Pharmacological Therapies LWW
The nurse is explaining the use of transdermal nitroglycerin, which is to be applied twice daily. The client demonstrates understanding when he states:
"My wife should be careful not to touch the patch with her fingers if she helps me."
A pregnant client asks the nurse whether she can take castor oil for her constipation. How should the nurse respond?
"No, it can initiate premature uterine contractions."
A client who's receiving phenytoin to control seizures is admitted to the health care facility for observation. The physician orders measurement of the client's serum phenytoin level. Which serum phenytoin level is therapeutic?
10 to 20 mcg/ml
After laparoscopic cholecystectomy, a client reports abdominal pain. The nurse prepares morphine 2 mg. If the label on the morphine reads 10 mg/ml, how many milliliters should the nurse have in the syringe after the correct dose is drawn up?
0.2
The nurse is caring for a 15-year-old who has suffered third degree burns to 30% total burn surface area (TBSA). The health care provider has order morphine 0.5 mg by mouth every 3 to 4 hours as needed for pain. The elixir comes in 2mg/1 ml. How many milliliters would the nurse give? Record your answer using two decimal places.
0.25
A client is to receive a glycerin suppository. When inserting the suppository, the nurse should advance it approximately how far into the client's rectum?
3" (7.5 cm)
After receiving an oral dose of codeine for an intractable cough, the client asks the nurse, "How long will it take for this drug to work?" How should the nurse respond?
30 minutes
After a 3-month trial of dietary therapy, a client with type 2 diabetes sill has blood glucose levels above 180 mg/dl. The physician adds glyburide, 2.5 mg P.O. daily, to the treatment regimen. The nurse should instruct the client to take glyburide:
30 minutes before breakfast
The nurse in a psychiatric inpatient unit is caring for a client with obsessive-compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam, 1 mg by mouth three times per day. During lorazepam therapy, the nurse should instruct the client to follow with advise?
Avoid caffeine
The nurse auscultates inspiratory and expiratory wheezes with a decreased forced expiratory volume in a client with asthma. Which class of medication would the nurse expect to administer IMMEDIATELY?
Bronchodilators
A client with severe preeclampsia is receiving an intravenous infusion of magnesium sulfate. The client is exhibiting signs and symptoms of magnesium toxicity. Which medication would the nurse expect to be given?
Calcium gluconate
A preschooler with a history of heart failure is prescribed digoxin. Which nursing intervention is most important to perform before administering this drug to a child?
Check apical heart rate for 1 minute
A client has a nasogastric (NG) tube. The physician prescribes an oral medication that is not available in liquid form. Which action should the nurse utilize to administer the tablet form to this client?
Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe.
The nurse is reviewing the teaching provided to the family of a client with a psychiatric disorder about traditional antipsychotic drugs and their effect on symptoms. The nurse understands that which symptoms would be MOST responsive to these types of drugs?
Delusions
A client with a history of atrial arrhythmia is receiving propranolol, 10 mg by mouth three times per day. The nurse knows that propranolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?
Heart
A client is taking antihypertensive medication and tells the nurse who's monitoring the blood pressure that he can't have sexual intercourse with his wife anymore. What likely cause should the nurse discuss with the client?
His blood pressure medication
In reinforcing education with the parents of an infant diagnosed with diabetes insipidus, the nurse should include which treatment?
Hormone replacement
For a client with an exacerbation of rheumatoid arthritis, the physician prescribes the corticosteroid prednisone. When caring for this client, the nurse should monitor for which adverse drug reactions?
Increased weight, hypertension, and insomnia
A client has been taking a decongestant for allergic rhinitis. During a follow-up visit, which data collected by the nurse suggests that the decongestant has been effective?
Less sneezing
A client with allergic rhinitis is prescribed loratadine. On a follow-up visit, the client tells the nurse, "I take one 10-mg tablet of Claritin with a glass of water two times daily." The nurse concludes that the client requires additional teaching about this medication because:
Loratadine should be taken once daily for allergic rhinitis.
A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention would the nurse use to determine if TPN is providing adequate nutrition?
Monitoring the client's weight every day
A client has been prescribed a new drug for hypertension. Thirty minutes after taking the drug, the client develops chest tightness, becomes short of breath and tachypneic, and exhibits an altered level of consciousness. What is the best explanation for these symptoms?
The client is experiencing a hypersensitivity reaction to the medication.
A client who's taking antipsychotic medication develops a very high temperature, severe muscle rigidity, tachycardia, and rapid deterioration in mental status. The nurse suspects what severe complication of antipsychotic therapy?
Neuroleptic malignant syndrome (NMS)
A client is refusing all medications and is having difficulty breathing, with a respiratory rate of 34 breaths/minute and anxiety. What is the PRIORITY nursing action?
Notify the health care provider of the status of this client
A client with a severe staphylococcal infection is receiving the aminoglycoside gentamicin sulfate by the I.V. route. The nurse should monitor the client for which adverse reaction to this drug?
Ototoxicity
Which finding indicates that oxycodone given to a client with breast cancer that has metastasized to the bone is exerting the desired effect?
Pain is 0 to 2 on a 10-point scale
A 5-year-old newly diagnosed asthma client is being discharged from the hospital following asthma exacerbation. While providing discharge instructions to an overwhelmed parent, which instruction is essential for for home medication use?
Provide the family with the drug's name, dosage, route, and frequency of administration
Which method should the nurse use to properly instill eardrops in an adult client with otitis externa?
Pull the pinna up and back.
A client in the terminal stage of cancer is receiving a continuous infusion of morphine for pain management. Which data collection finding suggests that the client is experiencing an adverse effect of this drug?
Respiratory rate of 8 breaths/minute
Hormonal effects of the anitpsychotic medications include:
Retrograde ejaculation and gynecomastia.
Which detail of a client's drug therapy is the nurse legally responsible for documenting?
Safe ranges of the drug
A client is to receive several oral medications. Which nursing instruction or action is appropriate in this situation?
Stating the name and action of use of each medication before administering it
The client with a peptic ulcer is prescribed an antacid. After administering the medication, the nurse assesses the pH of which organ contents to determine effectiveness?
Stomach
A primigravida client with severe gestational hypertension is admitted to the labor unit. She has been receiving magnesium sulfate IV for 3 hours. The latest data reveals deep tendon reflexes (DTRs) of +1, blood pressure of 150/100 mm Hg, a pulse of 92 beats/minute, a respiratory rate of 10 breaths/minute, and urine output of 20 mL/ hour. Which action would be most appropriate?
Stop the magnesium sulfate infusion
Teaching for women in their childbearing years who are receiving antipsychotic medications should include which of the following facts?
The client should continue using contraception during periods of amenorrhea
A nurse is caring for a client with myasthenia gravis. Which behavior during dinner indicates to the nurse that the client is having a therapeutic response to pyridostigmine?
The client swallows food without difficulty
Where should the nurse instill an ophthalmic medication in a 6-year-old child?
The lower conjunctival sac
The nurse is caring for a child who is receiving steroid therapy as part of the cancer treatment plan. The child tearfully asks the nurse, "Why does my face looks so "fat?" What information should be included in the nurse's response?
This change is temporary and will subside once the steriod medication has been discontinued
Why are antacids administered regularly, rather than as needed, to treat peptic ulcer disease?
To keep gastric pH at 3.0 to 3.5
The physician orders nitroglycerin, 5 mg by mouth twice per day, for a client. The drug is dispensed in 2.5-mg tablets. How many tablets will the nurse administer twice per day?
Two
Dextroamphetamine has been ordered for a client diagnosed with narcolepsy. The nurse understands that this medication acts as:
a central nervous system (CNS) stimulant.
A client with a diagnosis of diabetes insipidus is being treated with desmopressin acetate. The client asks, "What is this medication?" What is the best response by the nurse?
a synthetic vasopressin
After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which medication should the nurse anticipate administering?
calcium gluconate
A 59-year-old client is scheduled for cardiac catheterization the next morning. His physician prescribed secobarbital sodium, 100 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that:
sedatives reduce excitement; hypnotics induce sleep.
The nurse is caring for an infant who is receiving I.V. therapy. The health care provider orders D5NS 400-mL to infuse in 8 hours. How much I.V. solution would the nurse place in the buretrol?
50-mL
The physician prescribes norfloxacin, 400 mg by mouth twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. The nurse advises the client to take the medication for how many days?
7 to 10 days
A child is to receive furosemide 4 mg/kg/day in one daily dose. The child weighs 20 kg. How many milligrams should the nurse administer in each dose? Record your answer using a whole number.
80
A client comes to the clinic with back pain that has been unrelieved by continuous ibuprofen use over the past several days. Current prescription medications include captopril and hydrochlorothiazide. Which laboratory value should the nurse report?
Blood urea nitrogen (BUN) of 26 mg/dL and serum creatinine of 2.35 mg/dL
Before administering digoxin to a client, a nurse reviews information about the drug. She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:
kidneys
The nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?
low serum potassium level
Sildenafil has been prescribed for a client. While reviewing his medical records, the nurse would question which order?
use of nitroglycerin
The nurse suspects that a 68-year-old client has digoxin toxicity. The nurse should assess for:
vision changes.
A nurse is caring for a client diagnosed with bipolar disorder who is taking lithium carbonate. When reviewing information about this therapy, what instruction would be MOST important to reinforce with this client?
"Be sure to drink at least 2 1/2 quarts (2500 mL) a day."
The nurse reinforces disease management instructions for a client newly diagnosed with type 1 diabetes. Which statement indicates to the nurse that the client has understood the information?
"Checking my blood sugar before meals and at bedtime will help me manage my blood sugar."
A client is taking an oral antidiabetic agent, to treat type 2 diabetes. Which statement indicates the need for further client teaching about treatment of this disease?
"I often skip lunch because I don't feel hungry."
When reinforcing education with parents of an infant newly diagnosed with diabetes insipidus, which statement by the parent indicates an appropriate understanding of this condition?
"I realize that treatment for diabetes insipidus is lifelong."
A client is given triazolam for a sleep disorder. The nurse is reinforcing some teaching precautions concerning the medication. Which statements by the client indicate an understanding of the information provided?
"I shouldn't confuse this medication with Haldol."
A nurse is reinforcing education for a client who has been prescribed buspirone for long-term treatment of anxiety. The nurse determines that the education has been effective when which statement is made by the client?
"I will not take the medicine with grapefruit juice."
The nurse is reinforcing education about antihypertensive therapy with the parents of a child with glomerulonephritis. Which statement made by the parent indicates that further teaching is required?
"My child will need to take antihypertensive drugs for the rest of his life."
A client is prescribed heparin 6,000 units subcutaneously every 12 hours for deep vein thrombosis prophylaxis. The pharmacy dispenses a vial containing 10,000 units/1 mL. How many milliliter(s) of heparin should the nurse administer? Record your answer using one decimal place.
0.6
The physician prescribes meperidine, 30 mg I.M., as preoperative medication for a school-age child who weighs 66 lb (30 kg). The meperidine is supplied as 50mg/ml. How much meperidine should the nurse administer?
0.6 ml
A client has just had total hip replacement surgery. The client's primary care provider orders 8,000 units of heparin to be administered subcutaneously. The label on the heparin vial reads "Heparin 10,000 units/mL." How many milliliters of heparin should the nurse draw up in the syringe to administer the correct dose? Record your answer using one decimal place.
0.8
A health care provider prescribes I.V. normal saline solution to be infused at a rate of 150 mL/hour for a client. How many liter(s) of solution will the client receive during an 8-hour shift? Record you answer using one decimal place
1.2
An older adult client is prescribed fluoxetine, 40 mg by mouth twice per day, for treatment of depression. The client has difficulty swallowing, so the pharmacy dispenses the oral solution containing 20 mg/5 mL. How many milliliters of solution should the nurse administer to achieve the prescribed dose? Record your answer using a whole number
10
