Consume the medication with food

A male client received a kidney transplant 2 years ago. He asks the provider if he may begin to wean himself off of the immunosuppressive drug therapy. He is healthy and works as an engineer full time, and he finds the cost of the medication prohibitive. What would the nurse expect the health care provider to do?

Continue the medication because it is lifelong therapy.

A 1-year-old child will receive a scheduled MMR vaccination shortly. The nurse should teach the child's parents that the child may develop what possible adverse effect related to the administration of this medication?

Cough and fever

The health care provider has decided to prescribe T- and B-cell suppressors for a client diagnosed with psoriasis. What drug will be ordered for this client?

Cyclosporine

If a client who is prescribed tacrolimus has impaired liver function, what would the nurse expect the health care provider to do?

Decrease the dose

The nurse is providing education regarding immunization to the parent of an 11-year-old client. Which vaccine would the nurse indicate is recommended for both young adolescents and adults?

Diphtheria

A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?

Do not take any NDSAIDs

What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?

Endometrial cancer

A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization?

Epinephrine

A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse best demonstrates an understanding of the associated implications?

Estrogen increases the risk of certain cancers, MI, and blood clots.

A male patient, age 78, presents in the emergency department after stepping on a nail. The patient tells the nurse that he had his last tetanus shot 12 years ago and asks the nurse about the recommended interval for the administration of tetanus toxoid to adults. What would be the nurse's most correct response?

Every 10 years

An adult client received the annual influenza vaccine yesterday afternoon and has now presented back to the clinic reporting malaise. The client's oral temperature is 37.4°C (99.3°F). What is the nurse's best action?

Explain that vaccines often cause a mild immune response and have the client self-monitor

Serum sickness results from the overuse of vaccines.

False

A nurse is reviewing the history of a child who is scheduled to receive immunizations during this health care visit. A history of what issue would alert the need for cautious use of a vaccine?

Febrile convulsions

Temperature regulation occurs in the hypothalamus. Normally, when the body temperature increases the body will respond by causing vasodilation in the periphery. What physiologic change is occurring with fever that allows the body's temperature to increase?

Fever occurs as a result of increased synthesis of prostaglandin in the hypothalamus.

The nurse is caring for a client with gout that is taking colchicine. In addition to the administration of this medication, what education can the nurse provide to help with the prevention of future episodes of gout?

Follow a low purine diet

An 80-year-old male client presents to the health care provider's office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The provider orders a stool test for guaiac, which yields positive results. The provider discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs?

GI bleed

What drugs used to treat rheumatoid arthritis are contraindicated in a client who has a history of toxic levels of heavy metals?

Gold salts

The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering?

Gold Salts

A patient is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?

Have epinephrine available

A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?

Have epinephrine available during administration.

The perinatal nurse recognizes that what vaccine can be safely given to a neonate?

Hep B

A client is administered methotrexate for the treatment of severe rheumatoid arthritis. Administration of this drug should be performed with particular care because of the associated high risk of what condition?

Hepatotoxicity

The nurse is obtaining a history from a 23 year-old client. What symptom would lead the nurse to suspect that the client may be using DHEA?

Hirsutism

Which factors would predispose a female child to urinary tract infections? Select all that apply.

History of congenital bladder conditions Wiping back to front after using the toilet Evidence of recent sexual abuse

Which classification of medication is used to treat overactive bladder syndrome?

antispasmodics

Which statements indicate that a client understands the need for a follow-up after the initial injection of medroxyprogesterone?

I know that this injection last for 3 months

The nurse is evaluating the effectiveness of flavoxate (Urispas). Which report by the patient indicates the drug has been effective?

I slept uninterrupted through the night

A 9 year old child has been prescribed testosterone. What information should the nurse provide the client's parents regarding the continuation of the therapy?

If signs of early puberty are identified the therapy should be stopped

A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer?

antivenin

After teaching a group of students about immune modulators, the instructor determines that additional teaching is needed when the students identify what as an immune suppressant?

Interferon alfa-2b

Which agent would be classified as an immune stimulant?

Interferon alfa-2b

A patient with muscle ache would like to use an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The patient informs a nurse that he is taking antihypertensive drugs for blood pressure control. Why should the nurse caution the patient against the use of an NSAID while on antihypertensive drug therapy?

It causes decreased effectiveness of the antihypertensive drug.

A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's best response?

It is caused by a decrease in the number of RBCs.

An infant is being administered an immunization. Which statement provides an accurate description of an immunization?

It is the administration of an antigen for an antibody response.

A 38-year-old female client has just visited the health care provider and has received a prescription for birth control pills. The client calls the nurse and states that she doesn't need birth control pills because she had voluntary sterilization after her third child. The nurse explains that birth control pills may be used for what other reason?

Menstrual disorders

For what group of adults is pre-exposure immunization against hepatitis B recommended?

People with hemodialysis

The nurse is discussing proper use of oral contraceptives with a client. The nurse should instruct the client to immediately contact a health care provider if she:

Misses a menstrual period

A client is being treated for malignant melanoma and has been prescribed interferon alfa-2b. The client has complex medical history and the medication regimen includes aspirin, furosemide, bisoprolol and levothyroxine. When planning the client's care, what should the nurse prioritize?

Monitor the client's response to the medication and assess for adverse effects.

A 3-year-old has a history of recurrent urinary tract infections (UTI). Which practice implemented by the parents for the child indicates an understanding of preventive measures regarding these infections?

No use of bubble bath liquids or salts

What information should be provided to a client diagnosed with an acetylsalicylic acid allergy?

Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.

A nurse is reviewing the various anti-infective agents used to treat UTIs. With which would the nurse expect to administer a decreased dosage if the patient has renal dysfunction? (Select all that apply.)

Norfloxacin Co-trimoxazole Cinoxacin

A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route?

Oral

What conditions are salicylates are effective in managing? (Select all that apply.)

Pain Fever Inflammation

When acetylsalicylic acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action?

Platelet aggregation is inhibited.

The nurse is providing care for a client whose current medications include tacrolimus. The nurse should anticipate that this client is likely to be taking what medication concurrently?

Prednisone

The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug?

Prevention of organ rejection

A patient who is receiving an immune modulator has been admitted to the unit. What would be a priority action by the nurse?

Protect the patient from exposure to infection.

A client with dysmenorrhea has been prescribed naproxen 1250 mg PO b.i.d. What is the nurse's best action?

Question the prescriber about the dose

After an injection of oxytocin (Pitocin), during ongoing assessment what should the nurse monitor? (Select all that apply.)

RR, BP, and pulse

The nurse is instructing a client who will be taking finasteride for treatment of benign prostatic hypertrophy and gives the client information about which possible sexual side effects? (Select all that apply.)

Reduced libido Impotence Decreased volume of ejaculate

The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families?

Reduced risk for cervical cancer

A nurse is participating in an influenza vaccination clinic on a college campus. What action will best prepare the nurse for this role?

Review the procedure for IM injection

A nurse is caring for a patient who has been administered menotropins by the intramuscular route for the secretion of sex hormones. The patient reports pain after the drug is injected. Which intervention should the nurse perform for the patient?

Rotate sites and examine previous sites for redness

Which nursing diagnosis is highest priority for a patient with history of urinary urgency who is taking oxybutynin (Ditropan)?

Risk for impaired urinary elimination

A client is receiving anakinra for treatment of rheumatoid arthritis. The client is scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing diagnosis for this client after the procedure?

Risk for infection

A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?

Risk of birth defects

A nurse is caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for:

S/S of continuing UTI

A client enters the emergency department with reports of visual changes, drowsiness, and tinnitus. The client is found to be confused and hyperventilating. These signs and symptoms may be attributable to which condition?

Salicylism

A client with severe rheumatoid arthritis of the knees has arrived at the facility for an injection of a drug into the joint. Which agent would the nurse most likely expect to be used?

Sodium hyaluronate

Middle aged adults and health care workers should receive which immunizations?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually

The nurse is providing wellness information to a 50-year-old client who is employed as a paramedic. The client asks what, if any, vaccines the client should get. What is the nurse's best response?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually

A client seeking care for the treatment of a urinary tract infection (UTI) was prescribed nitrofurantoin. What change in the client's health status would prompt the use of an alternative medication?

The UTI progresses to urosepsis

It has been determined that a 33-year-old male client would likely benefit from treatment with testosterone. What aspect of the client's medical history could contraindicate this treatment?

The client has been diagnosed with hepatitis C.

A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider?

The client takes corticosteroids to treat rheumatoid arthritis

A male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?

The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.

A hospital patient began treatment with interferon alfa-2a several days ago and the care team is pleased with the patient's response at this point in treatment. However, the patient has stated to the nurse that he feels increasingly despondent and claims to have lost all hope of recovering from his disease, despite being an optimistic person. How should the nurse best interpret the patient's statements?

The patient may be having psychological adverse effects of interferon alfa-2a.

A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?

The risks of stroke and breast cancer are unacceptably high in women taking HRT.

While monitoring a woman who is receiving IV oxytocin for induction of labor, what event would cause the nurse to contact the health care provider immediately?

The uterine contractions are occurring every 90 seconds

A 37-year-old woman has just experienced the end of a long-term relationship and has expressed a desire to begin using oral contraceptives. What aspect of this woman's current health status would contraindicate this treatment?

The woman takes an antiplatelet medication for coronary artery disease.

While studying for a pharmacology test, a student asks peers about interferons. What statement about interferons is true?

They interfere with the ability of viruses in infected cells to replicate.

Aspirin has been prescribed for a 69-year-old client with a diagnosis of arthritis. The nurse monitors the client for which assessment finding that would indicate the presence of toxicity from this medication? (Select all that apply.)

Tinnitus Impaired hearing

The nurse anticipates the health care provider will order methylergonovine for which purpose?

To contract the uterus after delivery of the placenta

What is chrysotherapy?

Treatment with gold salts

A nurse suspects a client might be abusing anabolic steroids. Which signs might a client exhibit that would indicate abuse of anabolic steroids? (Select all that apply.)

Uncontrolled rage Jaundice Inability to concentrate Acne Severe depression

A client calls the clinic and tells the nurse about some urinary difficulties she is experiencing. What signs/symptoms would indicate to the nurse that this client may be experiencing overactive bladder syndrome? Select all that apply.

Urge incontinence Urinary urgency Frequency of urination

When describing the use of vaccines to a local community group, what would the nurse include?

Vaccines are used to provide active immunity.

A nurse is reviewing laboratory values of a client who has a urinary tract infection. Which cells protect the body from microorganisms?

WBCs

A client experiences intense knee pain due to arthritis and the use of a hyaluronidase derivative is being considered. What assessment finding must be considered?

Whether the client is comfortable having an injection into the knee joint

The nurse has administered a client's prescribed daily dose of filgrastim. When assessing for a therapeutic effect, what laboratory finding should the nurse prioritize?

White cell differential

The nurse is checking the orders for pain management for a client that had coronary surgery 24 hours ago. The nurse identifies that the client has been receiving Celebrex and a narcotic postoperatively for pain management. What is the most appropriate response of the nurse?

Withhold the Celebrex and notify the health care provider.

Which client is most likely to benefit from treatment with interferon beta?

a 51-year-old woman being treated for multiple sclerosis

A health care worker has received an annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend?

acetaminophen

Which is the antidote for acetaminophen poisoning?

acetylcysteine

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

acetylcysteine acid

A 24-year-old female athlete is using high doses of anabolic steroids to enhance her performance. She may be at risk for which condition?

acne

A nurse is planning care for a client who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug?

alt urinary elimination r/t overactive bladder

On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for sildenafil. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

angina, treated with nitroglycerin

A 52-year-old male client has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

are you taking any meds for High Bp?

The nurse is discussing adverse reactions involving the cardiovascular system after administration of oprelvekin. The nurse would include which reactions in the client teaching plan?

arrhythmia

A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem?

arthritis

The administration of immunizations to a client is a form of what type of immunity?

artificial active immunity

How should a nurse best explain the presence of the inflammation process?

as an attempt by the body to remove the damaging agent and repair the damaged tissue

A landscaper has sought care because of a puncture wound to her foot and the provider has prescribed 250 units of the tetanus immune globulin. In preparation for administration, the nurse should:

assess the skin integrity of potential intramuscular injection sites.

A nurse is required to care for a patient receiving the anti-infective methenamine for the treatment of chronic bacterial UTIs on an outpatient basis. What instruction should the nurse provide the patient related to the administration of the methenamine drug in the patient teaching plan?

avoid an excessive intake of citrus fruits

A nurse is working with a patient in the clinic who has erectile dysfunction. The patient has been prescribed sildenafil (Viagra). The patient wants to do everything he can to promote effectiveness of the drug. The nurse will instruct him to

avoid taking the drug a high-fat meal

Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to:

avoid taking the drug more than once in any 24-hour period.

The nurse is discussing the use of Depo-Provera with a 17-year-old female who desires birth control. The nurse recognizes that this medication is used in this client for what reason?

birth control for 3 months

When explaining the action of terazosin to a patient, which would the nurse include?

blocks apla 1 adrenergic receptors

A 52-year-old male with type 2 diabetes is using an anabolic steroid for treatment of hormonal deficiency. He is taking the sulfonylurea glyburide to treat his diabetes. The nurse caring for this client would closely monitor his:

blood glucose level

What is the most plausible rationale for a female client being prescribed danazol?

the client has endometriosis

Which monoclonal antibody is antibody specific to epidermal growth factor receptor sites?

cetuximab

A client is taking androgens and warfarin. What effect will these two medications have on the client's coagulation?

coagulation will be decreased

What is the role of interferons in the normal function of the immune system?

countering the replication and spread of viruses

While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is:

cyclosporine

A client is ordered to receive an nonsteroidal anti-inflammatory drug (NSAID) for pain. The client states that NSAIDs are taken only to decrease inflammation. The nurse instructs the client that these medications are also used for which?

decrease body temperature.

What would danazol be administered to women for?

decrease symptoms of endometriosis

A female patient receiving fluoxymesterone, an androgenic drug, for metastatic breast cancer is disturbed by the physical changes seen in her body. Which feature of virilization may be seen in the patient receiving this therapy?

deepening of the voice

A client who was prescribed doxazosin is talking with the nurse about adverse effects of the medication. What is the priority nursing diagnosis?

deficient knowledge

When fluoxymesterone is administered to a 14-year-old male, what is the expected result?

development of sexual organs

A patient with benign prostatic hypertrophy is receiving treatment with finasteride (Proscar). What is an appropriate patient instruction?

do not let your wife handle the pills

A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment?

do not take for more than 2 days

The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication?

enlarged penis

The nurse is aware that older men are more prone to urinary tract infections because of what physiologic change related to aging?

enlargement of the prostate

A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?

estrogen and progesterone diminish

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ?

every 10 years

The nurse would instruct a client who is using a transdermal system for testosterone administration to apply a new patch at which frequency?

every day

Dinoprostone can be used to terminate a pregnancy after 20 weeks.

false

a patient using an oxybutynin patch must change the patch daily

false

Which are common adverse reactions that is included in teaching a client about epoetin? Select all that apply.

fatigue nausea headache

A student asks the pharmacology instructor what effect the administration of androgens can have on a fetus if administered during pregnancy. What should the instructor respond?

female child may have masculinized features

The nurse administers ibuprofen to adult clients experiencing a variety of health disorders. Following administration, the nurse should assess for therapeutic effects related to what symptoms? Select all that apply.

fever inflammation moderate pain

A monophasic oral contraceptives composition is described as having which characteristic?

fixed amounts of both estrogen and progestin components

Which would lead a nurse to suspect that a client most likely has pyelonephritis?

flank pain

An older adult male prescribed anabolic steroids for a deficiency condition has presented with blood pressure above the normal baseline. What might be the cause for an increase in blood pressure associated with anabolic steroid therapy?

fluid and sodium retention

A client who is taking an estrogen reports swelling and weight gain. The nurse notes some peripheral edema. Which nursing diagnosis would the nurse identify as the priority?

fluid volume excess

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child?

hand and wrist epiphyseal growth plates

A client is admitted to the emergency department with suspect salicylism. The client's plasma salicylate level is 300 mcg/mL. Which sign/symptom would the nurse expect to assess? Select all that apply.

headache thirst flushing

Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen?

headaches

What client assessment finding will have the greatest effect on the half-life of methotrexate therapy?

history of chronic renal impairment

A client is prescribed methylergonovine. The nurse reviews the client's medical record for possible contraindications to the use of this drug. Which, if found, would the nurse identify as being a contraindication to the prescribed drug?

hypertension

A nurse educator is teaching nursing students about the administration colony-stimulating factors. Teaching is effective when the students identify the need to assess for which adverse reaction related to this drug?

hypertension

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

immune globulin

Which would a nurse expect to occur with the administration of anabolic steroids?

increased red blood cell mass

A client with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?

increased risk of pregnancy

A 53-year-old man is receiving cyclosporine in order to prevent rejection of a transplanted kidney. The nurse should prioritize assessments related to:

infection

A nurse is caring for a patient who is receiving azathioprine following kidney transplant. For what serious adverse effect should the nurse monitor the patient?

infection

A 78-year-old male client begins an immunosuppressant therapy for his rheumatoid arthritis. The nurse is concerned because this client is at greater risk for what complication, compared with younger adults using the same treatment modality?

infections

A group of students are reviewing information about immune modulators in preparation for a test. The students demonstrate understanding of the material when they identify what as an immune stimulant?

interferon

A client has been receiving long-term testosterone therapy. The nurse would expect to monitor:

liver function studies

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. Which potential adverse reaction should the nurse cite regarding the long-term use of these hormones?

liver tumors

When describing a urinary tract anti-infective, what would a nurse identify as one that acidifies the urine?

methenamine

A nurse should not administer solifenacin (Vesicare) to a patient with which medical condition?

myasthenia gravis

The pediatric client has a fever, and the nurse is preparing to administer an antipyretic. What drug would be the best choice for this client?

naproxen

A nurse is teaching a young adult client about oral contraceptives, which the client will soon begin taking. The client's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the client that oral contraceptives, when taken consistently, are how effective in preventing pregnancy?

nearly 100%

Which nursing observation is an appropriate outcome to indicate effective anti-infective therapy for a urinary tract infection?

negative urinalysis

A nurse is providing patient education to a 45-year-old man who is taking cyclosporine (Sandimmune). The nurse will provide the patient with education related to one of the most common and severe adverse effects of cyclosporine, which is:

nephrotoxicity

A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking:

nitroglycerin

The nurse is caring for an older adult. What is the primary nursing intervention to increase fluid intake in older adults?

offer a variety of fluids to the client every hour

After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency?

once a day

A client is prescribed sildenafil. Which statement should be included in teaching the client about the medication?

once daily dosing

A client is to receive methenamine. The nurse anticipates administering this drug by which route?

oral

A nurse is caring for a client following an organ transplant procedure. The client reports that oral cyclosporine tastes awful and that the client is unable to swallow it. The nurse tells the client that it is possible to make the medication more palatable by mixing it with:

orange juice

Which is the most likely indication for the use of immunosuppressant agents?

organ transplantation

A female client tells the nurse that she has been experiencing a strong and sudden desire to urinate and often cannot make it to the bathroom. The client also tells the nurse that she has to urinate all day and "many times" at night. The nurse suspects:

overactive bladder

A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would most likely identify this as which condition?

overactive bladder syndrome

A health care provider prescribes a urinary antispasmodic as a transdermal patch. The nurse identifies this as drug as:

oxybutynin

What would a nurse expect to be prescribed for a patient experiencing bladder spasms?

oxybutynin

A client with an extensive history of using herbal remedies asks the nurse if there is an herbal supplement for the diagnosis of BPH. Which supplement does the nurse provide information on for the treatment of BPH?

saw palmetto

Which conditions in a client's history should the nurse report to the health care provider who prescribed epoetin alfa? Select all that apply.

seizures hypertension congestive heart failure

What is an adverse effect of excessive immunosuppression?

serious infection

A client develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?

serum sickness

A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the client has been prescribed finasteride. When teaching the client about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of:

sexual dysfunction

A client with a recent history of benign prostatic hypertrophy (BPH) will soon begin treatment with finasteride. Before beginning this course of therapy, the nurse should caution the client to be aware of what potentially adverse effect?

sexual dysfunction

The anatomy and physiology instructor is discussing the action of endogenous estrogen on the body. What effect would the instructor tell the students estrogen has on breast tissue in the body?

stimulates construction of milk ducts

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

stomach

When considering the possible gastrointestinal side effects, what instruction should the nurse provide a client being prescribed a urinary tract antispasmodic?

take medication with food

The nurse is caring for a client who has been prescribed mycophenolate mofetil following kidney transplant. What instruction should the nurse provide during client teaching to minimize the risk of undesired effects?

taking the pills on an empty stomach

A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?

testosterone

What would the nurse identify as a vaccine that is a toxoid?

tetanus

A male adolescent is prescribed testosterone. In order to help the client deal with the added social stress that the medication may cause, the nurse should discuss which possible adverse effect?

the development of acne

A school nurse is educating a group of adolescents on the dangers of anabolic steroids. What statement by the nurse would explain why they are dangerous specifically to this age group?

these drugs can damage the heart, liver, and kidneys.

A nurse prepares to administer antithymocyte immune globulin. The nurse understands that this is used to:

treat acute renal transplant rejection

Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children.

true

After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given?

tuberculosis

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?

unstable angina and uses nitrglycerin patch

After experiencing several months of worsening nocturia, a client has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is the most likely to accompany BPH?

urinary frequency

Which laboratory test should the nurse monitor to evaluate treatment effectiveness, when a client has been prescribed a medication to manage bladder spasms associated with a urinary tract infection?

urine culture and sensitivity

A client has a history of recurrent urinary tract infection (UTI). The nurse should discuss which of the client's personal practices as possibly contributing to these infections?

using antacids to manager frequent indigestion

Medroxyprogesterone acetate is indicated for the treatment of women with what disorder?

uterine bleeding

A female client is prescribed fosfomycin for a urinary tract infection (UTI). Which reported condition suggests an adverse effect of the medication?

vaginal itching

The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?

vardenafil

A nurse is educating a group of young sports persons about the adverse effects associated with the use of anabolic steroids. Which of the following would the nurse include as occurring typically only in females?

virilization

A client receiving anti-infective therapy asks the nurse about the best fluids to drink to help eliminate the infection. Which would the nurse suggest as most appropriate? Select all that apply.

water cranberry juice prune juice

Which is an adverse effect caused by all uterine stimulants because of their antidiuretic effect?

water intoxication

The nurse has administered a client's prescribed daily dose of filgrastim. When assessing for a therapeutic effect, what laboratory finding should the nurse prioritize?

white cell differential

An older adult client has been brought to the clinic by family members who are concerned about the client's risk for developing shingles. The nurse should discuss what possible vaccination?

zoster vaccine