Pharmacology Practice 2019 A
A nurse in an urgent care clinic is collecting data from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? A. "I have tendonitis, so I haven't been able to exercise." B. "I take a stool softener for chronic constipation." C. "I take medicine for my thyroid." D. "I am allergic to sulfa."
A.
A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? A. Temp of 39.7 C (103.5 F) B. Urinary retention C. HR 56/min D. Muscle flaccidity
A.
A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? A. The client's capnography has returned to baseline B. The client can respond to their name when called. C. The client is passing flatus. D. The client is requesting oral intake
A.
A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? A. Turn the client to a side-lying position B. Disconnect the client's oxytocin for the maintenance IV. C. Apply oxygen to the client by face mask D. Increase the client's maintenance IV infusion rate.
A.
A nurse is caring for a client who is receiving oprelvekin. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? A. Increased platelet count B. Increased RBC count C. Decreased prothrombin time D. Decreased triglycerides
A.
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? A. Tingling of fingers B. Constipation C. Weight gain D. Oliguria
A.
A nurse is planning to teach about the use of spacer to a child who has a new prescription for fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? A. Oral candidiasis B. Headache C. Joint pain D. Adrenal suppression
A.
A nurse is preparing to administer heparin SQ to a client. Which of the following actions should the nurse plan to take? A. Administer the medication outside the 5-cm (2in) radius of the umbilicus. B. Aspirate for blood return before injecting. C. Rub vigorously after the injection to promote absorption. D. Place a pressure dressing on the injection site to prevent bleeding.
A.
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? A. Obtain the client's BP B. Contact the client's provider C. Inform the charge nurse D. Complete an incident report.
A.
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take? A. Document the refusal and inform the client's provider. B. File an incident report with the risk manager. C. Contact the pharmacist to pick up the medication D. Give the client the medication to take at home and document that it was administered.
A.
A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? A. Carbamazepine B. Sumatriptan C. Atenolol D. Glipizide
A.
A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? A. Hot flashes B. Urinary retention C. Constipation D. Bradycardia
A.
The nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that takin the docusate sodium daily can minimize which of the following adverse effects of morphine? A. Constipation B. Drowsiness C. Facial flushing D. Itching
A.
A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Tingling toes B. Sexual dysfunction C. Absence of dreams D. Pica
B.
A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? A. Methadone B. Naloxone C. Diazepam D. Bupropion
B.
A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? A. Serum calcium B. Pregnancy test C. 24-hr urine collection for protein D. Aspartate aminotransferase level
B.
A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? A. Vitamin K B. Acetylcysteine C. Benztropine D. Physostigmine
B.
A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the follwoing findings should the nurse identify as an adverse effect of the medication and report to the provider? A. Vomiting B. Blood in the urine C. Positive Chvostek's sign D. Ringing in the ears
B.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? A. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified B. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. C. 1 L of 0.9% sodium chloride completed at 09:00. Client denies shortness of breath. D. IV fluid initiated at 05:00. Lungs clear to auscultation.
B.
A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diptheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages? A. At birth B. 2 months C. 6 months D. 15 months
B.
A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? A. Aspirin B. Ibuprofen C. Rantitinde D. Bisacodyl
B.
A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? A. Weigh the client weekly B. Determine apical pulse prior to administering C. Administer the medication 30 min prior to breakfast. D. Monitor the client for jaundice
B.
A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? A. Muscle weakness B. Sedation C. Tinnitus D. Peripheral Edema
B.
A nurse is providing teaching to a client who has prescription for ergotamine sublingual to treat migraine headaches. Which of the follwoing information should the nurse include in the instructions? A. "Take one tablet three times a day before meals." B. "Take one tablet at onset of migraine." C. "Take up to eight tablets as needed within a 24-hour period." D. "Take one tablet every 15 min until migraine subsides."
B.
A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following as an indication of hypokalemia? A. Tall, tented T-waves B. Presence of U-waves C. Widened QRS complex D. ST elevation
B.
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? A. "It is safe to take an enteric coated aspirin." B. "Aspirin will increase the risk of bleeding." C. "Acetaminophen may be substituted for aspirin." D "The INR lab work must be monitored more frequently if aspirin is taken."
B.
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? A. Constipation B. Tinnitus C. Hypoglycemia D. Joint Pain
B.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? A. MSO4 5mg subcut every 4hr PRN severe pain B. Morphine 5 mg subcut every 4 hr. PRN severe pain C. MSO4 5mg SQ every 4 hr PRN severe pain D. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain.
B.
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching? A. "I should apply a patch every 5 minutes if I Develop chest pain." B. "I will take the patch off right after my evening meal." C. "I will leave the patch off at least 1 day each week." D. "I should discard the used patch by flushing it down the toilet."
B. Clients should remove the patch each evening for a medication free time of 12 to 14 hours before applying a new patch to avoid developing a tolerance to the medication's effects. INCORRECT EXPLAINATIONS A. Nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses sublingual tablet should place one tablet under their tongue at the onset of angina pain and continue taking a tablet every 5 min for a total of 3 doses of nitroglycerin. The effects of a nitro patch will take 30-60 mins to occur and are not useful to prevent an ongoing angina attack.
A Nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? A. Report the incident to the charge nurse B. Notify the provider C. Check the client's blood glucose D. Fill out an incident report
C.
A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? A. Potassium iodide B. Glucagon C. Atropine D. Protamine
C.
A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? A. Ondansetron B. Magnesium sulfate C. Flumazenil D. Protamine sulfate
C.
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? A. Diphenhydramine B. ALbuterol inhaler C. Epinephrine D. Prednisone
C.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings? A. Diastolic BP B. Systolic BP C. Heart Rate D. Respiratory Rate
C.
A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? A. 1000 B. 0900 C. 0830 D. 1200
C.
A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? A. "I should take the medication with food." B. "I should take naproxen if I develop joint pain." C. "I should tell my provider if I develop a sore throat." D. "I should expect the medication to cause my urine to look orange."
C.
A nurse is providing teaching to a client who has gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include? A. "Take the medication on an empty stomach for full effectiveness." B. "You may discontinue this medication when stomach discomfort subsides." C. "Report yellowing of the skin." D. "Store the medication in the refrigerator."
C.
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? A. Decreases stomach acid secretion B. Neutralizes acids in the stomach C. Forms a protective barrier over ulcers D. Treats ulcers by eradicating H. pylori
C.
A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? A. Felodipine B. Guaifenesin C. Digoxin D. Regular insulin
C.
A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? A. "I will have increased saliva production." B. "I will continue taking the medication until the rash disappears." C. "I will taper off the medication before discontinuing it." D. "I will report any urinary incontinence."
C.
A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? A. The client's provider is required to complete medication reconciliation. B. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. C. A transition in care requires the nurse to conduct medication reconciliation. D. Medical reconciliation is limited to the name of the medications that the client is currently taking.
C.
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Cough B. Joint pain C. Alopecia D. Insomnia
D
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? A. Dyspepsia B. Diarrhea C. Dizziness D. Dyspnea
D.
A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective? A. The client's vital signs are within normal limits. B. The client has not requested additional medication. C. The client is resting comfortably with eyes closed. D. The client rates pain as 3 on a scale from 0-10.
D.
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? A. Tachycardia B. Oliguria C. Xerostomia D. Miosis
D.
A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? A. Decrease in WBC count B. Decrease in amount of time sleeping C. Increase in appetite. D. Increase in ability to focus
D.
A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the follwoing client outcomes should the nurse administer chlordiazepoxide? A. Minimize diaphoresis B. Maintain abstinence C. Lessen craving D. Prevent delirium tremens
D.
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the follwoing adverse effects? A. Weight loss B. Increased intraocular pressure C. Auditory hallucinations D. Bibasilar crackles
D.
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? A. Hold the client's other oral medications for 8 hr post administration B. Inform the client that this medication can turn stool a light tan color C. Keep the client's solution in the refrigerator for up to 72 hr. D. Monitor the client for constipation
D.
A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? A. Chew on the medication stick to release the medication. B. Leave the medication stick in on location of the mouth until melted. C. Allow the medication 1 hr for analgesia effects to begin. D. Store unused medication sticks in a storage container.
D.
A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? A. "Take beclomethasone to avoid an acute attack." B. "Use beclomethasone 5 min before using albuterol." C. "Limit your calcium and vitamin D intake when taking beclomethasone." D. "Rinse your mouth after inhaling the beclomethasone."
D.
A nurse is reviewing the lab results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider? A. Calcium level 9.2 mg/dL B. Magnesium level 1.6 mEq/L C. Digoxin level 1.1 ng/mL D. Potassium level 2.8 mEq/L
D.
A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for DVT. The nurse should discontinue the medication infusion for which of the following client findings? A. Potassium 5.0 mEq/L B. aPTT 2 times the control C. Hemoglobin 15 g/dL D. Platelets 96,000/mm3
D.
A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? A. "I will drink a glass of milk when I take the risedronate." B. "I will take the risedronate 15 min after my evening meal." C. "I should take an antacid with the risedronate to avoid nausea." D. "I should sit up for 30 min after taking the risedronate."
D.
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? A. The medication should be taken 1 hr prior to eating B. It takes 48 hr for therapeutic effects to occur. C. Tablets should not be crushed or chewed. D. Decreased respirations might occur.
D.