Question Collection Pharm Final

A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome?

Acetylsalicylic acid

When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?

E. coli

The nurse is providing education to a client who has been prescribed naltrexone. What effect should the nurse teach the client to expect if an opioid is taken?

The absence of usual physiological effects

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine.

The nurse prepares to administer acetylcysteine by nebulization to an adult client diagnosed with chronic bronchitis. Which measures would the nurse provide for safe and effective drug administration? Select all that apply.

-Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. -Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. -Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber.

The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply.

-Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. -Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. -Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated.

A nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if what occurs? Select all that apply:

Blood is noted in the stool Diarrhea worsens Client reports severe abdominal pain Diarrhea is not relieved

The nurse has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next?

Call the provider as another dose of opioid antagonist may be necessary.

Tuberculosis caused by drug-resistant organisms should be considered in which clients? Select all that apply:

Clients who have no response to therapy Clients who have been treated in the past

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?

Drink a full glass of water when taking a dose of the drug.

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug?

Duration of action will be prolonged.

A nursing instructor is preparing a teaching plan for a nursing class on opioid analgesics. Which body system would the nursing instructor describe as not adapting to and compensating for the secondary effects of this class of drugs?

GI system

A 12-year-old cancer client is receiving morphine 5-10 mg PO q6 hours. The 12-year-old reports being in pain. The nurse checks the medication record and finds that it has been 5 1/2 hours since the client last received pain medicine. What would the nurse do?

Give the client 5 mg of morphine PO.

A client is treated for HIV with NNRTIs. The client develops tuberculosis, and the health care provider includes rifampin in the treatment regimen. Why would this be cause for concern?

Rifampin decreases blood levels of anti-HIV drugs.

Clients diagnosed with chronic pain should be given what information regarding opioids' effectiveness?

They should be given on a regular schedule, around the clock.

A postsurgical client has been prescribed morphine to address the pain that is anticipated over the next 24 to 48 hours. What is the most effective strategy to manage a client's postsurgical pain for the initial 24 to 48 hours?

administering morphine on a scheduled basis and supplementing it with additional morphine when the pain worsens

Repeated lab work shows positive cultures for a client prescribed drug therapy for tuberculosis (TB) over 4 weeks ago. What are the likely reasons for this failure to achieve treatment goals? Select all that apply.

client has been nonadherent with medication therapy a delay in the initial diagnosis of the client infecting strain of TB is drug resistant

What is first-line therapy for infants and children 1 to 4 years of age with diarrhea?

electrolyte replacement

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:

he should wear glasses during the therapy.

A caregiver asks the nurse what the caregiver can give a 9-year-old child for a headache. What is the nurse's best response?

"Acetaminophen is appropriate."

The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent doesn't know why the teeth are discolored and reports that the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask?

"Have they ever received tetracycline?"

A nurse is assessing a female client who has been taking NSAIDs. What statement by the client indicates a good understanding of the use of NSAID therapy?

"I asked my provider to check for blood in my stool on a regular basis."

A postsurgical client has been provided with a morphine patient-controlled analgesic (PCA) but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond to this client's concerns?

"It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."

A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug?

"Take this drug as soon as you feel the first signs of a migraine."

A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this client's statements?

"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."

A client is in the hospital recovering from surgery and is using a client-controlled anesthisia (PCA) pump. The client's adult child tells the nurse they are concerned about the possibility of morphine overdose because their parent keeps pressing the button on the PCA. In addition to reassessing the client's pain, what is the nurse's best response?

"The device has maximum limits programmed, so your parent cannot get more than a specific amount."

A female client asks why she must consult with the health care provider when she uses cold products for her children. What is the nurse's best response?

"There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies."

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium?

"This medication will only soften your stools over the next couple of days."

A client is concerned because his drug regimen for drug-resistant TB is different from that of his friends. Which explanation by the nurse is accurate?

"Treatment is based on drug susceptibility reports."

The nurse collects the past medical history of a client new to the clinic. The client reports an allergy to penicillin. What questions about the allergy should the nurse ask the client? Select all that apply.

"What signs and symptoms were displayed with the reaction?" "How many doses were administered before the reaction occurred?" "Had the medication ever been prescribed before the time when the reaction occurred?"

A client received erythromycin before dental surgery. The client has a past history of a cardiac surgery. The rest of the client's history is unremarkable. What does the nurse teach the client about this medication?

"You are receiving this medication to prevent infection that may affect your heart."

A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply.

-"Antihistamines are not recommended because they tend to worsen your cough." -"Antihistamines are used for allergy-related coughs."

Your client receives IV vancomycin every 12 hours. You know that this infusion should run over:

1 to 2 hours.

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long?

2 days

The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours?

2 to 3 L of clear liquids

Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake?

2 to 3 days

A patient is taking acetylsalicylic acid (aspirin) to prevent platelet aggregation. Which dose of aspirin will irreversibly acetylate circulating platelets within a few minutes, with effects lasting for the lifespan of the platelets?

325 mg

A woman who has given birth to a baby girl by cesarean delivery is experiencing abdominal pain. The client receive a bolus dose of morphine intravenously. The nurse would recommend that the mother refrain from breast-feeding the baby for how long?

4 to 6 hours

Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose?

81-325 mg

The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine?

A 78-year-old with osteoarthritis

For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply.

A client who is recovering from a myocardial infarction A client who has completed anthelmintic therapy

The healthcare provider prescribes codeine 20 mg PO q4h as an adjunctive therapy to a client's NSAID. What is the nurse's best action?

Administer the medication as prescribed and monitor the client's pain.

A client is taking a nonsteroidal anti-inflammatory agent. Which instruction should the client be given in regard to administration?

Administer the medication with food.

The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration?

Allergy to Aspirin

The nurse should question an order for bismuth salts for a client with what condition?

Allergy to aspirin

What effects are exerted by aspirin? (Select all that apply.)

Analgesic Antipyretic Anti-inflammatory

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.)

Anti-inflammatory Analgesic Antipyretic

To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.)

Assist client from their bed to the toilet. Assist client with rising from a lying position. Assist client with hall-walking activities.

A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?

Better mobility

Which of the following is a serious risk involved in the use of NSAIDs?

Cardiovascular thrombosis

Which agent acts directly on the medullary cough center?

Codeine

Linezolid can be used to treat which of the following infections? Select all that apply.

Community-acquired pneumonia (CAP) Vancomycin-resistant Enterococcus faecium (VREF) Methicillin-resistant Staphylococcus aureus (MRSA) Nosocomial pneumonia

Constipation is a frequent problem. The nurse knows that which of these statements regarding constipation is correct?

Constipation is characterized by hard, dry stools.

A nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate?

Consult with the prescriber about lowering the dosage of the drug.

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug?

Dizziness

A client has been prescribed metronidazole for treatment of Giardia. What instruction is most important for the nurse to give to this client?

Do not drink alcohol while taking this medication.

A new mother required an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will be the most effective drug for the nurse to administer?

Docusate

A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching?

Drink at least 8 ounces of fluid with the medication.

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.)

Drowsiness Dizziness

Determining the cause of diarrhea in a patient is important. It enables choosing the correct treatment. The nurse recognizes that a stool specimen is sometimes necessary to determine correct therapy. The nurse recognizes that a green, liquid stool may be from which of the following?

Escherichia coli

A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply.

Gastric emptying Administration of activated charcoal Life support, if indicated

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students?

High Fowler's

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

Humidification of the environment Sucking on hard candy or throat lozenges Adequate fluid intake

You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect?

Hypernatremia

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug?

Hypotension

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist?

Increase in the client's pain rating

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants?

Increase the fluid in the intestinal contents

A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis?

Increased risk of GI bleeding

Which medication will be administered for the treatment of salicylate overdose?

Intravenous sodium bicarbonate

Which of the following antitubercular drugs are used during the continuation treatment phase of tuberculosis? Select all that apply:

Isoniazid Rifampin

The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means?

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops.

What nursing intervention would not be effective in assisting the client in stopping his or her migraine headache?

Keeping the room well lit

Lactulose (Chronulac, Cephulac) is prescribed for a client. The nurse knows that which of these statements regarding lactulose are correct? Select all that apply.

Lactulose is used to manage hepatic encephalopathy. Lactulose can cause electrolyte imbalance. Lactulose should produce two or three soft stools every day.

Which should be included when assessing pain? (Select all that apply.)

Location of the pain Intensity of pain What factors cause the pain to improve or worsen What medications client usually takes to relieve the pain

The nurse is caring for a client newly admitted for chronic opioid abuse. What medication does the nurse expect to be prescribed to the client?

Methadone

The nurse is caring for a client who has had impacted stools twice in the past month. What is the most appropriate laxative for this client?

Mineral oil

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

The client returns to the unit following surgery. The client reports being in pain. After checking the medication administration record in the client's chart, the nurse sees that the client has not received the morphine the health care provider has ordered for over an hour. As the order reads q 1-2 hours, the nurse administers the low dose of the morphine. The PACU nurse calls to tell the floor nurse that the nurse forgot to chart the last dose of morphine the client had received just before the client was transferred to the floor. What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids?

Naloxone hydrochloride (Narcan) tartrate

The nurse should monitor the client for which common side effects of erythromycin therapy?

Nausea, vomiting, and diarrhea

Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?

Nephrotoxicity

A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer?

Oral rehydration solutions

A nurse should recognize which situations necessitate the need for an opioid antagonist. Which situations necessitate the need for an opioid antagonist? (Select all that apply.)

Postoperative acute respiratory depression Reversal of opioid induced hypotension Suspected acute opioid overdosage

A client is receiving acetaminophen for fever. The client also has inflammation in the knees and elbows with pain. Why will acetaminophen assist in reducing fever but not in decreasing the inflammatory process?

Prostaglandin inhibition is limited to the central nervous system.

A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend:

Psyllium (Metamucil).

The nurse should know that lactulose achieves a therapeutic effect by which means?

Pulling water into the intestinal lumen by osmotic pressure

A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what?

Pupil constriction

A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit?

Put side rails up and place bed in low position.

The nurse is giving instructions to a client who will be having a colonoscopy in the morning. The client will be taking polyethylene glycol-electrolyte solution for bowel cleaning. What information will help increase the palatability of this medication?

Refrigerate the solution until it is cold.

A client has been prescribed a fentanyl patch for chronic pain. What client teaching should the nurse provide to the client and family upon discharge?

Remove the patch every 3 days.

Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis? Select all that apply:

Sennosides (Senokot) Bisacodyl (Dulcolax)

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

Serum alanine transaminase, aspartate transaminase, and bilirubin

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action?

Slows peristalsis by acting on the smooth muscles of the intestine

The nurse is reviewing the discharge instructions with the client going home on an opioid analgesic for pain management. What would the nurse include in the instructions? Select all that apply.

Take a laxative/stool softener. Keep the room well lit during the day. Rise slowly from a sitting or lying position. Keep a record of bowel movements.

A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply.

Take the drug with food or milk to improve absorption. Continue therapy for at least 1 week. Notify the PHCP in case of fever, chills, or cough.

A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside?

The fluoroquinolone can be given orally.

A family member asks the nurse why a second dose of an opioid antagonist is needed. Which response by the nurse is correct?

The opioid medication that was given may last longer than the opioid antagonist medication.

The parent of a toddler asks about giving an over-the-counter (OTC) cough and cold product containing pseudoephedrine to the child. What information regarding safety and efficacy should the nurse offer?

There are concerns among health professionals about how safe and effective these medications are.

When teaching a client about the action of an opioid antagonist, what should the nurse include in the education?

This medication competes with the opioid pain medication, binding to the cell receptors instead.

A client is taking pseudoephedrine to reduce nasal congestion. The nurse should caution the client against use of this decongestant if the client is currently taking what other type of drug?

Thyroid preparations

The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?

To inhibit platelet aggregation

Which of the following can occur if the nurse administers naloxone (Narcan) as a rapid IV bolus? Select all that apply:

Withdrawal Intense pain Vomiting

The nurse is providing client teaching about a prescribed opioid analgesic. When monitoring the client for potential adverse effects, what assessment should the nurse prioritize?

blood pressure

What drugs are examples of second-line opioid agonists/antagonists prescribed for the treatment of moderate-to-severe pain? Select all that apply.

butorphanol nalbuphine pentazocine

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

can cause allergic reactions in clients who are allergic to penicillins.

When assessing a client who is to receive celecoxib, a history of which disease process or condition would be most important to assess?

cardiac disease

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?

cardiovascular

A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply.

consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day

A health care provider orders diphenoxylate to treat a client who has severe hepatorenal disease. The nurse calls the provider to question this order because it may precipitate:

hepatic coma.

A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure? (Select all that apply.)

inadequate initial drug treatment noncompliance with the therapeutic regimen

A nurse is preparing a community teaching program about tuberculosis. When describing the individuals who are susceptible, who would the nurse include? Select all that apply.

individuals living in crowded conditions individuals with human immunodeficiency virus (HIV)

How do opioid analgesics relieve moderate-to-severe pain?

inhibiting the transmission of pain signals from peripheral tissues to the brain

Which medication is prescribed parenterally for severe pain?

ketorolac

A 2-year-old child from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the family's arrival in the United States 3 weeks ago. History reveals nothing remarkable, but the mother comments on her child's love of (and continual consumption of) ice cream, something not available in their native country. This history supports what possible cause of the child's diarrhea?

lactase deficiency

What is a contraindication to use of a fluoroquinolone?

lactation

Acetaminophen overdose has the potential to cause fatal:

liver damage

A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed?

loperamide

A 75-year-old client is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the client is being treated for rheumatoid arthritis and hypertension. The client is in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the client's:

medication history

A 23-year-old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. During the assessment, she informs the nurse that she has been experiencing these symptoms for the last three months on a weekly basis. These symptoms are those of:

migraine headache.

A client needing to evacuate the colon for endoscopy would likely be prescribed which medication?

polyethylene glycol electrolyte solution

A male client who has been on a drug regimen for tuberculosis (TB) for the last 2 months says he has lost his appetite and 10 pounds. What should the nurse suggest to the health care provider for this client to help in the area of nutrition?

pyridoxine

An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction? Select all that apply.

rectal suppository enema

The client has been taking acetaminophen daily for two years. The health care provider has now prescribed ketoprofen in addition to the acetaminophen. The nurse plans to educate the client on NSAIDs and acetaminophen and that their interaction can cause what condition?

renal impairment

A nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved?

stomach

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to:

stop taking the medication and come to the clinic as ordered by the health care provider.

The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply.

tachycardia hypertension vomiting

While caring for a client who is prescribed an opioid antagonist for treatment of respiratory depression caused by opioid therapy, the nurse would assess the client for which adverse reaction? Select all that apply.

tachycardia tremors nausea

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that:

there is risk of an extremely high dose available all at once if the tablet is crushed.