PN Pharmacology Online Practice 2020 A

A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion?

"Discontinue use in the left nostril, then in the right nostril."

A nurse is reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching?

"Give acetaminophen as needed for discomfort and fever."

A nurse is reinforcing teaching with a client who has a new prescription for regular insulin. Which of the following statements by the client indicates an understanding of the teaching?

"I should ensure that the insulin is clear prior to drawing it up."

A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following statements should indicate to the nurse an understanding of the teaching?

"I will be sure to have my blood tested for anemia."

A nurse is reinforcing teaching with a client who has a new prescription for ethinyl estradiol/norethindrone, an oral contraceptive. Which of the following client statements should indicate to the nurse an understanding of the teaching?

"I will take the medication at the same time each day."

A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching?

"I will take the medication with 8 ounces of water."

A nurse is reinforcing teaching with a client who has a new prescription for propranolol. Which of the following information should the nurse include in the teaching?

"If your pulse rate is less than 50 beats per minute, notify your provider."

A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following information should the nurse include in the teaching? (Select all that apply.)

"You will need to have your liver enzymes monitored after 1 month." "You can have nosebleeds while taking this medication." "You should report any thoughts of harming yourself." "You will need to have two negative pregnancy tests prior to starting the medication."

A nurse is planning to reinforce teaching about newborn immunizations with a client who is 24 hr postpartum. Which of the following information should the nurse plan to include?

"Your baby will receive the first hepatitis B vaccine before discharge."

A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make?

"Your medication can't be given IV because it is not water-soluble."

A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL to infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the manual IV infusion is set to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

31 gtt/min Math steps: 1. convert 8 hr to min (8hr = 480 min) 2. set up a proportion to solve for X gtt/min (1,000mL/480min multiplied by 15 gtt/1mL) 3. solve proportion (mL unit cancels out; 1,000*15 gtt = 15000 gtt; 480 min*1 = 480 min; 15,000 gtt/480 min = 31.25 gtt/min; rounds down to 31 gtt/min)

At 0800 a nurse assists with initiating a 1,000mL IV infusion for a client, which is running at 125 ml/hr. How much fluid is left in the IV bag at 1300? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

375 mL Math Steps: 1. determine how many hours between 0800 and 1300 (5 hr) 2. determine how much fluid has already been infused (125 mL*5 hr = 625 mL infused) 3. subtract the mL completed by the total mL to be administered (1000 mL - 625 mL = 375 mL left to administer at 1300)

A nurse is preparing to administer a PRN medication to a group of clients. Which of the following clients should the nurse administer medication to first?

A client who is attending postoperative physical therapy and requests pain medication

A nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication?

Abdominal pain

A nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following adverse effects of valproic acid to the provider immediately?

Abdominal pain

A nurse is preparing to administer diphenhydramine 50 mg PO at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5 mg/5 mL PO. Which of the following nursing actions requires the completion of an incident report?

Administering 25 mL of the syrup

A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication?

Agranulocytosis

A nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication? (Select all that apply.)

Blurred vision Nausea Dysrhythmia

A nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypertension. Which of the following conditions should the nurse include as a contraindication for this medication?

Bradycardia

A client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me, and I require zolpidem." The client's pupils are dilated, along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances?

Cocaine

A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/carbidopa. The nurse should identify which of the following findings as an adverse effect of this medication?

Dark urine

A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following findings should indicate to the nurse that the medication has had a therapeutic effect?

Decreased T4

A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect?

Decreased muscle spasticity

A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take?

Determine the client's daily alcohol intake.

A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication?

Dilates bronchioles

A nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management. The nurse should instruct the client that which of the following over-the-counter medications is contraindicated while taking oxycodone?

Diphenhydramine

A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. Which of the following instructions about self-administering this medication should the nurse include?

Discard any solutions that are cloudy.

A nurse is reviewing medication prescriptions for a group of clients. The nurse should recognize that which of the following prescriptions can result in a medication administration error?

Furosemide 10.0 mg PO daily

A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization?

Gelatin

A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of the medication?

Glucosylated HbA1c

A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect?

Hemoglobin rises 0.5 g/dL

A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib?

History of myocardial infarction

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

Hyperkalemia

A nurse is assisting with the care of a client who has a methicillin-resistant staphylococcus aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider?

Hypotension

A nurse is caring for a client who is taking phenylephrine. The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication?

Increased heart rate

A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect?

Increased tolerance to exercise.

A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication?

Inform the client to apply sunblock before going outside.

A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching?

Maintain a consistent sodium intake.

A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider?

Muscle pain

A nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider?

Oxygen saturation 87%

A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medicaiton?

Penicillin allergy

A nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

Place the patch on a different site for each application.

A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops?

Press the nasolacrimal duct.

A nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective?

Pulse 82/min

A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching?

Restrict foods high in potassium.

A nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions?

Reye syndrome

A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1ºC (102.4ºF). Which of the following actions should the nurse take first?

Stop the transfusion.

A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include?

Swallow the medication whole.

A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluxetine. The nurse should notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects?

Tremors

A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take?

Withhold the client's medication.