Pharmacology Practice

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?

" I will fold the sticky sides of the old patch together before disposing it."

A nurse is caring for a client who is refusing to take their scheduled morning furosemide. Which of the following statements should the nurse make?

"By not taking your furosemide, you might retain fluid and develop swelling"

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?

"Drink a glass of milk with each dose of medication."

A nurse is teaching a client who is to start taking rantidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching?

"I know smoking makes ranitidine less effective."

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching?

"I should take acetaminophen instead of ibuprofin for my headaches while taking this medication."

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?

"I will check my heart rate before I take the medication."

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?

"I will remove the patch after 14 hours." (The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.)

A nurse is providing discharge instructions 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?

"I will store my unopened bottles of insulin in the refrigerator."

A nurse is teaching about zolpidem to a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching?

"I will use this medication for a short period of time."

A nurse is completing an incident report for a medication error. Which of the following information should the nurse include in the report?

Administered propanolol 80 mg PO at 1800 to the client who did not have a prescription for the medication.

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?

Administers isosorbide mononitrate to a client who has BP 82/60 mm Hg

A nurse is caring for a client who is recovering from 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?

Bleeding gums

A nurse is caring for a client who has a magnesium level of 3.1 mEq/L. The nurse should expect to administer which of the following medications?

Calcium gluconate

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication?

Client report of decreased paresthesia

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?

Cromolyn

A nurse is reviewing laboratory results for a client who is to receive a dose of ceftazidime 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?

Creatinine 2.6 mg/dL

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor?

Creatinine kinase

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?

Discontinue the medication IV infusion (The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion.)

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 for receiving which of the following medications?

Doxycycline (Doxycycline is a tetracycline antibiotic. The nurse should identify that doxycycline can cause teratogenic effects such as staining of the infant's teeth when exposed to this medication. Therefore, this medication is contraindicated for the client.)

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?

Dry mouth

A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take?

Ensure flumazenil is available to administer for toxicity management.

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?

Hemoglobin 7.0 g/dL Platelets 75,000/mm3 Potassium 5.2 mEq/L

A nurse is caring for a client who has heart failure and a prescription for enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication?

Hyperkalemia

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?

Hyperventilation

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?

Increased cardiac output.

A nurse is caring for a client who is to receive treatment for opioid use disorder. Which of the following medications should the nurse expect to administer?

Methadone (The nurse should expect to administer methadone for treatment of opioid use disorder. Methadone can be administered for withdrawal and to assist with maintenance and suppressive therapy.)

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?

Orthostatic hypotension

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports confused and anxious. Which of the following actions should the nurse take first?

Perform a capillary blood glucose test.

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?

Place monitoring cords and tubes in a stockinet. (to prevent direct contact with the client's skin)

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?

Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent

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 the adverse effects of fentanyl should the nurse plan to give to the client and family?

Take a stool softener on a daily basis

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 that she should complete an incident report?

The client reports shortness of breath. (A severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. Shortness of breath can indicate the client is developing anaphylaxis.)

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?

Urinary retention

A nurse is reviewing the laboratory results of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider?

WBC 3,500/mm3

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The clinet tells the nurse that they are allergic to penicillin. Which of the following actions should the nurse take first?

Withhold the medication.

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?

Yellow-tinged vision

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?

tinnitus

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?

total cholesterol

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?

Drink 2 L of water daily

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?

"Blood glucose levels will be monitored during therapy" "Avoid contact with persons who have known infections" "Grapefruit juice can increase the blood levels of the medication"

A nurse is teaching about a new prescription for ciprofloxacin to a client who has a UTI. The nurse should identify which of the following statements as an indication that the client understands the teaching?

"I will report any sings of tendon pain or swelling."

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?

"Increase intake of potassium-rich foods" "Monitor for muscle weakness" "Dangle your legs from the side of the bed before standing"

A nurse is caring for a client who is receiving haloperidol. The nurse should identify which of the following as an adverse effect of the medication?

Akathisia

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?

Change positions slowly

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?

Chest pressure

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?

Drink 8 to 10 glasses of water daily.

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider?

leg tenderness

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome?

Decrease in flexor and extensor spasticity

A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with iansopazole. The nurse should monitor the client for which of the following manifestations?

Disorientation

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?

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

a nurse contacts a client's provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take?

Have the provider spell out the unfamiliar medication names.

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

Increased blood pressure (The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.)

A nurse administered digoxin immune Fab to a client who received the incorrect dose of digoxin over a period of 3 days. The nurse should identify that which of the following findings indicates the antidote was effective?

Normal sinus rhythm

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?

Obtain WBC with absolute neutrophil count

A nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of the dollowing actions should the nurse take prior to administering the medication?

Obtain the client's blood pressure. (HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema. The nurse should obtain the client's blood pressure prior to administration of the medication.)

A nurse is providing teaching to 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?

Orange juice (Vit. C)

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 for receiving propranolol?

asthma (Asthma is a contraindication for receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest)

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?

blurred vision

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?

188 mL/hr Step 1: What is the unit of measurement the nurse should calculate? mL/hr Step 2: What is the volume the nurse should infuse? 1,500 mL Step 3: What is the total infusion time? 8 hr Step 4: Should the nurse convert the units of measurement? No Step 5: Set up an equation and solve for X. Volume (mL)X mL/hr = Time (hr) 1,500 mLX mL/hr = 8 hr X mL/hr = 187.5 mL/hr Step 6: Round if necessary. 187.5 mL/hr = 188 mL/hr Step 7: Determine whether the amount to administer makes sense. If the prescription reads 1,500 mL 0.9% sodium chloride IV to infuse over 8 hr, it makes sense to administer 188 mL/hr. The nurse should set the IV pump to deliver 0.9% sodium chloride IV at 188 mL/hr. Follow these steps to calculate the infusion rate using the Dimensional Analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) X mL/hr = Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 1,500 mLX mL/hr = 8 hr Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 1,500 mLX mL/hr = 8 hr Step 4: Solve for X. X mL/hr = 187.5 mL/hr Step 5: Round if necessary. 187.5 mL/hr = 188 mL/hr Step 6: Determine whether the amount to administer makes sense. If the prescription reads 1,500 mL 0.9% sodium chloride IV to infuse over 8 hr, it makes sense to administer 188 mL/hr. The nurse should set the IV pump to deliver 0.9% sodium chloride IV at 188 mL/hr.

A nurse is preparing to administer 0.9% sodium chloride 1,000 mL IV over 8 hr to a client. 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 Follow these steps to calculate the infusion rate using the Ratio and Proportion or Desired Over Have method of calculation: Step 1: What is the unit of measurement the nurse should calculate? gtt/min Step 2: What is the volume the nurse should infuse? 1 L= 1,000 mL Step 3: What is the total infusion time? 8 hr Step 4: Should the nurse convert the units of measurement? Yes (min does not equal hr) 1 hr8 hr = 60 minX min X min = 480 min Step 5: Set up an equation and solve for X. 1,000 mL15 gttX gtt/min = × 480 min1 mL X gtt/min = 31.25 gtt/min Step 6: Round if necessary. 31.25 = 31 Step 7: Determine whether the amount to administer makes sense. If the prescription reads 0.9% sodium chloride 1,000 mL IV to infuse over 8 hr with a drop factor of 15 gtt/min, it makes sense to administer 31 gtt/min. The nurse should set the manual IV infusion to deliver 0.9% sodium chloride IV at 31 gtt/min. Follow these steps to calculate the infusion rate using the Dimensional Analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) X gtt/min = Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 15 gttX gtt/min = 1 mL Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 15 gtt1,000 mL 1 hrX gtt/min = × × 1 mL8 hr 60 min Step 4: Solve for X. X gtt/min = 31.25 gtt/min Step 5: Round if necessary. 31.25 = 31 Step 6: Determine whether the amount to administer makes sense. If the prescription reads 0.9% sodium chloride 1,000 mL IV to infuse over 8 hr with a drop factor of 15 gtt/min, it makes sense to administer 31 gtt/min. The nurse should set the manual IV infusion to deliver 0.9% sodium chloride IV at 31 gtt/min.