Pharmacological and Parenteral Therapies - ML4

A client admitted to the hospital has unstable angina and receives routine applications of nitroglycerin paste. Which assessment findings would prompt the nurse to withhold the next dose? Select all that apply.

1. systolic blood pressure below 90 mmHg 2. heart rate less than 60 bpm

A client is receiving morphine for postoperative pain. What should the nurse assess before administering the drug? Select all that apply.

1. urinary output 2.mental status 3. pain level

The emergency room nurse is answering a client's call light. The client requests pain medication for a severe headache. What priority actions will the nurse implement? Select all that apply.

1. Obtain a medication order for a severe headache. 2. Identify the client with two identifiers. 3. Assess the client's pain severity with a pain scale.

A client wants to donate blood before his or her abdominal surgery next week. What should be the nurse's first action?

Explain the time frame needed for autologous donation.

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

Hypoglycemia

When caring for a client with diabetes insipidus, the nurse expects to administer

vasopressin.

A female client is diagnosed with primary herpes genitalis. Which instruction should the nurse provide?

"Apply acyclovir ointment to the lesions every 3 hours, six times per day for 7 days."

A client recently diagnosed with depression has been prescribed sertraline and is now being discharged. Which statement by the spouse indicates understanding of the medication teaching?

"I should remind my spouse to take the medication in the morning before going to work."

The nurse instructs a client on the use of transdermal nitroglycerin 0.2 mg/hour patch for angina pectoris. Which client statement indicates that teaching was effective?

"I should report any skin irritation to the healthcare provider."

The nurse instructs a child's parents to administer the pescribed ferrous sulfate with a citrus juice. The parents ask why they need to do this. Which response by the nurse is the best?

"The citrus juice helps with the absorption of ferrous sulfate."

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse?

"The full benefit of the medication may take up to 2 weeks to be achieved."

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor?

"You must have the second one in 1 month and the third in 6 months."

The healthcare provider orders hydroxyzine hydrochloride 50 mg IM q 4-6 hours. The nurse assesses the client body composition and selects which needle length? Select all that apply.

1" & 1 1/2"

Which type of medication may be used to inhibit bladder contraction in a client with incontinence?

Anticholinergic agent

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient?

Blurred vision results after application.

A client reports pain in the right heel and is requesting medication. The nurse assesses the client and administers an analgesic. The client experiences no pain relief and states that the heel pain is worse. What is an appropriate intervention by the nurse?

Call the physician to report the finding.

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications?

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication?

Employs the Z-track technique

A client is receiving general anesthesia. The nurse anesthetist starts to administer the anesthesia. The client begins giggling and kicking her legs. What stage of anesthesia would the nurse document related to the findings?

II

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?

NPH

A client has a history of dysmenorrhea. During monthly menses, the client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend?

NSAIDs

Which medication classification represents a proton (gastric acid) pump inhibitor?

Omeprazole

Which medication may be ordered to relieve discomfort associated with a urinary tract infection?

Phenazopyridine

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for?

Postural hypotension and resulting injury

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin?

They increase the need for insulin.

The nurse understands that which of the following medications will be administered to the client for 6 to 12 weeks following prosthetic porcine valve surgery?

Warfarin

Small air bubbles adhering to the interior surface of the syringe might have which effect on parenteral administration?

altered drug dose

After a 3-month trial of dietary therapy, a client with type 2 diabetes still has blood glucose levels above 180 mg/dl (9.99mmol/L). The physician adds glyburide, 2.5 mg P.O. daily, to the treatment regimen. The nurse should instruct the client to take the glyburide:

at breakfast.

A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?

blood pressure 84/52 mm Hg

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because they

cannot tolerate a high glucose concentration.

A client with an intravenous (I.V.) site is experiencing pain. The nurse understands that pain with infusion is a sign of:

catheter position at the insertion site due to movement.

A nurse should expect to administer which medication to a client with gout?

colchicine

A child has been prescribed a 3-day course of treatment with gentamicin sulfate while recovering from surgery. Which assessment of the child causes the nurse to be the most concerned?

decreased urine output

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch fo

dizziness

The nurse prepares to administer all of a client's medications via feeding tube. The nurse consults the pharmacist and/or physician when the nurse notes which type of oral medication on the client's medication administration record?

enteric-coated tablets

Rebound hypoglycemia is a complication of parenteral nutrition caused by

feedings stopped too abruptly.

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate?

international normalized ratio (INR)

A client is experiencing vomiting and diarrhea for 2 days. Blood pressure is 88/56, pulse rate is 122 beats/minute, and respirations are 28 breaths/minute. The nurse starts intravenous fluids. Which of the following prescribed prn mediciations would the nurse administer next?

ondansetron

A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for bleeding and other adverse effects of heparin. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that is specific to heparin. Which agent fits this description?

protamine sulfate

A client's medication order reads, "Thioridazine 200 mg P.O. q.i.d. and 100 mg P.O. p.r.n." A nurse should:

question the physician about the order.

A client who is 85 kg has a prescription for acyclovir 10 mg/kg in 100 mL sodium chloride to infuse over 1 hour. The client's IV infusion infiltrates 8 minutes before the infusion is completed. How much of the acyclovir has the client received? Round to one decimal point.

736.7

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment?

Administer antiemetics in anticipation of the patient's nausea.

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

Anticholinergic

A client comes into the emergency department with severe back pain radiating to the left lower groin. The healthcare provider prescribes morphine sulfate 5-10 mg IV every 2 hours. One hour after receiving 10 mg of morphine, the client is restless and distressed, reporting the pain is still at 8 of 10. What action will the nurse take?

Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control.

Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a selective estrogen receptor modulator (SERM)?

Tamoxifen

The nurse is reconstituting a powdered medication in a vial. After adding the solution to the powder, the nurse should

roll the vial gently between the palms.

A nurse suspects that a client has digoxin toxicity. The nurse should assess for

vision changes.

The nurse is calculating drug dosages for a child. What is the most important measurement for the nurse to consider?

weight in kilograms