PN Pharmacology Online Practice 2020A

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) a. Blurred Vision b. Nausea c. Hyperactivity d. Increased appetite e. Dysrhythmia

a. Blurred Vision b. Nausea e. Dysrhythmia Blurred vision is correct. The nurse should identify visual changes such as blurred vision, halos, and a yellow or green tinge to vision as adverse effects of digoxin. Nausea is correct. The nurse should identify that nausea and vomiting are adverse effects of digoxin. Hyperactivity is incorrect. The nurse should identify that fatigue and weakness are adverse effects of digoxin. Increased appetite is incorrect. The nurse should identify that anorexia is an adverse effect of digoxin. Dysrhythmia is correct. The nurse should identify that dysrhythmias are an adverse effect of digoxin.

A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/carvidopa. The nurse should identify which of the following findings as an adverse of this medication? a. dark urine b. hypertension c. increased salivation d. bradycardia

a. Dark Urine The nurse should identify that levodopa/carbidopa can cause a darkening of the client's urine, sweat, and saliva.

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? a. decreased muscle spasticity b. increased urinary output c. increased mental alertness d. decreased heart rate.

a. Decreased muscle spasticity. The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity in a client who has multiple sclerosis.

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? a. weight loss b. pulse 82/min c. respiratory rate 22/min d. decreased menstrual flow

b. Pulse 82/min Tachycardia is a manifestation of hyperthyroidism. The nurse should identify that a pulse of 82/min is within the expected reference range of 60 to 100/min, indicating that the medication is effective.

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? a. "If you miss a dise, double the next scheduled dose." b. "discontinue this medication if lightheadedness occurs." c. "If your pulse rate is less than 50 bpm, notify your provider." d. "This medication can cause heat intolerance."

c. " If you pulse rate is less than 50 beats per minute, notify your provider" The nurse should instruct the client to check their pulse before taking the medication and to withhold the medication if their pulse is less than 50/min. The client should also notify their provider. Bradycardia is a common adverse effect of beta blockers.

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 contraindicated for this medication? a. Peripheral vascular disease b. Diabetes mellitus c. Bradycardia d. Chronic Kidney Disease

c. Bradycardia Metoprolol is a beta blocker that slows the conduction through the AV node. Therefore, it is contraindicated for clients who have bradycardia, or a heart rate that is consistently less than 60/min.

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? a. Albumin is within the expected reference range. b. urine output increases to 60 mL/hour c. hemoglobin rises 0.5 g/dL d. blood urea nitrogen level is within the expected reference range

c. Hemoglobin rises 0.5 g/dL Initial therapeutic effects, such as hemoglobin rising 0.5 g/dL, can occur within the first 2 weeks of therapy. The client's hemoglobin should reach target levels of 10 to 11 g/dL in 2 to 3 months.

A nurse is collecting data from a client who is asking about taking celecoxib for treatment for joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib? a. hyperglycemia b. allergy to penicillin c. history of myocardial infarction d. peptic ulcer disease.

c. History of Myocardial infarction Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease.

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. A client who has GERD and requests an antacid. b. A client who reports constipation for 3 days and requests a stool softener. c. a client who has mild generalized anxiety disorder and requests an anti anxiety medication d. a client who is attending postoperative physical therapy and requests pain medication.

d. A client who is attending postoperative physical therapy and requests pain medication. When using the urgent vs. nonurgent approach to client care, the nurse should determine that the client who is postoperative and going to physical therapy should receive medication first. Administering medication to the client can reduce the client's pain during and after therapy.

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? a. Decreased blood glucose level b. Increased Hgb c. Increased platelets d. Decreased T4

d. Decreased T4 The nurse should identify that methimazole inhibits the synthesis of thyroid hormone, reducing levels to provide a euthyroid state. Therefore, a decreased level of T4 is an indication of a therapeutic effect.

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? a. Passing a soft, formed stool daily b. decreased number of viral illness c. Improved ability to fall asleep d. Increased tolerance to exercise.

d. Increased tolerance to exercise The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to be carried to the vital organs and tissues.

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 us in the left nostril, then in the right nostril"

A nurs eis reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a ow 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" The nurse should instruct the parent to administer analgesics, such as acetaminophen or ibuprofen, to decrease discomfort and fever related to otitis media.

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" Regular insulin is clear in appearance. Clients should discard the vial and use a new vial if the insulin appears cloudy.

A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? a. "I can have unprotected sex after 6 months of taking this medication." b. I can expect to have constipation while taking this medication." c.

"I will be sure to have my blood tested for anemia" R: Zidovudine can cause severe anemia and neutropenia. The client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment.

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 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 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 1,000mL to infuse over 8hr. 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 get/min. (Round to answer to the nearest whole number. use a leading zero if it applies. Do not use a trailing zero)

31 gtt/min

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

375mL

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 valporic acid. The nurse should instruct the client to report which of the following adverse effects of valporic acid to the provider immediately?

Abdominal pain

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

Administering 25mL of the syrup This dose is higher than the client should receive. The correct dosage is 20 mL. Administering an incorrect amount of medication to a client requires completion of an incident report.

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? Hypoglycemia Iron-deficiency anemia Serotonin syndrome agranulocytosis

Agrunolocytosis The nurse should monitor the client's WBC count and notify the provider for a value below the expected reference range of 5,000 to 10,000/mm3.

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

Determine the clients 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 for this medication?

Dilates bronchioles Theophylline is a bronchodilator, which affects smooth muscle relaxation and leads to opened airways.

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

Furosemide 10.0mg 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 The nurse should identify that a hypersensitivity reaction to either gelatin or neomycin is a contraindication for receiving the varicella vaccine because it contains both of these substances.

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 this medication?

Glycosylated HbA1c

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 aerus (MRSA) infection and is receiving vancocymin 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 When using the urgent vs. nonurgent approach to client care, the nurse determines that the priority finding to report to the provider is hypotension. If the client's vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria.

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 Due to cardiac effects, phenylephrine can cause tachycardia and other cardiac dysrhythmias

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? a. Suggest that the client apply antiperspirant deodorant more frequently b. Inform the client to apply sunblock before going outside. c. give the client a list of OTC antidiarrheal medications d. recommend that the client take the medication on an empty stomach.

Inform the client to apply sunblock before going outside The nurse should inform the client to apply sunblock, which will counteract the adverse effects of photosensitivity. Chlorpromazine increases skin's sensitivity to ultraviolet light causing temporary pigmentation changes and increases the risk of sunburn.

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 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 The nurse should instruct the client to notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis.

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% When using the airway, breathing, and circulation approach to client care, the nurse determines that the priority finding is an oxygen saturation of 87%, which is a manifestation of respiratory depression and should be reported to the provider.

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 form the clients medical record should the nurse report to the provider before the client begins receiving this medication?

Penicillin allergy

A nurse is reinforcing teaching with a client who is to start therapy using 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. The nurse should press the client's nasolacrimal duct after instilling the eye drops to prevent the medication from absorbing into systemic circulation.

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 in high potassium

A nurs eis 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?

Reyes Syndrome

A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1 C (102.4 F). 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 capsules. Which of the following instructions should the nurse include?

Swallow the medication whole The nurse should instruct the client to swallow the capsules or tablets whole and not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delayed-release tablets, as well as suspensions and powders.

A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. 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 Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. The client can experience tremors, confusion, and hallucinations.

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

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? a. "your baby will receive the first hepatitis B vaccine before discharge." b. "Your baby will receive the rotavirus vaccine if your blood titer is low." c. "Your baby will receive their first influenza vaccine at the 4-week check-up." d. "Your baby will receive the varicella vaccine if you have a history of chickenpox."

a. "Your baby will receive the first hepatitis B vaccine before discharge." The newborn should receive the first hepatitis B vaccine at birth, with the next dose at age 1 to 2 months.