Pharmacology Practice Assessment

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth.)

6.3 mL (I know. I put 6.25 mL too. Stupid rounding.)

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? A. Administer the medication outside the 5-cm (2-in) 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. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.--do not aspirate b/c injection site will bruise; admin by subcutaneous inj to the abdomen above the iliac crest and at least 2 in away from the umbilicus; hold pressure for 1-2 min to prevent bleeding/bruising

A nurse is precepting a newly licensed nurse who is caring for four clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse? A. Administers isosorbide mononitrate to a client who has a BP of 82/60 mmHg B. Administers digoxin to a client who has a heart rate of 92/min C. Administers regular insulin to a client who has a blood glucose of 250 mg/dL D. Administers heparin to a client who has an aPTT of 70 seconds

A. Administers isosorbide mononitrate to a client who has a BP of 82/60 mmHg--a nitrate used for treating angina; leads to vasodilation which can result in hypotension; nurse should withhold med and notify provider if ct systolic bp is below expected range

A nurse is caring for a client who is receiving haloperidol. The nurse should observe for which of the following findings as an adverse effect of the medication? A. Akathisia B. Paresthesia C. Excess tear production D. Anxiety

A. Akathisia--EPS like dystonia, pseudoparkinsonism and akathisia

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (SATA) A. Blood glucose levels will be monitored during therapy. B. Avoid contact with people who have known infections. C. Take the medication 1 hr before breakfast. D. Decrease dietary intake of foods containing potassium. E. Grapefruit juice can increase the effects of this medication.

A. Blood glucose levels will be monitored during therapy.--can raise glucose levels B. Avoid contact with people who have known infections.--suppress immune response and mask manifestations of infx E. Grapefruit juice can increase the effects of this medication.--increases absorption of med leading to toxicity and adrenal suppression--also decreases potassium levels thru urinary excretion so inc intake of potassium foods; take with food or milk to avoid GI manifestations

A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium on a daily basis can minimize which of the following adverse effects of morphine? A. Constipation B. Drowsiness C. Facial flushing D. Itching

A. Constipation--stool softener promotes easier evacuation of stool by increasing water and fat in the intestine

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply) A. Blood glucose levels will need to be monitored during therapy. B. Avoid contact with persons who have known infections. C. Take the medication 1 hour before a meal. D. Decrease intake of foods containing potassium. E. Grapefruit juice can increase the blood levels of the medication.

A. Blood glucose levels will need to be monitored during therapy. B. Avoid contact with persons who have known infections. E. Grapefruit juice can increase the blood levels of the medication.

A nurse is teaching a client who is starting to take ketorolac. Which of the following information should the nurse include in the teaching? A. Check for bruising while taking this medication. B. Take the medication on an empty stomach. C. The medication can cause anxiety. D. Increase iron intake with this medication.

A. Check for bruising while taking this medication.--can inc risk of bleeding by interfering with platelet aggregation

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? A. Chest pressure B. White patches on the tongue C. Bruising D. Insomnia

A. Chest pressure--antimigraine agent which can cause coronary vasospasms resulting in angina; client should report chest pressure or heavy arms to the provider; can cause drowsiness and sedation

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? A. Creatinine kinase B. Erythrocyte sedimentation rate C. International normalized ratio D. Potassium

A. Creatinine kinase--can develop an adv effect called rhabdomyolysis which causes muscle weakness or pain and can progress to myositis; CK levels rise in response to enzymes released with muscle injury

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? A. Cromolyn B. Beclomethasone C. Budesonide D. Tiotropium

A. Cromolyn sodium--stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. client should use cromolyn 10-15 min prior to exercise to prevent bronchospasms

A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? A. Docusate sodium reduces the surface tension of the stools to change their consistency. B. Docusate sodium causes rectal contractions. C. Docusate sodium acts as a fiber agent, increasing bulk in the intestines. D. Docusate sodium stimulates the motility of the intestines.

A. Docusate sodium reduces the surface tension of the stools to change their consistency.

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? (Select all that apply) A. Dry mouth B. Tinnitus C. Blurred vision D. Bradycardia E. Dry eyes

A. Dry mouth C. Blurred vision E. Dry eyes

A nurse is teaching about neural tube defects to a client who is planning a pregnancy. Which of the following vitamins should the nurse instruct the client to start taking before becoming pregnant? A. Folic acid B. Thiamine C. Pyridoxine D. Riboflavin

A. Folic acid

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (SATA) A. Hemoglobin 7.0 B. Creatinine 1 C. RBC 4.7 million D. Platelets 75,000 E. Potassium 5.2

A. Hemoglobin 7.0--hydroxyurea toxicity; report D. Platelets 75,000--toxicity; report E. Potassium 5.2--tumor lysis syndrome; report

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. Hot flashes--estrogen receptor blocking action of tamoxifen commonly results in the adv effect of hot flashes

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? A. Hyperventilation B. Heartburn C. Anorexia D. Swollen ankles

A. Hyperventilation--may have acute salicylate poisoning which causes respiratory alkalosis in the early stages

A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. 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. I have tendonitis, so I haven't been able to exercise.--due to risk of tendon rupture

A nurse is caring for a patient 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. Increased platelet count.--stimulates bone marrow to produce platelets; for ct's receiving chemotherapy, thrombocytopenia is minimized so these clients will require fewer plt transfusions; can cause dec in hgb, hct, and rbc due to inc plasma volume that results from this med

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 blood pressure. B. Contact the client's provider. C. Inform the charge nurse. D. Complete an incident report.

A. Obtain the client's blood pressure.

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a 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. Oral candidiasis--effects of inhaled corticosteroids can include dysphonia and oral candidiasis; using spacer and rinsing mouth after inhalation will minimize amt of med remaining in the oropharynx preventing development of adv effects

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? A. Perform a capillary blood glucose test. B. Provide the client with a protein-rich snack. C. Give the client 120 mL (4 oz) of orange juice. D. Schedule an early meal tray.

A. Perform a capillary blood glucose test.--possible hypoglycemia; s/s weakness, anxiety, confusion, sweating, and seizures

A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication? A. Smoked sausage. B. Cottage cheese. C. Green beans. D. Apple pie.

A. Smoked sausage.--contains tyramine with can result in hypertensive crisis

A nurse is providing care for a client who is postoperative following an open cholecystectomy with the placement of a closed suction drain and is receiving morphine via patient-controlled analgesia for pain. Which of the following assessments is the nurse's priority? A. Respiratory rate B. Bowel sounds C. Drainage amounts D. Wound appearance

A. Respiratory rate

A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used to treat tuberculosis? (SATA) A. Rifampin B. Mirtazapine C. Temazepam D. Infliximab E. Isoniazid

A. Rifampin--inhibits production of mycobacteria E. Isoniazid--treats tb by inhibiting production of mycobacteria

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication she should complete an incident report? A. The client reports shortness of breath. B. The client is also taking lisinopril. C. The client's pulse rate is 60/min D. The client's WBC count is 14,000

A. The client reports shortness of breath.--severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin ab due to the potential for cross sensitivity; sob can indicate ct is developing anaphylaxis

The 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. Tingling of fingers.--adv effect of paresthesia (tingling sensation of extremities); polyuria; weight loss due to gi disturbance which causes reduced appetite; diarrhea

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 from the maintenance IV. C. Apply oxygen to the client by face mask. D. Increase the client's maintenance IV infusion rate.

A. Turn the client to a side-lying position.--greatest risk is injury from uteroplacental insufficiency

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first DTaP vaccine. The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? A. Birth B. 2 months C. 6 months D. 15 months

B. 2 months

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. Benzotrophine D. Physostigmine

B. Acetylcysteine is a specific antidote for acetaminophen; it can prevent severe injury when given orally or by IV infusion within 8-10 hours of overdose

A nurse is teaching a client about warfarin. The client asks if she 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. Aspirin will increase the risk of bleeding.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol? A. Cholelithiasis B. Asthma C. Angina pectoris D. Tachycardia

B. Asthma contraindicated; propranolol is an adrenergic antagonist which blocks the beta 2 receptors in the lungs causing bronchoconstriction and leads to serious airway resistance and possibly resp arrest

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following 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. Blood in the urine--other manifes. include bruising, hematomas, hypotension, and tachycardia

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome? A. Increase in seizure threshold. B. Decrease in flexor and extensor spasticity. C. Increase in cognitive function. D. Decrease in paralysis of the extremities.

B. Decrease in flexor and extensor spasticity.--adv effect of memory impairment and dec in cognitive fx, inhibited reflexes at the spinal level; can dec seizure threshold

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 minutes prior to breakfast. D. Monitor the client for jaundice

B. Determine apical pulse prior to administering.--adv effect for ct is life-threatening bradycardia; assess apical pulse prior to admin med; if pulse rate is less than 60/min, nurse should withhold and notify provider; admin following meals or at bedtime if orthostatic hypotension occurs

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? A. Administer epinephrine 0.5 mL via IV bolus B. Discontinue the medication IV infusion C. Elevate the client's legs above the level of the heart. D. Collect a blood specimen for ABGs.

B. Discontinue the medication IV infusion--greatest risk is resp arrest from anaphylaxis; do not remove catheter; change tubing and admin 0.9% sodium chloride by continuous infusion; will also elevate ct's legs and feet above the level of the heart to facilitate blood flow to vital organs and collect a blood specimen for ABGs levels to evaluate client's resp status; admin epinephrine to stimulate the heart causing vasoconstriction of blood vessels in skin and mucous membranes which causes bronchodilation in lungs

A nurse is caring for a client who has heart failure and is prescribed enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? A. Bradycardia B. Hyperkalemia C. Loss of smell D. Hypoglycemia

B. Hyperkalemia--improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassiuim retention by the kidneys

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching? A. I will stop taking ranitidine when my stomach pain is gone. B. I know smoking makes ranitidine less effective. C. I will take ranitidine anytime my stomach hurts. D. I know that ranitidine will turn my stools black.

B. I know smoking makes ranitidine less effective.--by exacerbating the ulcere manifestations

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. I will take the patch off right after my evening meal.--remove patch every evening for med free time of 12-14 hours before applying new patch to avoid developing a tolerance to meds effects; antianginal med that results in dilation of coronary vessels

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? A. I will need to get laboratory testing prior to a refill of this medication. B. I will use this medication for a short period of time. C. I will need to take this medication for 1 week before results are seen. D. I will need to change the medications to prevent building up a tolerance.

B. I will use this medication for a short period of time.--short term treatment of insomnia; provider must reassess before refilling Rx; should have improved sleep within 2 days of starting med

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. Ranitidine D. Bisacodyl

B. Ibuprofen--most NSAIDs can significantly inc lithium levels

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. Naloxone--opioid antagonist to reverse resp depressive effects of heroin; do not admin too quickly b/c naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause client to enter a state of opioid withdrawal--methadone is an opioid agonist and can be given in a nonemergent situation to dec manifestations of opioid withdrawal and to suppress the euphoria

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all that apply) A. Take the second dose at bedtime B. Increase intake of potassium-rich foods. C. Obtain your weight weekly. D. Monitor for muscle weakness. E. Dangle your legs from the side of the bed before standing.

B. Increase intake of potassium-rich foods.--loop diruetics act on loop of henle by blocking resorption of sodium, water, and potassium; adv effect of med is development of electrolyte imbalances like hyponatremia, hypochloremia, ad hypokalemia; to prevent hypokalemia, inc intake of potassium rich foods like potatoes, spinach, dried fruit and nuts D. Monitor for muscle weakness.--hypokalemia like difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness; report to provider E. Dangle your legs from the side of the bed before standing.--can reduce vascular tone and inc fluid excretion; dec blood return to heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position; chg position -slowly--also daily weights

A nurse is teaching a client who has an upper respiratory infection about guaifenesin. Which of the following statements should the nurse include in the teaching? A. Constipation is an expected adverse effect of this medication. B. Increase your fluid intake to at least 2 liters each day while taking this medication. C. Store your medication in the refrigerator. D. You can expect to experience insomnia while taking this medication.

B. Increase your fluid intake to at least 2 liters each day while taking this medication.--increase in fluid intake facilitates the removal of secretions and helps to create a more productive cough; store med at room temp (refrigeration can alter the properties of the med); drowsiness is an expected adv. reaction

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? A. Paresthesia B. Increased blood pressure C. Fever D. Respiratory depression

B. Increased blood pressure--therapeutic effect increases hct levels which can result in an increase in client's bp; it the hct rises too rapidly, htx and seizures can result; nurse should monitor client's bp and ensure hypertension is controlled prior to administering the med; adverse effect is heart failure so monitor Resp. status and notify provider if crackles or rhonchi occur; by stimulating bone marrow to inc production of rbc, adverse effects can be seizures, ha, and dizziness; coldness and sweating are also neuro manifestations from taking

A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication? A. Tachycardia B. Oliguria C. Hyperkalemia D. Weight gain

B. Oliguria--can indicate renal compromise; report to provider; hypokalemia (due to kidney dmg); bradycardia; weight loss

A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? A. Vitamin E B. Orange juice C. Milk D. Antacids

B. Orange juice--enhanced by vit c source like oj; increasing dose of ferrous sulfate can provide the same benefit to increase the amount of iron uptake

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Hypoglycemia B. Orthostatic hypotension C. Bradycardia D. Xanthopsia

B. Orthostatic hypotension--antihypertensive thiazide diuretic med which can cause orthostatic hypotension and light headedness; instruct to rise slowly when moving from recumbent to standing position; adv effect of blurred vision; palpitations is an adv effect; can cause hyperglycemia

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? A. Schedule the client for the last surgery of the day. B. Place monitoring cords and tubes in a stockinet. C. Choose rubber injection ports for fluid administration. D. Ensure phenytoin IV is readily available.

B. Place monitoring cords and tubes in a stockinet.

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 hour urine collection for protein D. Aspartate aminotransferase level

B. Pregnancy test--med has teratogenic effects; test is mandatory before initial prescription (two tests) and before monthly refills (one test)

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. Sedation--a central dopamine receptor antagonist that increases gastrointestinal motility and prevents nausea; adv effect is tardive dyskinesia; multiple effects on the CNS including dizziness, fatigue and sedation

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. Sexual dysfunction--dec libedo, impotence, and delayed organsm or anorgasmia is common side effect and occurs in about 70% of clients taking this ssri antidepressant

A nurse is teaching a client who is to start taking diltiazem. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A. Blurred vision B. Shortness of breath C. Muscle twitching D. Dry cough

B. Shortness of breath.--report to provider immediately; can have weakness, insomnia, tremors and paresthesia, rhinitis, dyspnea and pharyngitis

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in her 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 minutes until migraine subsides.

B. Take one tablet at onset of migraine.--take one tab immed after onset of aura or ha

A nurse has administered 2 doses of betamethasone to a client in preterm labor. After delivery of the newborn, the nurse understands the medication was effective when she observes which of the following? A. The newborn is free of infection. B. The newborn has normal respiratory patterns. C. Mother's blood pressure is within the expected reference range. D. Mother's postpartum bleeding is minimal.

B. The newborn has normal respiratory patterns.--medication stimulates surfactant production which improves oxygenation and lung compliance in neonates

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? A. Troponin B. Total cholesterol C. Creatinine D. Thyroid stimulating hormone

B. Total cholesterol--med can cause dyslipidemia (remember metabolic syndrome from class? central obesity, hypertension, high bs, and dyslipidemia)

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 transition in care requires the nurse to conduct medication reconciliation.--nurse should conduct anytime ct is undergoing a change in care (admission, transfer from one unit to another, discharge); complete listing of all prescribed and otc meds should be reviewed

A nurse in the 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. Atropine--cholinergic crisis is caused by an excess amount of cholinesterase inhibitor such as neostigmine; nurse should plan to admin atropine and anticholinergic agent to reverse cholinergic toxicity

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? A. Difficulty seeing in the dark. B. Pinpoint pupils. C. Blurred vision. D. Excessive tearing.

C. Blurred vision.--expected finding due to cycloplegic effects of medication which cause distant objects to appear blurry to the client; dilation of pupils or mydriasis is expected finding; can have photosensitivity

A nurse is providing teaching about insulin glargine to a client who has type 1 diabetes mellitus. Which of the following information should the nurse include in the instructions? A. Observe for hypoglycemia when the insulin peaks. B. Administer the insulin immediately before meals. C. Do not mix this medication in a syringe with other insulin. D. Rotate the bottle gently prior to drawing up the insulin.

C. Do not mix this medication in a syringe with other insulin.--b/c it alters meds effects; can inject once or twice a day any time during day but always at the same time every day; it is clear so no need to rotate bottle prior to drawing up; does not cause peaks...instead it maintains a steady blood level up to a 24 hr period

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? A. Plan to increase the dosage each week by 200 mg increments. B. Prolonged use of this medication can cause glaucoma. C. Drink 2 L of water daily. D. A fine red rash is transient and can be treated with antihistamines.

C. Drink 2 L of water daily.--at least 2 L to prevent renal stone formation and kidney injury b/c allopurinol is eliminated by the kidneys

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? A. Take the medication with food. B. Expect a fine, red rash as a transient effect. C. Drink 8-10 glasses of water daily. D. Store the medication in the refrigerator.

C. Drink 8-10 glasses of water daily.--increase water intake to 1,920 to 2,400 ml (64-80 oz) a day to dec the chance of kidney damage from crystallization; store in light resistant container at room temp; notify provider if rash develops as it can be an indication of Stevens Johnson syndrome; take med on empty stomach either 1 hr before or 2 hr after meals

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Tinnitus B. Urinary frequency C. Dry mouth D. Diarrhea

C. Dry mouth

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. Epinephrine-to induce vasoconstriction and bronchodilation during anaphylaxis

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. Flumazenil

A nurse is providing teaching to a client who has a 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. Forms a protective barrier over ulcers.--mucosal protectant forms a gel like substance that coats the ulcer creating a barrier to hydrochloric acid and pepsin

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching? A. I should take my medication with antacids to minimize gastric upset. B. This type of medication does not require blood monitoring. C. I should let my dentist know I'm taking this medication. D. I should expect to experience some unusual eye movement when taking this medication.

C. I should let my dentist know I'm taking this medication.--gingival hyperplasia; nystagmus is serious side effect and should be reported; antacids should be taken 2 hr before or after phenytoin

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. I should tell my provider if I develop a sore throat.--because this can indicate neutropenia, a serious adv effect of captopril; neutropenia can be reversed if it is recognized early and the med is promptly d/c; take on a empty stomach b/c food reduces absorption of med; take 1 hr before or 2 hr after meal; affects the urinary system causing dysuria, urinary frequency, and changes in normal amt of urine; naproxen and other nsaids can interact with captopril, decreasing the effect of the antihypertensive which can result in renal impairment when used concurrently

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I will apply the patch once a week for 2 weeks. B. I will leave the existing patch on for 4 hours after applying the new patch. C. I will fold the sticky sides of the old patch together before disposing of it. D. I will apply the patch within 14 days of menses.

C. I will fold the sticky sides of the old patch together before disposing of it.--then place it in a childproof container to ensure safe disposal of patch; apply within 7 days of menses to prevent ovulation and need for another contraceptive; remove and dispose of old patch before applying new patch to prevent overdose; apply once a week for 3 weeks and then no patch for 1 week to promote menstruation

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I can apply the patch to a chest area that has hair. B. I can take this medication if using an erectile dysfunction product. C. I will remove the patch after 14 hours. D. I need to apply a new patch to the same area every day.

C. I will remove the patch after 14 hours.--remove patch after 12-14 hr to prevent tolerance of the med

A nurse is teaching about a new prescription for ciprofloxacin to an older adult client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? A. I will take this medication with an antacid to prevent gastrointestinal upset. B. I will stop taking this medication when I no longer have pain upon urination. C. I will report any signs of tendon pain or swelling. D. I will take this medication with milk.

C. I will report any signs of tendon pain or swelling.--a fluroquinolone is associated with risk of tendon rupture; inc risk in older adult so notify if this happens

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? A. I should avoid getting rid of the air bubble in the syringe. B. I should inject the insulin into my thigh for the fastest absorption. C. I will store my unopened bottles of insulin in the refrigerator. D. I need to shake the insulin before using it to make sure it is well mixed.

C. I will store my unopened bottles of insulin in the refrigerator.--up to one month; fastest absorption is in abdominal injection; slowest is in thigh

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. I will taper off the medication before discontinuing it.--to prevent return of the musculoskeletal condition; take for the treatment of muscle spasms; report any urinary retention due to anticholinergic effects; use gum or sip on water to prevent dry mouth

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? A. Decreased blood pressure. B. Increased heart rate. C. Increased cardiac output. D. Decreased serum potassium.

C. Increased cardiac output.--adrenergic that causes a receptor specificity effect which increases cardiac output and improves perfusion; tachycardia is an adv effect of dopamine

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? A. Infuse 0.9% sodium chloride 1,000 mL IV bolus B. Schedule the client for an electroencephalogram C. Obtain WBC with absolute neutrophil count. D. Place the client on a tyramine-free diet.

C. Obtain WBC with absolute neutrophil count.--lethargy and myalgia caused by adv effect of agranulocytopenia; monitor weekly for the first 6 months wbc with absolute neutrophil count; after 6 months monitoring can change to every 2 weeks up to one year

A nurse is providing follow-up care to a client who is taking lisinopril. Which of the following manifestations should the nurse instruct the client to report as an adverse effect of lisinopril? A. Drowsiness B. Hallucinations C. Persistent cough D. Weight gain

C. Persistent cough

A nurse is providing teaching to a client who has a 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. Report yellowing of the skin.--can be hepatotoxic and cause jaundice; monitor and report

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? A. Diarrhea B. Cough C. Urinary retention D. Increased libido

C. Urinary retention--DRY MOUTH (urinary retention not an option on my B test; was an option on A test); due to blocking of acetylcholine receptors that cause anticholinergic responses

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that he is allergic to penicillin. Which of the following actions should the nurse take first? A. Update the client's medical record. B. Notify the provider. C. Withhold the medication. D. Inform the pharmacist of the client's allergy to penicillin.

C. Withhold the medication.

A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for long-term complications of prednisone? A. Pulmonary function tests B. Electrocardiograms C. Liver function studies D. Bone density scans

D. Bone density scans--glucocorticoid to monitor adv effect of osteoporosis

A nurse is preparing to teach a client who is to start a new prescription for extended-release verapamil. Which of the following instructions should the nurse plan to include? A. Take the medication on an empty stomach. B. Avoid crowds. C. Discontinue the medication if palpitations occur. D. Change positions slowly.

D. Change positions slowly.--prevent orthostatic hypotension and syncope; can cause palpatations which should be reported to the provider; take extended release with food to minimize gastric distress

A nurse is reviewing laboratory results for a client who is to receive a dose of ceftazadime via intermittent IV bolus. Which of the following laboratory findings is the priority for the nurse to report to the provider before administering the medication? A. Total bilirubin 0.4 B. Alanine aminotransferase 26 C. Platelet count 360,000 D. Creatinine 2.6

D. Creatinine 2.6 mg/dL--primarily excreted by renal system; if serum cr level is above 1.3 mg/dl can indicate a kidney disorder requiring reduction in dosage admin; notify provider who is likely to prescribe a lowered dose of med;

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 hour prior to eating. B. It takes 48 hours for therapeutic effects to occur. C. Tablets should not be crushed or chewed. D. Decreased respirations might occur.

D. Decreased respirations might occur.--take with food or milk to dec gastric irritation; avoid taking otc meds or newly prescribed meds without consulting provider to avoid inc resp depression; effects within 20 min of admin and pain relief is for 4-6 hr; avoid crushing, chewing, or breaking XR or immediate release tabs to prevent immediate inc in cns effects; tablets can be crused if needed (regular)

A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to receiving which of the following medications? A. Acetaminophen B. Ipratropium C. Benzonatate D. Doxycycline

D. Doxycycline--tetracycline abx and contraindicated for pregnancy (category D)--only take for life threatening condition

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? A. This medication increases your risk for hypertension. B. Avoid potassium-rich foods in your diet. C. Take each dose of medication in the evening before bed. D. Drink a glass of milk with each dose of medication.

D. Drink a glass of milk with each dose of medication.--to reduce gastric irritation; take in morning to avoid sleep disturbances from nocturia; inc risk of hypotension due to fluid loss from diuretic effect inc risk of potassium loss

A nurse is providing teaching to a client who is to start taking lisinopril. Which of the following findings is an adverse effect that the nurse should instruct the client to monitor and report to the provider? A. Hair loss B. Ringing in the ears C. Facial flushing D. Dry cough

D. Dry cough--persistent dry irritating nonproductive cough from excessive buildup of bradykinin; report this adv effect to the provider

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. Dyspnea--caused by bronchoconstriction; bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the inc in acetylcholine levels which is the primary effect of donepezil

A nurse is caring for a client in the emergency department following a diazepam overdose. Which of the following medications should the nurse anticipate administering to the client? A. Naloxone B. Leucovorin C. Neostigmine D. Flumazenil

D. Flumazenil--is a benzo receptor antagonist that can decrease the sedative effects of benzos; admin via iv bolus, titrating doses as needed for a max of 3 mg; can precipitate seizures and might not reverse respiratory depression so airway support may be necessary

A nurse is caring for a client who is receiving cefazolin IV. The nurse should identify that which of the following medications can potentiate nephrotoxicity if administered concurrently? A. Famotidine B. Levofloxacin C. Metoclopramide D. Gentamicin

D. Gentamicin--gentamicin an aminoglycoside abx, can damage renal fx; when combined with a penicillin or cephalosporin like cefazolin client is at inc risk for nephrotoxicity

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 minutes after my evening meal. C. I should take an antacid with the risedronate to avoid nausea. D. I should sit up for 30 minutes after taking the risedronate.

D. I should sit up for 30 minutes after taking the risedronate.--reduces adv gastrointestinal effects of esophagitis and dyspepsia; contraindicated for ct who cannot sit or stand upright for this length of time; immediate release form should be taken at least 30 min prior to consuming food or other liquids; delayed release can be taken after eating; both forms should be taken in the morning upon arising; don't take with antacids containing ca, aluminum or mg; take antacid 2 hr after taking risedronate; take with full glass of water

A nurse is providing teaching to a client who has depression and has a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? A. I should start to feel better within 24 hours of starting this medication. B. I will be sure to follow a strict diet to avoid foods with tyramine. C. I will continue to take St. John's Wort to increase the effects of the medication. D. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication.

D. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication.--fluoxetine suppresses platelet aggregation which increases the risk of bleeding when used concurrently with nsaids and anticoagulants; so take acetaminophen for ha or pain since it ddoes not suppress plt aggregation

A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. I will stop taking the medication if I get dizzy. B. I should not drink orange juice while taking this medication. C. I should expect to gain weight while taking this medication. D. I will check my heart rate before I take the medication.

D. I will check my heart rate before I take the medication.--diltiazem is a ccb; has cardio-suppressant effects at the SA and AV nodes which can lead to bradycardia; so ck heart rate before taking med and notify provider if it falls below the expected reference range

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. Insomnia--atypical antidepressant has stimulant properties which can result in agitation, tremors, mania, and insomnia

A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include? A. Limit continuous use to 7 to 10 weeks. B. Schedule doses for early morning before breakfast. C. Expect that it will take 4 nights before benefits are noticed. D. Plan to withdraw from the medication gradually.

D. Plan to withdraw from the medication gradually.--to avoid mild withdrawal syndrome; limit to 7-10 days; admin at bedtime to treat insomnia will take 2 nights before benefits are noticed

A nurse is reviewing 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 B. aPTT 2x the control C. Hemoglobin 15 D. Platelets 96,000

D. Platelets 96,000--plt less than 100,000 while receiving heparin can indicate heparin induced thrombocytopenia, potentially fatal condition which requires stopping infusion

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? A. Minimize diaphoresis B. Maintain abstinence C. Lessen craving D. Prevent delirium tremens

D. Prevent delirium tremens--during acute alcohol withdrawal

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? A. Administer the reconstituted medication slowly over 5 minutes. B. Store the reconstituted medication in the refrigerator. C. Use the reconstituted medication within 12 hours. D. Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.

D. Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.--and inject rapidly; use within 6 hr; use three way stopcock; store at room temp and protect from light until used

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 minutes before using albuterol. C. Limit your calcium and vitamin D intake when taking beclomethasone. D. Rinse your mouth after inhaling the beclomethasone.

D. Rinse your mouth after inhaling the beclomethasone.--glucocorticoid inhaler to prevent oropharyngeal candidiasis and hoarseness; inc the intake of calcium and vit d to minimize bone loss; take albuterol prior to taking beclomethasone to enhance absorption; take albuterol a short acting beta 2 adrenergic agonist to avoid an acute asthma attack

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 one 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. Store unused medication sticks in a storage container.--unused, used, or partially used med sticks in safe storage container that comes in the kit when the med is initially Rx; place between cheek and lower gum and to actively suck it for inc absorption of the med; expect analgesia effects to begin within 10-15 min; instruct to periodically move med stick to different location in the mouth for best absorption

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding adverse effects of fentanyl should the nurse plan to give the client and family? A. The provider will prescribe naloxone at home for respiratory depression. B. Remove the patch to reverse the adverse effects immediately. C. Expect an increase in urinary output. D. Take a stool softener on a daily basis.

D. Take a stool softener on a daily basis.--constipation is an adv effect and stool softeners decrease severity of adv effect; after removing patch the effects will persist for several hours due to the absorption of the residual medication on the skin; urinary retention

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 the pain at a 3 on a scale from 0 to 10.

D. The client rates the pain at a 3 on a scale from 0 to 10.--client's description of pain is most accurate assessment of pain

A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? A. Gastric distress. B. Oliguria. C. Excessive bruising. D. Tinnitus.

D. Tinnitus.--also sweating, ha, and dizziness

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? A. Dry cough B. Pedal edema C. Bruising D. Yellow- tinged vision

D. Yellow-tinged vision--sign of digoxin toxicity and should report; also nausea, vomiting, loss of appetite, fatigue; as dig levels inc client can experience dysrnhythmias

A nurse is preparing to administer dextrose 5% in water (D5W) 400mL IV to infuse over 1 hour. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

100 gtt/min

A nurse is preparing to administer 0.9% sodium chloride (NaCl) 1,500 mL to infuse over 8 hr to a client who is postoperative. The nurse should set the IV pump to deliver how many ml/hr? (Round to the nearest whole number)

188

A nurse is reviewing the health history of a client who has diabetes mellitus and will begin taking insulin. Which of the following findings should the nurse identify as a factor that might cause the client to have difficulty safely self-administering insulin? A. Macular degeneration B. Right-sided heart failure C. Hyperlipidemia D. Stage II chronic kidney disease

A. Macular degeneration--loses central vision making it difficult to accurately draw up insulin for self admin or dial the insulin pen to the appropriate dosage; nurse should determine adaptive equipment is necessary for this client

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. Tinnitus--aminoglycosides are ototoxic which manifests as tinnitus or deafness; monitor client for high pitched ringing in the ears and should notify provider if these occur; aminoglycosides can cause neuromuscular effects like twitching or flaccid paralysis; can cause inflammation of liver and spleen (gentamicin)

A nurse is providing teaching about adverse effects of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider? A. Orange urine B. Watery diarrhea C. Weight gain D. Headache

B. Watery diarrhea--can lead to c-diff associated diarrhea or pseudomembranous colitis; report immed to provider; can develop jaundice which can cause the urine to turn dark brown in color; can have weight loss

A nurse is caring for a client who is taking atenolol. Which of the following findings should indicate to the nurse that the medication is effective? A. The client has an increase in urinary output. B. The client reports an improvement in memory. C. The client has a decrease in blood pressure. D. The client reports having an increase in libido.

C. The client has a decrease in blood pressure.--a beta-adrenergic blocking agent, lowers bp by decreasing peripheral vascular resistance

A nurse is teaching a client who has tuberculosis about the adverse effects of isoniazid. The nurse should instruct the client to report to the provider which of the following findings as an adverse effect of the medication? A. Reddish-orange urine B. Photosensitivity C. Yellowish skin tones D. Headache

C. Yellowish skin tones--hepatoxic med can cause hepatitis; monitor for and report signs of hepatitis, such as malaise, nausea, and yellowish skin tones

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 following adverse effects? A. Weight loss B. Increased intraocular pressure C. Auditory hallucinations D. Bibasilar crackles

D. Bibasilar crackles--mannitol is an osmotic diuretic which can precipitate heart failure and pulmonary edema; lung crackles is an indicator of a potential complication and stop infusion; neurologic adverse effects include increased intracranial pressure, seizures, confusion, and ha

A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? A. Hypertension B. Low INR C. Constipation D. Bleeding gums

D. Bleeding gums

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. Increase in ability to focus--Graves dz client experiences psychological minifestations like difficulty focusing, restlessness, and manic type behaviors; propylthiouracil is a thyroid hormone antagonist that dec the circulating T4 hormone reducing the manifestations of hyperthyroidism; inc ability to focus shows it is effective; decreased WBC is an adv effect which can cause myelosuppression; graves dz is a form of hyperthyroidism with neuro manifestation of insomnia; graves dz can result in gastro manifestations of inc appetite, weight loss, and inc gastrointestinal motility

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect? A. Tachycardia B. Oliguria C. Xerostomia D. Miosis

D. Miosis--which is pupillary constriction, is a common adv effect of neostigmine due to excessive muscarinic stimulation that causes difficulty with visual accommodation; can cause inc salivation; can cause bradycardia; can cause urinary urgency

A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose?

300 mg

A nurse is preparing to administer to a client 0.9% sodium chloride 1,000 mL IV over 8 hours. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

31 gtt/min

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. Carbamazepine--causes accelerated inactivation of oral contraceptives because of its action on hepatic medication metabolizing enzymes

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (SATA) A. Report muscle pain to the provider. B. Avoid taking the medication with grapefruit juice. C. Take the medication in the early morning. D. Expect a flushing of the skin as a reaction to the medication. E. Expect therapy with this medication to be lifelong.

A. Report muscle pain to the provider.--myopathy is an adverse effect and can lead to rhabdomyolysis; so report B. Avoid taking the medication with grapefruit juice.--increase the risk of muscle injury from elevations in CK E. Expect therapy with this medication to be lifelong.--if d/c, cholesterol levels will return to the pretreatment range within several weeks to months----most effective when taken in the evening b/c cholesterol production generally increases overnight

A nurse is caring for a client who recently began taking oral amoxicillin/clavulanate and reports urticaria. Which of the following actions should the nurse take? A. Request a change in the type of antibiotic. B. Ask for a change in the route of administration. C. Check for pitting edema. D. Check the client's WBC count.

A. Request a change in the type of antibiotic.--urticaria after taking a penicillin based med indicate a mild allergic rxn

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. 0830