Pharmacology ATI Learning System Quiz, FINAL HESI 2022

A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

"I should notify my provider immediately if my urine turns an orange color."

A client with CHF is being discharges with a new prescription for ACE inhibitor Captopril (Capoten). The nurse's discharge instruction should include reporting which problem to the health care provider? A. weight loss B. Dizziness C. Muscle cramps D. Dry mucous membreanes

B. Dizziness

A health care provider prescribes bisacodyl for a client with cardiac disease. The nurse explains to the client that this drug acts by what mechanism? 1 Producing bulk 2 Softening feces 3 Lubricating feces 4 Stimulating peristalsis

4 Stimulating peristalsis

What information should the nurse include when teaching a client about antacid tablets? 1 Take them at 4-hour intervals. 2 Take them 1 hour before meals. 3 They are as effective as the liquid forms. 4 They interfere with the absorption of other drugs

4 They interfere with the absorption of other drugs

Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (inderal) A. headache, hypertension, blurred vision B. wheezing, hypotension, and AV block C. vomiting, dilated pupils and papilledma D. tinnitus, muscle weakness and tachypnea.

B. wheezing, hypotension, and AV block

which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? A. loperamide (Imodium) B. probanthine (Propantheline) Bismuth subsalicylate (Pepto Bismol) D. diohenoxylare hydrochloride with atropine (lomotil)

C. Bismuth subsalicylate (Pepto Bismol)

which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? A. an older client with type 2 diabetes B. a client with chronic rheumatoid arthritis C. a client with an open compound fracture D. a young adult with inflammatory bowel disease

D. a young adult with inflammatory bowel disease

Nurse is caring for older adult pt who has new prescription for zolpidem at bedtime to promote sleep. Nurse should plan to monitor pt for which of following adverse effects?

Dizziness Zolpidem can cause dizziness and daytime drowsiness. It can cause confusion in the older adult client.

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects?

Tachycardia

A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?

Reduce the infusion rate

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching?

Respiratory depression can occur 7 min after the morphine is administered.

A client who is receiving pregabalin (Lyrica) for fibromyalgia complains of tremors in the hands. What action should the nurse implement? a. obtain orthostatic BP readings b. notify the HCP c. collect a capillary glucose level d. administer PRN of an anti anxiety drug

b. notify the HCP

To assess for the effectiveness of amlodipine (Norvasc), a calcium channel blocker, what action should the nurse implement? a. review the client's intake and output b. note the client's serum calcium levels c. measure the client's BP d. monitor the client's serum electrolytes

c. measure the client's BP ??

A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

Hypotension

Nurse is providing teaching to pt who has UTI and new prescriptions for phenazopyridine and ciprofloxacin. Which of following statements by pt indicates need for further teaching?

"I should notify my provider immediately if my urine turns an orange color." Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. The medication can cause the client's urine to turn a reddish-orange color. This coloration is an expected effect of this medication, although it can stain clothing, and does not need to be reported to the provider.

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?

"I will give my child a dose as soon as wheezing starts."

Nurse is providing teaching to parent of child who has asthma and new prescription for cromolyn sodium metered dose inhaler. Which of following statements by parents indicate need for further teaching?

"I will give my child a dose as soon as wheezing starts." Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication.

Nurse is providing teaching to newly licensed nurse about administering morphine via IV bolus to pt. Which of following information should nurse include in teaching?

"Respiratory depression can occur 7 min after the morphine is administered." Respiratory depression can occur within 7 min following the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine. The nurse should administer morphine via IV bolus slowly over 4 to 5 min to prevent hypotension and respiratory depression. The nurse should withhold the morphine if the client has a respiratory rate less than 12/min. IV morphine peaks in 20 min.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

"Rifampin can turn body fluids orange."

Nurse is caring for pt who has been taking isoniazid and rifampin for 3 wks for Tx of active pulmonary TB. Pt reports his urine is orange color. Which of following statements should nurse make?

"Rifampin can turn body fluids orange." Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

"Take hydrochlorothiazide in the morning."

Nurse is providing teaching to pt who has new prescription for hydrochlorothiazide 50 mg PO to Tx HTN. Which of following instructions should nurse include in teaching?

"Take the hydrochlorothiazide in the morning." The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and prevent nocturia.

The nurse retrieves hydromorphone (Dilaudid) 4mg/ ml from the Pyxis Medstation, an automated dispensing system, for a client who is receiving Dilaudid 3 mg IM q6 hours PRN severe pain. How many ml should the nurse administer to the client. (Enter the numerical value only. If rounding is required round to the nearest tenth.

*not multiple choice 0.8 d/h x v = 3mg/ 4mg x 1 ml = 0.75 = 0.8 ml

A client receives a prescription for penicillin G 1,000,000 units IM daily. The medication is available in 1,200,000 until/ 2 ml syringe. How many ml should the nurse administer?

.83 ??

A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)

0.5

Nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/ml. How many ml should nurse administer? (Round to nearest tenth)

0.5 ml

A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr. Available is heparin 10,000 units/1 mL. How many mL should the nurse administer per dose? (Round the answer to the nearing tenth)

0.8

Nurse is preparing to administer heparin 8,000 units subq q8h. Available is heparin 10,000 units/ml. How many mL should nurse administer per dose? (Round to nearest tenth)

0.8 mL

A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? 1 "Exercise increases the need for carbohydrates and decreases the need for insulin." 2 "Exercise increases the need for insulin and increases the need for carbohydrates." 3 "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." 4 "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."

1 "Exercise increases the need for carbohydrates and decreases the need for insulin."

Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching? 1 "I will drink 2 to 3 quarts (2 to 3 liters) of fluid a day." 2 "Any reconstituted solution must be discarded in 1 week." 3 "I can continue driving my car as long as I have the stamina." 4 "While taking this medicine I should be able to continue my usual activity."

1 "I will drink 2 to 3 quarts (2 to 3 liters) of fluid a day."

A client with a new diagnosis of type 1 diabetes is told that lifelong insulin will be needed. The client becomes agitated and says, "I am scared of shots. If that is my only option, I'll just have to go into a coma and die!" What is the nurse's best response? 1 "Injections are not the only option available for insulin." 2 "It won't be so bad; you will get used to it if you will only try." 3 "This is one of those times when you need to act like an adult." 4 "Clients have the right to refuse treatment, but I need you to sign this form that removes us from liability for your decision."

1 "Injections are not the only option available for insulin."

A healthcare provider prescribes an antibiotic intravenous piggyback twice a day for a client with an infection. The healthcare provider prescribes peak and trough levels 48 and 72 hours after initiation of the therapy. The client asks the nurse why there is a need for so many blood tests. What reason does the nurse provide? 1 "They determine adequate dosage levels of the drug." 2 "They detect if you are having an allergic reaction to the drug." 3 "The tests permit blood culture specimens to be obtained when the drug is at its lowest level." 4 "These allow comparison of your fever to when the blood level of the antibiotic is at its highest."

1 "They determine adequate dosage levels of the drug."

A nurse is caring for a female client who is receiving rifampin for tuberculosis. Which statements indicate that the client understands the teaching about rifampin? Select all that apply 1 "This drug may be hard on my liver so I must avoid alcoholic drinks while taking it." 2 "This drug may reduce the effectiveness of the oral contraceptive I am taking." 3 "I cannot take an antacid within 2 hours before taking my medicine." 4 "My healthcare provider must be called immediately if my eyes and skin become yellow.

1 "This drug may be hard on my liver so I must avoid alcoholic drinks while taking it." 2 "This drug may reduce the effectiveness of the oral contraceptive I am taking." 4 "My healthcare provider must be called immediately if my eyes and skin become yellow.

A client with tuberculosis is to begin combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, "I've never had to take so much medication for an infection before." How will the nurse respond? 1 "This type of organism is difficult to destroy." 2 "Streptomycin prevents side effects of the other drugs." 3 "You'll only need to take the medications for a couple of weeks." 4 "Aggressive therapy is needed because the infection is well advanced."

1 "This type of organism is difficult to destroy."

In what ways can a nurse prevent medication errors? Select all that apply 1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 3 Try to guess what the client is saying if the language is not understood 4 Document each dose of the drug using trailing zeros when recording the dose 5 Check three times before giving a drug by comparing the drug order and medication profile

1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 5 Check three times before giving a drug by comparing the drug order and medication profile

A client who has been prescribed tetracycline continues the course of treatment during the first trimester of pregnancy. Which teratogenic effect may occur in the fetus? 1 Bone anomalies 2 Central nervous system malformations 3 Facial malformations 4 Internal organ defects

1 Bone anomalies

Loratadine, 10 mg by mouth once a day in the morning, is prescribed for a 15-year-old girl with hay fever. The girl tells the school nurse that she is concerned that she will be sleepy for a quiz the next day. How should the nurse respond? 1 By explaining that this medication rarely causes drowsiness 2 By advising her to take half a tablet in the morning before school 3 By suggesting that she skip the next day's dose if she can tolerate the hay fever 4 By recommending that she call the allergist for a prescription containing a stimulant

1 By explaining that this medication rarely causes drowsiness

A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications? 1 Eat yogurt with active cultures daily. 2 Avoid spicy foods. 3 Drink more fruit juices. 4 Take a multivitamin every day

1 Eat yogurt with active cultures daily.

Which first line medication would the nurse state is used to treat anaphylactic reactions? 1 Epinephrine 2 Norepinephrine 3 Dexamethasone 4 Diphenhydramine

1 Epinephrine

A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? 1 Increase the intake of fluids. 2 Strain the urine for crystals and stones. 3 Stop the drug if urinary output increases. 4 Maintain the exact time schedule for taking the drug

1 Increase the intake of fluids.

A nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply 1 Irritability 2 Glycosuria 3 Dry, hot skin 4 Heart palpitations 5 Fruity odor of breath

1 Irritability 4 Heart palpitations

A client is diagnosed with tuberculosis associated with human immunodeficiency virus infection. What crucial laboratory test results should the nurse review before antitubercular pharmacotherapy is started? 1 Liver function studies 2 Pulmonary function studies 3 Electrocardiogram and echocardiogram 4 White blood cell (WBC) count and sedimentation rate

1 Liver function studies

A client with gastroesophageal reflux disease (GERD) receives a prescription for an H2 receptor antagonist. Which medications are within the classification of an H2 receptor antagonist? Select all that apply 1 Nizatidine 2 Ranitidine 3 Famotidine 4 Lansoprazole 5 Metoclopramide

1 Nizatidine 2 Ranitidine 3 Famotidine

A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide? 1 Stimulates the pancreas to produce insulin 2 Accelerates the liver's release of stored glycogen 3 Increases glucose transport across the cell membrane 4 Lowers blood glucose in the absence of pancreatic function

1 Stimulates the pancreas to produce insulin

A mother complains that her child's teeth have become yellow in color. With prolonged use, which medication may be responsible for the child's condition? 1 Tetracycline 2 Promethazine 3 Chloramphenicol 4 Fluoroquinolones

1 Tetracycline

A nurse is preparing to administer insulin to a client with diabetes. In which order should the nurse perform the actions associated with insulin administration? Correct 2. Rotate the vial of insulin between the palms of the hands. 4 Instill air into the vial of insulin equal to the desired dose. 3. Wipe the top of the insulin vial with an alcohol swab. 5. Withdraw the correct amount of insulin from the inverted vial. 1. Wash hands with soap and water

1,2,3,4,5 1. Wash hands with soap and water 2. Rotate the vial of insulin between the palms of the hands. 3. Wipe the top of the insulin vial with an alcohol swab. 4 Instill air into the vial of insulin equal to the desired dose. 5. Withdraw the correct amount of insulin from the inverted vial.

A client with type 1 diabetes self-administers NPH insulin every morning at 8 am. The nurse evaluates that the client understands the action of the insulin when the client identifies which time range as the highest risk for hypoglycemia? 1. 2 pm to 8 pm 2. 8 pm to noon 3. 9 am to 10 am 4. 10 am to 11 am

1. 2 pm to 8 pm

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)

1. PTT 2. Asparate aminotransferase (AST) 3. Alanine aminotransferase (ALT)

A healthcare provider prescribes a medication to be administered via a metered-dose inhaler (MDI) for a young adult with asthma. List in order the steps the nurse teaches the client to follow when using the inhaler. 1. Shake the inhaler for 30 seconds. 2. Hold the inhaler upright in the mouth. 3. Exhale slowly and deeply to empty the air from the lungs. 4. Start breathing in and press down on the inhaler once

1. Shake the inhaler for 30 seconds. 3. Exhale slowly and deeply to empty the air from the lungs. 2. Hold the inhaler upright in the mouth. 4. Start breathing in and press down on the inhaler once

upon admission to the emergeny center, an adult client with acute status astmaticus is prescribed this series of medications. in which order should the nurse administer the prescribed meds? 1. Gentamicin 2.prednisone 3.albuterol 4.salmeterol

1. albuterol 2. salmeterol 3. prednisone 4.gentamycin

A client with tuberculosis is started on a chemotherapy protocol that includes rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? 1 "I need to drink a lot of fluid while I take this medication." 2 "I can expect my urine to turn orange from this medication." 3 "I should have my hearing tested while I take this medication." 4 "I might get a skin rash because it is an expected side effect of this medication.

2 "I can expect my urine to turn orange from this medication."

A nurse evaluates that a client understands appropriately how to take the antacids prescribed by the primary health care provider when the client makes which statement? 1 "I will take this antacid at the onset of pain." 2 "I will take this antacid 30 minutes after meals." 3 "I will take this antacid every 4 hours around the clock." 4 "I will take this antacid each time I have something to eat."

2 "I will take this antacid 30 minutes after meals."

During a teaching session about insulin injections, a client asks the nurse, "Why can't I take the insulin in pills instead of taking shots?" What is the nurse's best response? 1 "Insulin cannot be manufactured in pill form." 2 "Insulin is destroyed by gastric juices, rendering it ineffective." 3 "Your health care provider decides the route of administration." 4 "Your health care provider will prescribe pills when you are ready."

2 "Insulin is destroyed by gastric juices, rendering it ineffective."

A senior nurse teaches a nursing student about how to treat poisoning in young children. Which statement by the nursing student indicates the need for further teaching? 1 "An emergency team should be called if the victim stops breathing." 2 "Syrup of ipecac should be administered immediately after poisoning." 3 "The National Poison Control hotline should be called if a poison is ingested." 4 "The child should be removed from the hazardous environment if the poison has been inhaled."

2 "Syrup of ipecac should be administered immediately after poisoning."

A client with a history of malabsorption syndrome is admitted to the hospital for medical management. Total parenteral nutrition (TPN) has been prescribed. What action will the nurse take to prevent a major reaction to the TPN infusion? 1 Record the intake and output. 2 Administer the infusion slowly. 3 Change the site every 24 hours. 4 Check the vital signs every 4 hours

2 Administer the infusion slowly.

A nurse is reviewing a newly admitted client's medication administration record (MAR). Which element, if missing, makes the record incomplete? 1 Height 2 Allergies 3 Vital signs 4 Body weight

2 Allergies

After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with a gastric ulcer. The client receives a prescription for ranitidine 150 mg twice a day. What concern prompts the nurse to contact the health care provider about the prescription? 1 Ranitidine can increase bleeding risk. 2 An administration route is not specified. 3 Ranitidine is contraindicated for gastric ulcers. 4 The recommended dose is higher than prescribed

2 An administration route is not specified.

Daily regular insulin has been prescribed for a client with type 1 diabetes. The nurse administers the insulin at 8 am. When should the nurse monitor the client for a potential hypoglycemic reaction? 1 At breakfast 2 Before lunch 3 Before dinner 4 In the early afternoon

2 Before lunch

A health care provider prescribes vancomycin peak and trough levels for a client who is receiving vancomycin intravenous piggyback (IVPB). When should the nurse have the laboratory obtain a blood sample to determine a peak level of the antibiotic? 1 Halfway between two doses of the drug 2 Between 30 and 60 minutes after a dose 3 Immediately before the medication is administered 4 Anytime it is convenient for the client and the laboratory

2 Between 30 and 60 minutes after a dose

Which Food and Drug Administration pregnancy risk category do drugs that have not undergone any studies in animal and pregnant women belong to? 1 Category B 2 Category C 3 Category D 4 Category X

2 Category C

A nurse administers beclomethasone by inhalation to a client with asthma, and the client asks why this medication is necessary. What should the nurse explain is the purpose of this pharmacologic therapy? 1 Promotes comfort 2 Decreases inflammation 3 Stimulates smooth muscle relaxation 4 Reduces bacteria in the respiratory tract

2 Decreases inflammation

What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators? 1 Is able to obtain pulse oximeter readings 2 Demonstrates use of a metered-dose inhaler 3 Knows the healthcare provider's office hours 4 Can identify the foods that may cause wheezing

2 Demonstrates use of a metered-dose inhaler

A nurse determines that the teaching about the side effects of azithromycin has been understood when the adolescent client identifies which problem as the most common side effect of this medication? 1 Tinnitus 2 Diarrhea 3 Dizziness 4 Headache

2 Diarrhea

A health care provider prescribes psyllium 3.5 g twice a day for constipation. What is most important for the nurse to teach this client? 1 Urine may be discolored. 2 Each dose should be taken with a full glass of water. 3 Use only when necessary because it can cause dependence. 4 Daily use may inhibit the absorption of some fat-soluble vitamins

2 Each dose should be taken with a full glass of water.

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide? 1 To augment the immune response 2 To potentiate the effect of antacids 3 To treat Helicobacter pylori infection 4 To reduce hydrochloric acid secretion

3 To treat Helicobacter pylori infection

A nurse plans an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin. What is the purpose of this snack? 1 Encouragement to stay on the diet 2 Food to counteract late insulin activity 3 Added calories to promote weight gain 4 High carbohydrates to provide nourishment for immediate use

2 Food to counteract late insulin activity

A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client? 1 Determine the client's emotional state. 2 Give prescribed drugs to promote bronchiolar dilation. 3 Provide education about the impact of a family history. 4 Encourage the client to use an incentive spirometer routinely

2 Give prescribed drugs to promote bronchiolar dilation.

A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action? 1 NPH insulin 2 Insulin lispro 3 Regular insulin 4 Insulin glargine

2 Insulin lispro

A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug? 1 Arterial blood pH 2 Intake and output 3 Fasting serum glucose 4 Pulse and respiratory rates

2 Intake and output

A nurse administers a tube of glucose gel to a client who is hypoglycemic. What explanation does the nurse share regarding the reversal of hypoglycemia? 1 It liberates glucose from hepatic stores of glycogen. 2 It provides a glucose source that is rapidly absorbed. 3 Insulin action is blocked as it competes for tissue sites. 4 Glycogen is supplied to the brain as well as other vital organs

2 It provides a glucose source that is rapidly absorbed.

Which nursing action is the priority when administering chelation therapy for a toddler-age client? 1 Assessing vital signs 2 Monitoring urine output 3 Conducting a behavioral assessment 4 Providing education to reduce lead exposure

2 Monitoring urine output

What are the desired outcomes that the nurse expects when administering a nonsteroidal antiinflammatory drug (NSAID)? Select all that apply 1 Diuresis 2 Pain relief 3 Antipyresis 4 Bronchodilation 5 Anticoagulation 6 Reduced inflammation

2 Pain relief 3 Antipyresis 6 Reduced inflammation

A client with type 1 diabetes requests information about the differences between penlike insulin delivery devices and syringes. What information does the nurse provide about the penlike devices? 1 The penlike devices have a shorter injection time 2 Penlike devices provide a more accurate dose delivery. 3 The penlike delivery system uses a smaller-gauge needle. 4 Penlike devices cost less by having reusable insulin cartridges

2 Penlike devices provide a more accurate dose delivery.

What interventions are needed to help prevent accidental poisoning of children? Select all that apply 1 Medicines should be referred to as candy. 2 Potent poisons should be kept out of reach of children. 3 Containers of the poisonous substances should be tightly closed. 4 Old unused and unnecessary medications should be safely disposed. 5 Medications should be transferred from their original containers to alternate ones

2 Potent poisons should be kept out of reach of children. 3 Containers of the poisonous substances should be tightly closed. 4 Old unused and unnecessary medications should be safely disposed.

A health care provider prescribes ranitidine for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works? 1 Ranitidine increases gastrointestinal peristalsis. 2 Ranitidine reduces gastric acidity in the stomach. 3 Ranitidine neutralizes the acid that is present in the stomach. 4 Ranitidine stops production of hydrochloric acid in the stomach

2 Ranitidine reduces gastric acidity in the stomach.

What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy? 1 Exercise regularly. 2 Rotate injection sites. 3 Use the Z-track technique. 4 Avoid massaging the injection site

2 Rotate injection sites.

Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate? 1 Antacids should be taken 30 minutes before a meal. 2 Sucralfate should be taken on an empty stomach one hour before meals. 3 Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease. 4 Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects

2 Sucralfate should be taken on an empty stomach one hour before meals.

The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling? 1 At bedtime 2 With meals 3 One hour before meals 4 On arising each morning

2 With meals

A 67-year-old client has tested positive for influenza A. The client also has asthma. Which drug would the nurse recommend be avoided in this client? 1 Ribavirin 2 Zanamivir 3 Oseltamivir 4 Amantadine

2 Zanamivir

A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number)

20

Nurse is preparing to administer furosemide 4mg/kg/day PO divided into 2 equal doses daily to toddler who weighs 22 lbs. How many mg should nurse administer per dose? (Round to nearest whole number)

20 mg

A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor or the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how may gtt/min? (Round the answer to the nearest whole number).

21

Nurse is preparing to administer LR 1,000mL IV over 8hr. Drop factor of manual tubing is 10 gtt/ml. Nurse should set manual IV infusion to deliver how many gtt/min. (Round to nearest whole number)

21 gtt/min

Pyridoxine (vitamin B6) and isoniazid (INH) are prescribed as part of the chemotherapy protocol for a client with tuberculosis. Which response indicates to the nurse that vitamin B6 is effective? 1 Weight gain 2 Absence of stomatitis 3 Absence of numbness and tingling in extremities 4 Acceleration of dormant tubercular bacilli destruction

3 Absence of numbness and tingling in extremities

For a client with difficulty swallowing, the nurse should crush which medication? 1 Metoprolol extended release 2 Felodipine sustained release 3 Acetaminophen extra strength 4 Potassium chloride extended release

3 Acetaminophen extra strength

A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? 1 Overeating 2 Intestinal virus 3 Aerobic exercise 4 Missed insulin dose

3 Aerobic exercise

A client has an anaphylactic reaction after receiving intravenous penicillin. What does the nurse conclude is the cause of this reaction? 1 An acquired atopic sensitization occurred. 2 There was passive immunity to the penicillin allergen. 3 Antibodies to penicillin developed after a previous exposure. 4 Potent antibodies were produced when the infusion was instituted

3 Antibodies to penicillin developed after a previous exposure.

The nurse is preparing to discharge a client who presented to the emergency room for an acute asthma attack. The nurse notes that upon discharge the healthcare provider has prescribed theophylline 300 mg orally to be taken daily at 9:00 AM. The nurse will teach the client to take the medication on which schedule? 1 With a meal 2 Only at bedtime 3 At a specific time prescribed 4 Until symptoms are gone

3 At a specific time prescribed

A client is started on tetracycline antibiotic therapy. What should the nurse do when administering this drug? 1 Administer the medication with meals or a snack. 2 Provide orange or other citrus fruit juice with the medication. 3 Give the medication an hour before milk products are ingested. 4 Offer antacids 30 minutes after administration if gastrointestinal side effects occur

3 Give the medication an hour before milk products are ingested.

A client newly diagnosed with diabetes arrives at the emergency department complaining of dizziness and weakness. The client's spouse reports that the client has been confused since this morning. The spouse reports that the client administered the morning dose of 10 units of regular insulin and 25 units of NPH insulin with difficulty and did not eat much breakfast. What does the nurse identify as the most likely cause of the client's signs and symptoms? 1 Hyperglycemia 2 Hyperlipidemia 3 Hypoglycemia 4 Hypocalcemia

3 Hypoglycemia

Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client identifies which times for the medication schedule? 1 At bedtime with a snack 2 Three times a day with meals 3 In the early morning with food 4 One hour before or two hours after eating

3 In the early morning with food

A nurse identifies that an older adult has not achieved the desired outcome from a prescribed proprietary medication. When assessing the situation, the client shares that the medication is too expensive and that the prescription was never filled. What is an appropriate nursing response? 1 Ask the pharmacist to provide a generic form of the medication. 2 Encourage the client to acquire the medication over the Internet. 3 Inform the healthcare provider of the inability to afford the medication. 4 Suggest that the client purchase medical insurance that covers prescription medications

3 Inform the healthcare provider of the inability to afford the medication.

During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. What is the priority nursing intervention? 1 Restart the client's infusion at another site. 2 Slow the rate of the client's infusion of the TPN. 3 Interrupt the client's infusion and notify the healthcare provider. 4 Obtain the vital signs and continue monitoring the client's status

3 Interrupt the client's infusion and notify the healthcare provider.

A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which drug does the nurse expect the health care provider to prescribe? 1 Psyllium 2 Bisacodyl 3 Loperamide 4 Docusate sodium

3 Loperamide

A healthcare provider prescribes ampicillin for a client with an infection. What information should the nurse include in the teaching plan about this medication? 1 Take the ampicillin with meals. 2 Store the ampicillin in a light-resistant container. 3 Notify the healthcare provider if diarrhea develops. 4 Continue the drug until a negative culture is obtained

3 Notify the healthcare provider if diarrhea develops.

A client is receiving penicillin G and probenecid for syphilis. What rationale should the nurse give for the need to take these two drugs? 1 Each drug attacks the organism during different stages of cell multiplication. 2 The penicillin treats the syphilis, whereas the probenecid relieves the severe urethritis. 3 Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods. 4 Probenecid decreases the potential for an allergic reaction to penicillin, which treats the syphilis

3 Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods.

A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe? 1 NPH insulin 2 Inhaled insulin 3 Regular insulin 4 Insulin glargine

3 Regular insulin

A client admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease has received a prescription for a medication that is delivered via a nebulizer. When teaching about use of the nebulizer, the nurse should teach the client to do what? 1 Hold the breath while spraying the medication into the mouth. 2 Position the lips loosely around the mouthpiece and take rapid, shallow breaths. 3 Seal the lips around the mouthpiece and breathe in and out, taking slow, deep breaths. 4 Inhale the medication from the nebulizer, remove the mouthpiece from the mouth, and then exhale.

3 Seal the lips around the mouthpiece and breathe in and out, taking slow, deep breaths.

A client receiving intravenous vancomycin reports ringing in both ears. Which initial action should the nurse take? 1 Notify the primary healthcare provider. 2 Consult an audiologist. 3 Stop the infusion. 4 Document the finding and continue to monitor the client

3 Stop the infusion.

A nurse is administering a histamine H2 antagonist to a client who has extensive burns. The nurse explains to the client that this drug is given prophylactically during the first few weeks after extensive burns. What complication of burns will it prevent? 1 Colitis 2 Gastritis 3 Stress ulcer 4 Metabolic acidosis

3 Stress ulcer

Naltrexone is used to treat clients with substance abuse problems. In which situation does the nurse anticipate that naltrexone will be administered? 1 To treat opioid overdose 2 To block the systemic effects of cocaine 3 To decrease the recovering alcoholic's desire to drink alcohol 4 To prevent severe withdrawal symptoms from antianxiety agents

3 To decrease the recovering alcoholic's desire to drink alcohol

A client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important? 1 "Report any changes in vision." 2 "Take the medicine with my meals." 3 "Call my doctor if my urine or tears turn red-orange." 4 "Continue taking the medicine even after I feel better.

4 "Continue taking the medicine even after I feel better.

A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? 1 "I will take the drug with food." 2 "I must swallow my medication whole and not crush or chew it." 3 "I will notify my doctor if I develop muscular or abdominal discomfort." 4 "I will stop taking metformin for 24 hours before and after having a test involving dye."

4 "I will stop taking metformin for 24 hours before and after having a test involving dye."

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? 1 "I will need to have my eyes and vision examined once a year." 2 "I will need to check my blood sugar at home to evaluate my response to my treatment plan." 3 "I can improve metabolic and cardiac risk factors of this disease if I follow a low-calorie diet and lose weight." 4 "Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."

4 "Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."

A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? 1 "Eliminating fluids with meals will prevent pain." 2 "I will increase my food intake to avoid an empty stomach." 3 "Taking an aspirin with milk will relieve my pain and coat my ulcer." 4 "Taking an antacid preparation will decrease pain due to gastric acid."

4 "Taking an antacid preparation will decrease pain due to gastric acid."

Ampicillin 250 mg by mouth every 6 hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin? 1 "I should drink a glass of milk with each pill." 2 "I should drink at least six glasses of water every day." 3 "The medicine should be taken with meals and at bedtime." 4 "The medicine should be taken one hour before or two hours after meals

4 "The medicine should be taken one hour before or two hours after meals

A client is receiving dexamethasone to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client? 1 Hyperkalemia 2 Liver dysfunction 3 Orthostatic hypotension 4 Increased blood glucose

4 Increased blood glucose

A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse? 1 "Sedatives can be given to help you relax." 2 "We can give you immune serum globulin." 3 "Vitamin supplements are frequently helpful and hasten recovery." 4 "There are medications to help reduce viral load and liver inflammation.

4 "There are medications to help reduce viral load and liver inflammation.

A client develops a fever after surgery. Ceftriaxone is prescribed. For which potential adverse effect should the nurse monitor the client? 1 Dehydration 2 Heart failure 3 Constipation 4 Allergic response

4 Allergic response

A healthcare provider prescribes ophthalmic drops for a client. What should a nurse include in the instructions for a client learning to self-administer eyedrops? 1 Lie on the unaffected side for administration. 2 Instill drops onto the pupil to promote absorption. 3 Close eyes tightly after administering the eyedrops. 4 Apply pressure to the nasolacrimal duct after instillation

4 Apply pressure to the nasolacrimal duct after instillation

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

Muscle weakness

The nurse is preparing to administer an intravenous piggyback antibiotic that has been newly prescribed. Shortly after initiation, the client becomes restless and flushed and begins to wheeze. The nurse determines the that appropriate priority action will be to stop the antibiotic infusion and then do what? 1 Notify the physician immediately about the client's condition. 2 Take the client's blood pressure. 3 Obtain the client's pulse oximetry. 4 Assess the client's respiratory status

4 Assess the client's respiratory status

The nurse provides discharge teaching to a client with tuberculosis. Which treatment measure does the nurse reinforce as the highest priority? 1 Getting sufficient rest 2 Getting plenty of fresh air 3 Changing the current lifestyle 4 Consistently taking prescribed medication

4 Consistently taking prescribed medication

A nurse has provided teaching to a client with a newly prescribed proton pump inhibitor (PPI). The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of which condition? 1 Diarrhea 2 Vomiting 3 Cardiac dysrhythmias 4 Gastroesophageal reflux disease (GERD

4 Gastroesophageal reflux disease (GERD

A client with type 1 diabetes tells the nurse, "I take guaifenesin cough syrup when I have a cold." What important instruction does the nurse include in client teaching about this medication? 1 Substitute an elixir for the cough syrup. 2 Increase fluid intake and use a humidifier to control the cough. 3 The small amounts of sugar in medications are not a concern with diabetes. 4 Include the glucose in the cough syrup when calculating daily carbohydrate allowance

4 Include the glucose in the cough syrup when calculating daily carbohydrate allowance

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? 1 Increases gastric motility 2 Neutralizes gastric acidity 3 Facilitates histamine release 4 Inhibits gastric acid secretion

4 Inhibits gastric acid secretion

A client is diagnosed with type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. For what side effect should the nurse teach this client to monitor? 1 Ketonuria 2 Weight loss 3 Ketoacidosis 4 Low blood sugar

4 Low blood sugar

A health care provider prescribes daily docusate sodium for a client. The nurse explains to the client that this drug has what action? 1 Lubricates the feces 2 Creates an osmotic effect 3 Stimulates motor activity 4 Lowers the surface tension of feces

4 Lowers the surface tension of feces

The postoperative prescriptions for a client who had repair of an inguinal hernia include docusate sodium daily. Before discharge, the nurse instructs the client about what potential side effect? 1 Rectal bleeding 2 Fecal impaction 3 Nausea and vomiting 4 Mild abdominal cramping

4 Mild abdominal cramping

A healthcare provider prescribes famotidine and magnesium hydroxide/aluminum hydroxide antacid for a client with a peptic ulcer. The nurse should teach the client to take the antacid at what time? 1 Only at bedtime, when famotidine is not taken 2 Only if famotidine is ineffective 3 At the same time as famotidine, with a full glass of water 4 One hour before or 2 hours after famotidine

4 One hour before or 2 hours after famotidine

A nurse is caring for a client who has been taking several antibiotic medications for a prolonged time. Because long-term use of antibiotics interferes with the absorption of fat, what prescription does the nurse anticipate? 1 High-fat diet 2 Supplemental cod liver oil 3 Total parenteral nutrition (TPN) 4 Water-soluble forms of vitamins A and E

4 Water-soluble forms of vitamins A and E

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? 1 Is the easiest method for administering needed nutrition 2 Is the safest method for meeting the client's nutritional requirements 3 Will satisfy the client's hunger without the discomfort associated with eating 4 Will meet the client's nutritional needs without causing the discomfort precipitated by eating

4 Will meet the client's nutritional needs without causing the discomfort precipitated by eating

A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number)

5 mL

RN is preparing to administer amoxicillin 250 mg liquid suspension PO q8h to older adult pt. Available is amoxicillin 50 mg/ml. How many ml should administer? (Round to nearest whole number)

5 ml

A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number)

63

Nurse is preparing to administer enteral tube feeding through NG tube at 250mL over 4hr. Nurse should set pump to deliver how many mL/hr? (Round to nearest whole number)

63 mL/hr

The HCP prescribed 2 L of 5% dextrose in water (d5w) to infuse in 24 hours. The IV administration set delivers 15 gtt/ ml. How many ml/ hour should the nurse program the infusion pump. (enter the numeric value only. if rounding is required, round to the nearest whole number)

83 ml/hr

an adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (toradol) 30 mg IV q6h. which action should the nurse implement? A. administer both medications according to the prescription. B. hold the ketorolac to prevent an antagonistic effect. C. hold the morphine to prevent an additive drug interaction. D. contract the healthcare provider to clarify the prescription.

A. administer both medications according to the prescription.

an adult client is given a prescription for a scopolamine patch (transferm scop) to prevent motion sickness while on a cruise. which information should the nurse provide to the client? A. apply the patch at least 4 hours prior to departure B. change the patch every other day while on the cruise C. place the patch on a hairless area at the base of the skull D. drink no more than 2 alcoholic drinks during the cruise

A. apply the patch at least 4 hours prior to departure

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A. client states chest pain is relieved B. client's pulse decreases from 120 to 90 C. client's systolic BP decreases from 180 to 90. D. clients Oxygen level increases form 92% to 96%

A. client states chest pain is relieved

A client with hyperlipidemia receives a prescription of niacin (niaspan). which client teaching is most important for the nurse to provide? A. expected duration of flushing B. symptoms of hyperglycemia C. diets that minimize GI irritation D. comfort measures for pruritis.

A. expected duration of flushing

a client is receiving digoxin for the onset of supraventricular tachycardia. which lab findings should the nurse identify that places this client at risk? A. hypokalemia B. hyponatremia C. hypercalcemia D. low uric acid levels

A. hypokalemia

Which instruction(s) should the nurse give to a female client who just recieved a prescription for oral metronidazole (flagyl) for treatment of trichomonas vaginalis? (select all that apply). A. increase fluid intake, especially cranberry juice. B. do not abruptly discontinue the medication, taper use. C. check BP daily to detect hypertension D. avoid drinking alcohol while taking this medication E. use condoms until treatment is completed F. ensure that are sexual partners are treated at the same time.

A. increase fluid intake, especially cranberry juice. D. avoid drinking alcohol while taking this medication E. use condoms until treatment is completed F. ensure that are sexual partners are treated at the same time.

A client is admitted to the coronary care unit with a medical diagnosis of acute MI. which medication prescription decreases both preload and afterload? A. nitroglycerin B. propranolol (inderal) C. morphine D. captopril (capoten)

A. nitroglycerin

Which method of medication administration provides the client with the greatest first-pass effect? A. oral B. sublingual C. intravenous D. subcutaneous.

A. oral

A client with a dysrhythmia is to receive procainamide (pronestyl) in divided 4 doses over the next 24 hours. what dosing schedule is best for the nurse to implement? A. q6h B. QID C. AC and bedtime D. PC and bedtime

A. q6h

A client is revieving ampicillin sodium (Omnipen) for a sinus infection. the nurse should instruct he client to notify the healthcare provider immediately is which symptom occurs? A. rash B. nausea C. headache D. dizziness

A. rash

A client is receiving methylprednisolone (solu-medrol) 40 mg IV daily. the nurse anticipates an increase in which lab value as the result of this medication? A. serum glucose B. serum calcium C. RBCs D. serum potassium

A. serum glucose

A client is being treated for osteoporosis with alendronate (fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? A. take medication, go for a 30 minute morning walk, then eat breakfast B. take medication, rest in bed for 30 minutes , eat breakfast, go for morning walk C. take medication with breakfast, then take a 30 minute morning walk. D. go for a 30 minute morning walk, eat breakfast, then take medication

A. take medication, go for a 30 minute morning walk, then eat breakfast

After abdominal surgery, a male client is prescribed low molecular weight heparin. during administration of the medication, the client asks the nurse why he is receiving this medication. which is the best response for the nurse to provide? A. this medication is a blood thinner given to prevent blood clot formation B. this medication enhances antibiotics to prevent infection C. this medication dissolves any clots that develop in the legs D. this abdominal injection assists in the healing of the abdominal wound.

A. this medication is a blood thinner given to prevent blood clot formation

A category X drug is prescribed for a young adult female client. which instruction is most important for the nurse to teach this client? A. use a reliable source of birth control B. avoid exposure to UV light C. refuse this medication if planning pregnancy D. abstain from intercourse while on this drug.

A. use a reliable source of birth control

a female client with rheumatoid arthritis take ibuprofen (motrin) 600mg PO 4 times a day. to prevent gastrointestinal bleeding, misorpostol (cytotec) 100 mcg PO is prescribed. which information is most important for the nurse to include in client teaching? A. use contraception during intercourse B. ensure the cytotec is taken on an empty stomach C. encourage oral fluid intake to prevent constipation D. tale cytotect 30 minutes prior to motrin

A. use contraception during intercourse

the nurse is transcribing a new prescription for spironolactone (adactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. which action should the nurse implement? A. verify both prescriptions with the healthcare provider B. report the medication interactions to the nurse manager C. hold the ACE inhibitor and give the new prescription D. transcribe and send the prescription to the pharmacy

A. verify both prescriptions with the healthcare provider

the nurse is preparing the 0900 dose of losartan (cozaar), an ARB for a client with hypertension and heart failure. the nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. what action should the nurse take first? A. withhold the scheduled dose B. check the client's apical pule C. notify the healthcare provider D. repeat the serum potassium level

A. withhold the scheduled dose

A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer?

Acetaminophen

Nurse is caring for pt who has peptic ulcer disease and reports headache. Which of following meds should nurse plan to administer?

Acetaminophen Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding. Ibuprofen is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage. Naproxen is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage. Aspirin is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage.

A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take?

Administer the medication into the client's abdomen.

Nurse is administering subq heparin to pt who is at risk for DVT. Which of following actions should nurse take?

Administer the medication into the client's abdomen. The heparin should be administered into the client's abdomen. The nurse should administer heparin using a 25-gauge or smaller needle to decrease the risk of hemorrhage.

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?

Amantadine

Nurse is assessing pt who has new prescription for chlorpromazine to Tx schizophrenia. Pt has mask-like facial expression and is experiencing involuntary movements and tremors. Which of following meds should nurse anticipate administering?

Amantadine The client is experiencing parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

Ambulate the client to a chair prior to administering the medication

Nurse on medical unit is preparing to administer alendronate 40 mg PO for older adult pt who has Paget's disease of bone. Which of following actions should be nurse's priority?

Ambulate the client to a chair prior to administering the medication. The nurse should ambulate the client to a chair and ensure that the client is sitting upright before administering the alendronate to prevent esophagitis from occurring. The client must also be able to sit or stand upright for 30 min after taking the medication. The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of Needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client.

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

Antiestrogenic

Nurse is caring for pt who has new prescription for tamoxifen. Nurse should recognize that tamoxifen has which of following therapeutic effects?

Antiestrogenic Tamoxifen is an antiestrogen medication used to treat cancer of the breast in both pre- and postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk.

A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Arthralgia

In evaluation the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended? A. increase in urine output B. 2 or 3 soft stools per day. C. watery, diarrhea stools D. increased serum bilirubin

B. 2 or 3 soft stools per day.

When assessing and adolescent who recently overdosed on acetaminophen (tylenol), it is most important for the nurse to assess for pain in which area of the body? A. flank B. abdomen C. chest D. head

B. abdomen

The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with CHF. which intervention should the nurse implement prior to administering Digoxin? A. observe respiratory rate and depth B. assess serum potassium level C. obtain the client's BP D. Monitor the serum glucose level

B. assess serum potassium level

which medication should the nurse caution the client about taking while receiving an opioid analgesic? A. antacids B. benzodiazepines C. antihypertensives D. oral antidiabetics

B. benzodiazepines

While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agen should the nurse ask the client about when taking the nursing history? A. aminoglyocosides B. cephalosporins C. sulfonamides D. tetracycline

B. cephalosporins

the nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effect. the nurse should prepare the client for which side effect that is mostly likely to persist during long-term use of opioids? A. sedation B. constipation C. urinary retention D. respiratory depression

B. constipation

The nitrate isosorbide dinitrate (isordil) is prescribed for a client with angina. which instruction should the nurse include in this client's discharge teaching plan? A. quit taking the medication if dizziness occurs. B. do not get up quickly. always rise slowly. C. take the medication with food only. D. increase your intake of potassium rich foods.

B. do not get up quickly. always rise slowly.

which dosing schedule should the nurse teach the client to observe for a controlled release oxycodone prescription? A. as needed B. every 12 hours C. every 24 hours D. every 4 to 6 hours

B. every 12 hours

A peak and trough level must be drawn for a client receiving antibiotic therapy. what is the optimum time for the nurse to obtain the trough level? A. sixty minutes after the antibiotic dose is administered B. immediately before the next antibiotic dose is given C. when the next blood glucose level is to be checked. D. thirty minutes before the next antibiotic dose is given.

B. immediately before the next antibiotic dose is given

A client with Parkinson's disease is taking carbidopa-levadopa (Sinemet). which observation by the nurse would indicate that the desired outcome of the medication is being achieved? A. decreased BP B. lessening of tremors C. increased salivation D. increased attention span

B. lessening of tremors

a client with osteoarthritis receives a new prescription for celecoxib (celebrex) orally for symptom management. the nurse notes the client is allergic to sulfa. which action is most important for the nurse to implement prior to administering the first dose? A. review the client's hemoglobin results B. notify the healthcare provider C. inquire about he reaction to sulfa D. record the client's vital signs

B. notify the healthcare provider

In teaching a client who had a liver transplant about cylcospoine (sandimmune), the nurse should encourage the client to report which adverse response to the healthcare provider? A. changes in urine color B. presence of hand tremors C. increasing body hirsutism D. nausea and vomiting

B. presence of hand tremors

Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin (coumadin). In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? A. perfusion scan B. Prothrombin Time (PT/INR) C. activated partial thromboplastin (APPT) D. serum coumadin level (SCL).

B. prothrombin time (PT/INR)

a client with heart failure is prescribed spironolactone (aldactone). which information is most important for the nurse to provide to the client about diet modifications? A. do not add salt to foods during preparation B. refrain from eating foods high in potassium. C. restrict fluid intake to 1000 ml per day D. increase fluid intake of milk and milk products.

B. refrain from eating foods high in potassium.

the healthcare provider prescribes naloxone (narcan) for a client in the emergency room. which assessment data would indicate that the naloxone has been effective? the client's: A. statement that the chest pain is better B. respiratory rate is 16 breaths/ min C. seizure activity has stopped temporarily D. pupils are constricted bilaterally.

B. respiratory rate is 16 breaths/ min

A 43 year old female client is receiving thyroid replacement hormone following a thryoidectomy. what adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? A. tinnitus and dizziness B. tachycardia and chest pain C. dry skin and intolerance to cold D. weight gain and increased appetite.

B. tachycardia and chest pain

a 43 year old female client is receiving thyroid replacement hormone following a thyroidectomy. what adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the provider? A. tinnitus and dizziness B. tachycardia and chest pain C. dry skin and intolerance to cold D. weight gain and increased appetite

B. tachycardia and chest pain

the nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client int he immediate postop period. the client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA pump to a total 5 mg IV maximally per hour. what assessment has the highest priority before initiating the PCA pump. A. the expiration date on the morphine syringe in the pump B. the rate and depth of the client's respirations C. the type of anesthesia used during the surgical procedure. D. the client's subjective and objective signs of pain.

B. the rate and depth of the client's respirations

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?

Bleeding

Nurse is caring for pt who has prescription for clopidogrel. Nurse should monitor pt for which of following adverse effects?

Bleeding Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee ground emesis, black tarry stools, ecchymosis, or any indication of bleeding.

A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? A. glaucoma B. hypertension C. heart failure D. asthma

C. heart failure

A client is receibing metoprolol (Lopressor). What assessment is most important for the nurse to obtain? A. temp. B. lung sounds C. BP D. urinary output

C. BP

A postoperative client has been receiving a continuous IV infusion of meperidine (demerol) 35mg/hr for four days. the client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. what action should the nurse take first? A. administer a PRN dose of PO meperidine (Demerol). B. administer naloxone (Narcan) IV per PRN protocol/ C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol. D. notify the healthcare provider of the client's confusion and hallucinations

C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.

the nurse is assessing a client who is experiencing anaphylaxis from an insect sting. which prescription should the nurse prepare to administer this client? A. dopamine B. ephedrine C. Epinephrine D. diphenhydramine

C. Epinephrine

A client is taking hydromorphone (dilaudid) PO q4h at home. following surgery, diluadid IV q4h PRN and butorphanol tartrate (stadol) IV q4h PRN as prescribed for pain. the client received a dose of Dilaudid IV 4 hours ago,and is again requesting pain medication. what intervention should the nurse implement? A. alternate the 2 medications q4h PRN for pain B. alternate the 2 medications Q2h PRN for pain C. administer only the diluadid q4h for pain D. administer only the stadol q4h PRN for pain.

C. administer only the diluadid q4h for pain

A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. when the client reports the onset of a headache prior to the next scheduled does, which action should the nurse implement? A. hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (tylenol) B. administer the 40mg of imdur and then contact the healthcare provider. C. administer the 60mg dose of Imdur and a PRN dose of acetaminophen (tylenol) D. do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider.

C. administer the 60mg dose of Imdur and a PRN dose of acetaminophen (tylenol)

A client receiving albuterol (proventil) tablets complains of nausea every evening with her 9pm dose. what action shoul dthe nurse take to alleviate this side effect? A. change the time of the dose B. Hold the 9pm dose C. administer the dose with a snack D. administer an antiemetic with the dose.

C. administer the dose with a snack

The healthcare provider prescribes naproxen twice daily for a client with osteoarthritis in the hands. the client tells the nurse that the drug does not seem to be effective after 3 weeks. which is the best response for the nurse to provide? A. the frequency of the dosing in necessary to increase the effectiveness B. therapeutic blood levels of this drug are reached in 4 to 6 weeks. C. another type of anti steroidal anti-inflammatory drug may be indicated D. systemic corticosteroids re the next drug of choice for pain relief.

C. another type of anti steroidal anti-inflammatory drug may be indicated

Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (adenocard)? A. assess pupillary response to light. B. instruct the patient that facial flushing may occur C. apply continuous cardiac monitoring D. request that family members leave the room

C. apply continuous cardiac monitoring

Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy? A. hydrate the client with IV fluids before and after insulin B. assess the client for numbness and tingling of extremities C. inspect the client's oral mucosa for ulcerations D. monitor the client's urine PH for increased acidity.

C. inspect the client's oral mucosa for ulcerations

an antacid (Maalox) is prescribed for a client with peptic ulcer disease. the nurse knows that the purpose of this medicatio is: A. decrease production of gastric secretions B. produce an adherent barrier over the ulcer C. maintain a gastric pH of 3.5 or higher D. decrease gastric motor activity

C. maintain a gastric pH of 3.5 or higher

A client who was prescribed atorvastatin (lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. which statement reflects the correct drug-specific teaching the nurse should provide to this client? A. Increase consumption of potassium-rish food since low potassium levels can cause muscle spasms. B. Have serum elctrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping C. make an appointment to see the healthcare provider because muscle pain may be an indication of a serious side effect D. be sure to consume low-cholesterol diet while taking the drug to enhance the effectiveness of the drug.

C. make an appointment to see the healthcare provider because muscle pain may be an indication of a serious side effect

A client asks the nurse if glipizide (glucotrol) is an oral insulin. which response should the nurse provide? A. yes, it is in an oral insulin and has the same actions and properties as intermediate insulin B. yes it is an oral insulin and is distributed, metabolized and excreted in the same manner as insulin. C. no it is not an oral insulin and can be used only when some beta cell function is present. D. no it is not an oral insulin, but it is effective for those who are resistant to injectable insulins.

C. no it is not an oral insulin and can be used only when some beta cell function is present.

the nurse is assessing the effectiveness of high doese aspirin therapy for an 88 year old client with arthritis. The client reports that she can't hear the nurse's question because her ears are ringing. what action should the nurse implement. A. refer the client to an audiologist for evalutation for her hearing. B.advise the patient that this is a common side effect of aspirin therapy. C. notify the healthcare provider of this finding immediately. D. ask the client to turn off her hearing aid during the exam

C. notify the healthcare provider of this finding immediately.

A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. the nurse knows that which medication would be contraindicated for this client? A. liothyronine (cytomel) to replace iodine B. furosemide (lasix) for relief of fluid retention C. pentobarbital sodium (numbutal sodium) for sleep D. Nitroglycerin (nitrostat) for angina pain.

C. pentobarbital sodium (numbutal sodium) for sleep

Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? A. fluid volume deficit B. risk for infection C. risk for injury D. impaired sleep patterns

C. risk for injury

a client is receiving clonidine (catapres) 0.1 mg/24 hr via transdermal patch. which assessment finding indicated that the desired effect of the medication has been achieved? A. client denies recent episodes of angina B. change in peripheral edema from +3 to +1 C. client denies recent N/V D. BP has changed from 180/120 to 140/70

D. BP has changed from 180/120 to 140/70

Which change in data indicates to the nurse that the desired effect of the angiotensin 2 receptor agonist valsartan (diovan) has been achieved? A. dependent edema reduced from +3 to +1 B. serum HDL increased from 35 to 55 mg/dl C. pulse rate reduced from 150 to 90 beats/ minute D. BP reduced from 160/90 to 130/80.

D. BP reduced from 160/90 to 130/80.

which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? A. morphine sulfate (duromorph) B. ibuprofen (advil) C. Amitriptyline (amitiril) D. dexamethasone (decadron)

D. dexamethasone (decadron)

A client recieving doxorubicin (adriamycin) intravenously complains of pain at the insertion site. the nurse notes edema at the site. which intervention is most important for the nurse to implement? A. assess for erythema B. administer the antidote C. apply warm compressions D. discontinue the IV fluids.

D. discontinue the IV fluids.

An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? A. absorption B. metabolism C. elimination D. distribution.

D. distribution.

Dobutamine (dobutrex) is an emergency drug most commonly prescribed for a client with which condition? A. shock B. asthma C. hypotension D. heart failure

D. heart failure

A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to: A. decrease the amount of thyroid-stimulating hormone circulating in the blood. B. increase the amount of thyroid-stimulating hormone circulating in the blood. C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid. D. inhibit synthesis of T3 and T4 by the thyroid glanf

D. inhibits synthesis of T3 and T4 by the thyroid gland.

a client has continuous IV infusion of dopamine (intropin) and an IV of normal saline at 50 ml/hr. the nurse notes that the client;s urinary output has been 20 ml/hour for the last 2 hours. which intervention should the nurse initiate? A. stop the infusion of dopamine B. change the normal saline to keep open rate C. replace the urinary catheter D. notify the healthcare provider of the urinary output.

D. notify the healthcare provider of the urinary output.

a client with giardiasis is taking metronidazole (flagyl) 3mg PO. which information should the nurse include in the clients instruction? A. notify the clinic of any changes in the color of urine B. avoid overexposure to the sun C. stop the medication after the diarrhea resolves D. take the medication with food

D. take the medication with food

a client with coronary artery disease who is taking digoxin (lanoxin) receives a new prescription for atrovastatin (lipitor). two weeks after initiation of the Lipitor prescription, the nurse assesses the client. which finding requires the most immediate intervention? A. heartburn B. headache C. constipation D. vomiting.

D. vomiting.

A client who has been tkaing levodopa PO TID to control the symptoms of parkinson's disease has a new prescription for sustained release levadopa/carbidopa (sinement 25/100) PO BID. the client took his levadopa at 0800. which instruction should the nurse include in the teaching for this client? A. "Take the first done of sinement today, as soon as your prescription is filled" B. "Since you already took your levodopa, wait until tomorrow to take the sinement" C. "take both drugs for the first week, then switch to taking only the sinement" D. you can begin taking the sinemet this evening, but do not take any more levodopa"

D. you can begin taking the sinemet this evening, but do not take any more levodopa"

A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. the nurse prepares for intravenous administration of edrophonium chloride (tensilon). what is the expected outcome for this client following administration of this pharmacologic agent? A. progressive difficulty with swallowing. B. decreased respiratory effort. C. improvement in generalized fatigue D.decreased muscle weakness

D.decreased muscle weakness

A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?

Dizziness

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

Electrocardiogram

Nurse is caring for older adult who has new prescription for amitriptyline to Tx depression. Which of following Dx tests should nurse plan to perform prior to starting pt on this med?

Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects of amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

Fever

Nurse is teaching pt who has gout and new prescription for allopurinol. Nurse should instruct pt to d/c med for which of following adverse effects?

Fever Fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue the allopurinol and notify the provider if a fever or rash develops.

Nurse is caring for pt who has new prescription for enalapril. Nurse should monitor pt for which of following adverse effects of med?

Hypotension Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hr following the initial dosage.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication?

Intestinal obstruction

Nure is providing teaching to newly licensed nurse about metoclopramide. Nurse should include in teaching that which of following conditions is contraindicated to this med?

Intestinal obstruction Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.

Nurse is providing teaching to pt who has ulcerative colitis and new prescription for sulfasalazine. Nurse should instruct pt to monitor for which of following adverse effects of this med?

Jaundice Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur.

A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?

Levothyroxine

Nurse is reviewing lab values for pt who reports fatigue and cold intolerance. Pt has increased TSH level and decreased total T3 and T4 levels. Nurse should anticipate prescription for which following meds?

Levothyroxine Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical manifestations for hypothyroidism include fatigue, cold intolerance, and a decreased body temperature and pulse.

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

Liver function

Nurse is providing teaching to newly licensed nurse about caring for pt who has prescription for gemfibrozil. Nurse should instruct newly licensed nurse to monitor which of following lab tests?

Liver function Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches

Nurse is caring for pt who has new prescription for ergotamine. Nurse should recognize that ergotamine is administered to Tx which of following conditions?

Migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels.

Nurse is caring for pt who has prescription for cholorthiazide to Tx HTN. Nurse should plan to monitor pt for which of following adverse effects?

Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes excretion of water, sodium, and potassium, and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

Nurse is caring for pt who has new prescription for amphotericin B. Nurse should plan to monitor pt for which of following adverse effects?

Nephrotoxicity Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the client's creatinine every 3 to 4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the client's creatinine is 3.5 mg/dL or greater.

A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

Neprhotoxicity

A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

Neutrophil count

Nurse is review lab results for pt who has prescription for filgrastim. Nurse should recognize that an increase in which of following values indicates therapeutic effect of this med?

Neutrophil count Filgrastim increases neutrophil production. It is given to treat neutropenia and reduce the risk of infection for clients who are receiving chemotherapy for cancer or who have undergone bone marrow transplant.

A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

Nifedipine

Nurse is caring for pt who is at 28 wks of gestation and is experiencing preterm labor. Which following meds should nurse plan to administer?

Nifedipinie Nifedipine is a tocolytic medication that is administered to stop preterm labor. -Ca channel blocker -Beta adrenergic (terbutaline) -MgSO4 NSAIDS (indomethacin)

Nurse is planning care for pt who has seizure disorder and new prescription for valporic acid. Which of following lab values should nurse plan to monitor? (Select all that apply)

PTT: Valproic acid can alter coagulation; therefore, PT and PTT should be monitored. Aspartate aminotransferase (AST): Valproic acid can cause life-threatening hepatotoxicity. The client should have baseline liver function tests (LFTs) before starting this medication and LFTs should be repeated at regular intervals during therapy. Alanine aminotransferase (ALT):ALT is a liver enzyme that is measured as a component of liver function tests. Levels of the enzyme identify liver damage.

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications is a contraindication to ceftriaxone?

Piperacillin

Nurse is teaching newly licensed nurse about contraindications to ceftriaxone. Nurse should include severe allergy to which of following meds as contraindicated to ceftriaxone?

Piperacillin Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross sensitivity to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for the client who has an allergy to cephalosporins or a severe allergy to penicillin.

A nurse is providing teaching to a client who has chronic kidney failure which an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?

Promotes RBC production

Nurse is providing teaching to pt who has CKF w/ AV fistula for hemodialysis and new prescription for epoetin alfa. Which of following therapeutic effect of epoetin alfa should nurse include in teaching?

Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure, since erythropoietin is produced by the kidney.

A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

Proteinuria

Nurse is assessing pt who is receiving IV gentamicin TID. Which of following findings indicate pt is experiencing adverse effects of med?

Proteinuria Proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should monitor for oliguria and hematuria.

Nurse is reviewing lab values for pt who is receiving continuous IV heparin infusion and has aPTT of 90 secs. Which of following action should nurse prepare to take?

Reduce the infusion rate An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause anticoagulation. The nurse should contact the provider, reduce the infusion rate, and assess the client for bleeding.

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

Reduces ammonia levels

Nurse is providing teaching to pt who has cirrhosis and new prescription for lactulose. Nurse should instruct pt that lactulose has which of following therapeutic effects?

Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?

Reye's syndrome

Nurse is providing teaching to a group of new parents about meds. Nurse should include that aspirin is contraindicated for children who have viral infection d/t risk of developing which of following adverse effects?

Reye's syndrome Aspirin should not be given to children or adolescents who have a viral infection, such as chickenpox or influenza, due to the risk of developing Reye's syndrome.

A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures

Nurse is providing teaching to pt who has rheumatoid arthritis and prescription for long-term prednisone therapy. Nurse should instruct pt to monitor for which of following adverse effects?

Stress fractures Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures.

A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

Superinfection

Nurse is caring for pt who has new Dx of oral candidiasis after taking tetracycline for 7 days. Nurse should recognize that candidiasis is manifestation of which of following adverse effects?

Superinfection A superinfection can develop from the overgrowth of fungus due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a superinfection, such as soreness of the mouth and a swollen tongue.

Nurse is administering subq epinephrine for pt who is experiencing anaphylaxis. Nurse should monitor pt for which of following adverse effects?

Tachycardia Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias as the result of cardiac stimulation.

A client with asthma is receiving long term glucorcoticoid therapy. The nurse includes a risk for impaired skin integrity to the problem list in the client's plan of care. Which rations is the reason for including this problem?

Thinned skin bruises and tears more easily

A female client has a hgb of 9 g/dL (90 g/L) and iron supplements are prescribed. When teaching this client about the administration of iron supplements, how should the nurse instruct her to take the iron tablets?

Two hours after breakfast, with a small sn

A female client is being treated for TB with rifampin (Rifadin). Which statement indicates that further teaching is needed? a. I'll take my usual oral contraceptives for birth control b. even when not menstruation, my urine may be red-tinged c. my nausea will disappear as I adjust to the medication d. I might be having an allergic reaction if a rash occurs

a. I'll take my usual oral contraceptives for birth control ??

A client diagnosed with myasthenia gravis receives a prescription for the anticholinesterase medication, pyridostigmine (Mestinon). Which intervention should the nurse implement when preparing to administer this medication? a. administer the medication thirty minutes prior to meals b. schedule the medication to be given just before bedtime c. instruct the client to avoid dairy products for 30 minutes d. break the medication into small pieces and sprinkle onto food

a. administer the med 30 minutes prior to meals this medication should be administered before meals because it increases muscle strength to help enhance chewing and swallowing b. this would not help improve strength during the day c. it can be taken with dairy to minimize side effects d. do not sprinkle on food

Hormone replacement therapy with levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much of the hormonal agent, Synthroid? a. decreased appetite b. restlessness c. intolerance to cold d. constipation

a. decreased appetite ??

A client has been taking ibuprofen, an NSAID, PO, 2q daily for chronic lower back pain for several months. Which assessment is most important for the nurse to complete? a. determine presence of abdominal pain b. evaluate ongoing sleeping patterns c. evaluate volume of pedal pulses d. assess back pain using numeric scale

a. determine presence of abdominal pain ??

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxatives a. follow medication administration with an additional glass of water b. avoid the intake of dairy products while using the medication c. remain upright for 30 minutes following drug administration d. take the medication one hour after meals and other medications

a. follow medication administration with an additional glass of water ??

A client asks the nurse about using zinc as a complementary therapy for treatment of cold symptoms. What should the nurse explain to the client regarding the use of zinc? a. it is relatively safe when taken at recommended dosages b. interference may occur if taken with almost any other drugs c. there is very limited evidence it reduces cold symptoms d. take with caffeine or dairy products to enhance absorption

a. it is relatively safe when taken at recommended dosages

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride (Cipro) tablets, which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? (SATA) a. limit exposure to sunlight and avoid tanning beds b. crush and mix tabs with pudding if you have trouble swallowing c. increase fluid intake while taking the medication d. use NSAIDs to relieve mild joint aches caused by medication e. report and tendon pain or swelling to the HCP immediately

a. limit exposure to sunlight and avoid tanning beds c. increase fluid intake while taking the medication e. report and tendon pain or swelling to the HCP immediately ??

A client with chronic kidney disease is receiving calcium acetate (PhosLo) 667 mg PO. a decrease in which blood values indicates to the nurse that the medication is having the desired effect. a. phosphate b. potassium c. calcium d. ph

a. phosphate ??

A client with a history of asthma is experiencing an acute episode of wheezing and SOB four hours after returning from surgery. Which prescription should the nurse administer at this time? a. pirbuterol (maxair) b. theophylline c. cromolyn d. montelukast (singulair)

a. pirbuterol (maxair) ??

A client with a respiratory infection has been receiving an antibiotic and antipyretic for five days. What current datum is the best indication that the antibiotic is effective? a. the sputum specimen culture report shows no growth b. the client has been afebrile for 48 hrs c. the client's WBC has remained stable at 12,000 mm3 d. the peak antibiotic level is within the therapeutic range

a. the sputum specimen culture report shows no growth the lack of growth of organisms indicates that the ab has been effective b- this may be the result of the antipyretic, rather than the ab c- is elevated (normal is 5,000 mm3 to 10,000 mm3) and a likely indication that infection is still present d- indicates that the desired amount of antibiotic is present, but does not evaluate the effect of the ab on the infection

A client with TB, whose anti tubercular drugs include rifampin (Rifadin), reports to the nurse that his urine in reddish-orange. What response should the nurse provide to this client? a. this is an expected side effect and is harmless b. drink 8 oz of cranberry juice a day c. a UA should be done ASAP d. discontinue the medication, and call your HCP

a. this is an expected side effect and is harmless ??

A nitroglycerin infusion is prescribed for a client whose BP is 210/112. Ten minutes after initiating the infusion at 10 mcg/ minute, the client complains of a severe headache and numbness of the left arm. Which intervention should the nurse implement? a. turn off the nitroglycerin infusion b. reevaluate the BP c. increase the infusion to 20 mcg/ minute d. administer a dose acetaminophen

a. turn off the nitroglycerin infusion ??

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigue and dizzy. What instruction should the nurse provide? a. stop taking the medication immediately b. avoid hazardous activities until symptoms subside c. increase intake of fluids and high protein foods d. obtain transportation to the ED

b. avoid hazardous activities until symptoms subside fatigue and dizziness are common side effects of baclofen, so the client should be instructed to avoid hazardous activities until symptoms subside a- abrupt withdrawal of baclofen may precipitate withdrawal symtoms c/d- not necessary

thirty minutes after administer trimethobenzamide (Tigan) to a client with nausea, the nurse observes that the client is sedated, but arouses easily, and denies further nausea. Which action should the nurse implement? a. administer a PRN protocol dose of naloxone b. encourage the client to rest until feeling more alert c. remain in the room until the client is fully awake d. notify the HCP of the client's lethargy

b. encourage the client to rest until feeling more alert ??

After receiving the first dose of penicillin, the client begins wheezing and has trouble breathing. The nurse notifies the HCP immediately and receives several prescriptions. Which medication prescription should the nurse administer first? a. albuterol inhaler b. epinephrine injection, USP IV c. diphenhydramine (Benadryl) IV d. methylprednisolone (medrol) OV

b. epinephrine injection, USP IV ??

A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take? a. advise the client to schedule an appointment for liver function test b. explain that medication takes several weeks to reverse symptoms c. document the assessment finding in the EHR d. withheld the medication until the HCP is notified

b. explain that medication take several weeks to reverse symptoms ??

During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a prescription for rivastigmine (Exelon). the caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take? a. advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed b. explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started c. notify the HCP that the dosage of the medication may need to be increased to manage the client's insomnia d. instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety

b. explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started ??

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa (Epogen) two months ago. Which client finding best indicates that the medication is effective a. reports of increased energy levels and decreased fatigue b. hemoglobin level increase to 12 grams/ dL (120 mmol/L) c. food diary shows increased consumption of iron-rich foods d. takes concurrent iron therapy, without adverse effects

b. hemoglobin level increased to 12 grams/ dL ??

After taking lactulose (cholac) for several days. What therapeutic response for a patient with hepatic encephalopathy? a) reduce liquid stools b) improve mental status c) increase urine output d) ability to ambulate independently

b. improved mental status Lactulose, a hyperosmotic laxative, draws water into the gut, reduces the formation of ammonia in the gut, and lowers serum ammonia levels, which are elevated in hepatic encephalopathy and cause confusion that can lead to pre-coma and coma. The client's mental status should improve after taking lactulose. a/c/d- not expected outcomes

What action should the nurse take prior to administering digoxin (Lanoxin) PO? a. Obtain a left radial pulse for 30 seconds b. listen to the heart at the left 5th intercostal space c. check the client for signs of orthostatic hypotension d. verify that the urine output exceeds 30 ml/ hour

b. listen to the heart at the left 5th intercostal space Bradycardia, a late sign of digtox, should be assessed for by counting the client's apical heart rate (with the stethoscope positioned at the 4th or 5th intercostal space at the midclavicular line) for a full minute. a. is often irregular and can vary significantly from apical rate c/d. can provide information but not priority assessments

A female client who has trichomonas vaginalis receives a prescription for metronidazole (flagyl). which instruction should the nurse provide this client? a. take the medication only when symptomatic b. male partners must also be treated c. report any difficulty with hearing d. urine may turn an orange color

b. male partners must also be treated

A client with a history of angina is taking diltiazem, a calcium channel blocker. The client reports increasing fatigue with periods of feeling "faint". Which client assessment should the nurse complete first? a. auscultate lungs for adventitious breath sounds b. measure pulse and BP for changes c. review fluid intake and outage for imbalances d. observe gait and posture for muscle weakness

b. measure pulse and blood pressure for changes ??

The nurse is teaching a male client with Type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine (Lantus) insulin. If the insulin is self-administered at 0800, when is the client most likely to experience hypoglycemia a. midmorning b. mid-afternoon c. no peak occurs d. shortly after midnight

b. midafternoon ??

A male client who has been taking a high-dose of an NSAID comes to the clinic complaining of gastric pain and blood in his stool. The HCP discontinues the NSAIDs and prescribes esomeprazole (Nexium). Which information should the nurse include in this client's teaching plan? a. once pain subsides, NSAID therapy can be resumed b. notify the HCP of the passage of black stools c. resume a diet that consists of milk, cream, and bland foods. d. call the clinic if diarrhea or headache occur when taking Nexium.

b. notify the HCP of the passage of black stools ??

When preparing to administer the next scheduled dose of fentanyl (Sublimaze) transdermal patch to a client with metastatic cancer and renal insufficiency. The nurse notes that the client has shallow respiration at 8 breath/ minute. What action should the nurse take first? a. apply the transdermal patch b. notify the healthcare provider c. give a breakthrough pain medication d. assess deep tendon reflexes

b. notify the healthcare provider respiratory depression is a side effect of opioid analgesics in a client with renal failure. the HCP should be notified so Rx changes can be made

A client who is obtunded arrives in the ED with a suspected drug overdose. The client becomes responsive after the administration of IV naloxone, but within a short period, the client's LOC decreases again and the respiratory rate decreases to 6 breaths per minute. Which action should the nurse take first? a. administer an additional dose of naloxone b. prepare to initiate CPR c. determine if results of the drug toxicity screen are available d. initiate a second intravenous access site

b. prepare to initiate CPR ??

A client is receiving tamsulosin (Flomax), an alpha adrenergic blocking agent, for the management of urinary retention due to BPH. Which instruction is most important for the nurse to provide. a. take the medication early in the day b. stand and sit up slowly c. use a twice-a-week dosing schedule d. reduce daily fluid intake

b. stand and sit up slowly Perpheral vasodilation is the therapeutic outcome of alpha adrenergic blocking agents such as tamsulosin, which relay veins, arteries, and in the client with BPH also relaxes the muscle in the prostate and bladder neck to ease initiating a urinary stream. Orthostatic hypotension due to rapid mobilization is a common side effect. a/c/d- Flomax is prescribed once daily and should be taken half an hour following the same meal each day

Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication? a. mix with an antacid b. use a straw to ingest c. take with a glass of milk d. swallow undiluted

b. use a straw to ingest ??

The wife of a client diagnosed with Parkinson's disease calls the client and tells the nurse her husband d is having involuntary jerky movements of the legs and arms and is confused. What action should the nurse implement? a. determine how long he has been diagnosed with Parkinson's b. request that the client's wife bring him to the clinic ASAP c. ask the client's wife to list all medications her husband is currently taking d. advise client's wife to call an ambulance to take him to the ER

c. ask the client's wife to list all medications her husband is currently taking ??

A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 2100 dose. What action can the nurse take to alleviate this side effect? a. change the time of the dose b. hold the 2100 dose c. administer the dose with a snack d. administer and antiemetic with the dose

c. administer the dose with a snack administering oral doses with food helps minimize GI discomfort a- would be appropriate only if changing the time of the dose corresponds to meal times while also maintaining an appropriate interval b/w doses b- would disrupt dousing schedule which could result in a non therapeutic serum level of the medication d- should not be attempted before other interventions

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing "heartburn." How should the nurse respond? a. advise the client to go to the nearest ED b. suggest use of an antacid 2 hours after the medication c. ask the client to describe how she takes the medication d. remind the client to take the medication with plenty of water

c. ask the client to describe how she takes the medication ??

The nurse suspects that a client has experienced an adverse reaction to a prescribed medication. Which action should the nurse take first? a. determine how long the client has been taking the drug b. review the half life of the medication in a drug guide c. complete a focused systems assessment of the client d. notify the HCP who prescribed the medication

c. complete a focused systems assessment of the client ??

An adolescent receives a new prescription for isotretinoin (Claravis) for cystic acne. Which information is most important for the nurse to provide? a. discontinue all multi-vitamins during acne medication therapy b. store the medicine in a plastic, tight, light-resistant container c. consider an alternative summer job, other than lifeguarding d. start the second course of therapy after an 8 week delay

c. consider an alternative summer job, other than life guarding ??

A nurse administered a second dose of an opioid containing codeine and acetaminophen to a client fifteen after a first dose was administered by another nurse, because the first dose was not documented in the medication record. Which intervention is most important for the nurse to implement? a. obtain a serum liver panel b. complete a medication error form c. evaluate vital signs d. assess the client's pain on a 10 point scale

c. evaluate the client's vital signs an opioid containing codeine and acetaminophen can cause CNS depression and the nurse's highest priority is to assess the client's vital signs and LOC a. high doses of acetaminophen can cause liver toxicity, but it is not the highest priority b/d. also important but not as important

A male client receives a scopolamine transdermal patch 2 hours prior to surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. What action should the nurse take? a. offer to apply a new transdermal patch to relieve the pain b. check for correct placement of the patch behind the client's ear c. explain that the medication is not given to precent pain d. advise the client that the effects of the medication have worn off

c. explain that the medication is not given to prevent pain ??

Prior to administering oral doses of calcitriol (Rocaltrol) and calcium carbonate (os-cal) to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL or 3.5 mmol/ L (SI). Which action should the nurse implement? a. hold the rocaltrol, but administer the os-cal as scheduled b. administer both prescribed medications as scheduled c. hold both medication until contacting the HCP d. hold the oas-cal, but administer the rocaltrol as scheduled

c. hold both medications until contacting the HCP ??

The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. What instruction is most important for the nurse to provide to this client? a. use the inhaler when first awakening in the morning b. avoid shaking the inhaler immediately before using c. hold one nostril closed while spraying the other nostril d. angle the tip of the inhaler upward while spraying

c. hold one nostril closed while spraying the other nostril to receive the medication as prescribed, one nostril should be held closed while the other is sprayed. a. inhaler use is not limited to morning b. the inhaler should be shaken before use d. this is not necessary

A client with emphysema is complaining of difficulty breathing and is exhibiting audible wheezing. The nurse administers albuterol (Proventil) as prescribed for the third time within the last 12 hours. Which assessment finding warrants immediate intervention by the nurse? a. throat irritation b. increased anxiety c. irregular rapid heart beat d. uncontrollable shaking

c. irregular rapid heart beat A critical side effect of Proventil is an irregular rapid heart beat that requires immediate intervention for a potential life-threatening dysrhythmia a/b/d. these are common side effects that should resolve without intervention

A client with heart failure develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care? a. cover your skin before going outside b. monitor skin for excessive bruising c. limit intake of high-potassium foods d. replace salt with a salt substitute

c. limit intake of high- potassium foods ??

Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client? a. administer a stool softener/ laxative at the same time as the analgesic b. instruct the client to request assistance when ambulating to the bathroom c. tell the client to notify the nurse if the pain is not relieved d. advise the client that the medication should start to work in about 30 minutes

c. tell the client to notify the nurse if the pain is not relieved ??

A client is discharged with a prescription for warfarin (Coumadin). Which discharge instruction should the nurse emphasize to the client? a. add large amounts of spinach to the diet b. use an astringent for superficial bleeding c. take a multi-vitamin supplement daily d. avoid going barefoot, especially outside

d. avoid going barefoot, especially outside

The nurse is preparing medications for a client with bipolar disorder and notices that the antipsychotic medication was discontinued several days ago. Which medication should be discontinued? a. magnesium (milk of magnesia) b. alprazolam (xanax) c. lithium (lithotabs) d. benztropine (cogentin)

d. benztropine (congentin) ??

The nurse notes that a client has a new prescription for 20 mEq of potassium chloride (KCl) to be administered IV push STAT. The client's IV site is slightly inflamed but is not tender and has a blood flashback. What action should the nurse take? a. fax the prescription to the pharmacy for immediate delivery of the medication b. obtain a liter of normal saline with 20 mEq of KCl from the supply cart c. withheld the prescribed medication until a new IV is inserted d. Contact the healthcare provider to clarify the prescription

d. contact the healthcare provider to clarify the prescription IV administration of undiluted KCl can cause life-threatening dysrhythmias, so the nurse must contact the HCP to clarify the prescription a/c- may result in the administration of a fatal dose of medication. b- Although 20 mEq of KCl diluted in a liter of normal saline solution is a safe dilution for administration, the nurse cannot prescribe medications and must contact the HCP to change the Rx

The home health nurse observes that a female client is using a topical preparation that contains echinacea to treat a canker sore. Her husband expresses concern regarding the effectiveness and safety of using herbs. How should the nurse respond? a. many of the herbal preparations are helpful primarily because of their placebo effect b. this product is essentially harmless, but also is not very beneficial in treating skin infections c. topical echinacea is usually used to soothe burns and can cause damage to the skin d. echinacea seems to be useful in the treatment of some infections such as canker sores

d. echinacea seems to be useful in the treatment of some infections such as canker sores echinacea stimulates the immune system and seems to be useful in the prevention and treatment of some infections including its topical use to treat canker sores. A- while a placebo can play a role in disease management, herbal remedies have evidence of effectiveness b- if used improperly it can be harmful c- aloe vera is used to soothe burns

The nurse is administering the muscle relaxant baclfen (Lioresal) PO to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement? a. advise the client to move slowly and cautiously when rising and walking b. monitor intake and output q 8 hrs c. ensure the client knows to stop baclofen before using other antispasmodics d. evaluate muscle strength q 4 hours

d. evaluate muscle strength q 4 hours ??

The nurse is administering IV fluconzale (Diflucan) to a client who has systemic candidiasis. After reviewing the client's diagnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST, also called SGOT). What action should the nurse implement? a. hold the dose and notify the pharmacy to stop dispensing the next premixed doses b. begin the infusion and submit a drug reaction report to the nursing supervisor c. begin the infusion and monitor the client's BUN, serum creatinine, and liver function tests d. hold the dose and notify the HCP of the changes in the lab studies

d. hold the dose and notify the HCP of the changes in the lab studies ??

A peak and trough level was obtained from a client receiving an amino glycoside IV piggyback q 8 hours. Which finding presents highest risk for the client and should be reported immediately to the HCP? a. decreased peak only b. decreased peak, decreased trough c. decreased trough only d. increased peak, increased trough

d. increased peak, increased trough ??

A client receiving the urinary antispasmodic oxybutynin Cl (Ditropan XL) reports having an extremely dry mouth. How should the nurse respond? a. stop taking the medication immediately and schedule an appointment to see the HCP b. it sounds as if you are losing too much fluid, so increase your fluid intake to 3 L a day c. secondary infections, which must be treated with a different medication, sometimes occur during treatment. d. you can such on hard candy to help relieve the mouth dryness, which is a common side effect

d. you can suck on a hard candy to help relieve the mouth dryness, which is a common side effect ??