VN NCLEX, PHARM MUSCULOSKELETAL
A nurse is reinforcing teaching for a female client who has multiple sclerosis and a new prescription for dantrolene. Which of the following client statements indicates an understanding of the teaching?
" I need to notify my provider if I don't get some relief from my muscle spasms within three months" Dantrolene is hepatotoxic. If the client does not get relief from muscle spasm within 45 days, the provider should discontinue the medication.
A nurse is assisting with the admission of a client to the medical unit. The clients valuables include a container of Ginko biloba. The client states he takes it does each day to improve his memory. Which of the following statements should the nurse make?
" I will check with your doctor to be sure it's OK for you to take it while you're in the hospital" The nurse is using a therapeutic response by acknowledging the client and responding in a nonjudgmental manner. The nurse is also ensuring the safety of the client because keeping Ginko biloba can interact with other medications and can cause various adverse effects.
A nurse is referring to administer ofloxacin optic drops To an adult client who has otitis externa. Which of the following actions should the nurse take?
Apply gentle pressure with a finger to the tragus of the ear. Apply gentle pressure with a finger to the tragus of the ear after administration will facilitate movement of the fluid down the ear canal.
The nurse is reinforcing teaching with a client who has multiple sclerosis and a new prescription for baclofen. Which of the following instructions should the nurse include?
Avoid Driving into the medications effects are evident. several CNS related effects are common, including drowsiness, dizziness, headache, and confusion. Therefore, until the client knows how the medication will affect her, she should not drive a vehicle.
The nurse reinforcing teaching with a client who is to start taking methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching?
Drink at least 2 L of water per day.
A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. The nurse should recognize that which of the following statements by the client indicates a need for further teaching?
I'll be glad when my seizures stop so I can quit taking this medication The client should not discontinue phenytoin abruptly. Because withdrawal from treatment can cause seizures to resume. Clients taking anti-convulsants Medication often require them for life, and phenytoin should not be stopped unless indicated by the provider
A nurse is caring for a client who is taking Celecoxib daily. The nurse should identify that history of which of the following disorders indicate a need for this type of medication
Osteoarthritis Celecoxib is a nonsteroidal anti-inflammatory, cyclooxygrnase-2 (COX-2), Inhibitor used to relieve the pain and inflammation caused by rheumatoid arthritis and osteoarthritis in adults.
The nurse is collecting data from a client who has been taking cyclobenzaprine for the past week. Which of the following therapeutic effects should the nurse expect to find?
Relief of muscle spasms Cyclobenzaprine is a centrally acting skeletal muscle relaxant that is prescribed for relief for muscle spasms
The nurse is reinforcing teaching with a client who is experiencing severe pain from rheumatoid arthritis and has a new prescription for methyl tracks eight. Which of the following information should the nurse include in the teaching?
Take the medication by mouth once weekly Clients who are taking methotrexate for rheumatoid arthritis should take the medication once weekly either orally or intramuscularly.
a nurse is caring for a client who states, " i am not going to take my medications anymore". which of the following responses should the nurse make?
Tell me more about this decision. the client has the right to refuse the medication but the nurse has the responsibility to gather more data to find out why the client is making this decision. the nurse is providing a general lead to encourage the client to express his feelings. the nurse can then address the specific problem.
Is there a nurse is reinforcing teaching about colchicine With client who has gout. Which of the following statements by the client indicates understanding of the teaching.
This medication should eliminate the swelling in 2 to 3 days. Gout is an anti-inflammatory disorder. High dose colchicine produces relief within several hours and can reverse inflammation and bring significant pain relief and 48 to 72 hours.
a nurse in a community clinic is collecting data from a client who is withdrawing from heavy cocaine use. when collecting date from the client, which of the following manifestations should the nurse expect to observe?
apathy manifestation of withdrawl from cocaine, a central nervous system stimulant, include apathy, depression, drowsiness and irritability.
a nurse is reinforcing dietary teaching for a client who is to start taking a monoamine oxidase inhibitor (MAOI). which of the following food choices should the nurse identify as having the highest tyramine content?
avocadoes clients who are receiving an MAOI should avoid foods containing high tyramine content such as avocadoes. eating foods with high tyramine content can lead to hypertensive crisis. the client can have a severe HA, tachycardia, hypertension, confusion which can lead to stroke and death.
a nurse is reinforcing teaching with a female client who has rheumatoid arthritis and a rx for methotrexate. which of the following information should the nurse include in the teaching?
drink 10-12 glasses of water per day. methotrexate can cause toxicity. adequate hydration promotes its excretion and helps prevent this adverse effect.
a nurse is preparing a presentation for coworkers about the various herbal remedies clients might report using. Which of the following should she include as an herbal supplement clients might use to lose weight and improve mental clarity?
green tea although evidence is inconclusive, clients can drink green tea to help lose weight and improve mental clarity, as well as protect and treat stomach, skin, bladder and breast cancer. the polyphenols in green teach have anti-inflammatory, chemo-proactive, and antioxidant effects. the caffeine in green tea might result in weight loss and mental clarity.
a nurse is reinforcing teaching with a client who is taking ibuprofen to treat chronic hip pain. which of the following instructions should the nurse include in the teaching?
have regular eye exams done while taking this medications the nurse should instruct the client to have regular vision and hearing examinations due to the potential adverse effects of ibuprofen.
a nurse is reinforcing teaching with a client who is about to start taking allopurinol to treat gout. which of the following statements by the client indicates an understanding of the teaching.
i need to drink at least 3 quarts of water a day. the nurse should instruct the client to drink 3000 ml or 3 quarts, of fluid each day to produce 2000 ml of urine.
a nurse is reinforcing discharge teach with a client who is postoperative following hip arthroplasty and is to continue use of enoxaparin at home. which of the following statements by the client indicates an understanding of the teaching.
i will need to give myself an injection in my abdomen twice a day. enoxaparin is an anticoagulant used to prevent to deep vein thrombosis after orthopedic and other types of surgery. it is administered only by the subcutaneous route and its duration of action is 12 hr. it is considered safe to allow the client to self- administer this medication.
a nurse is collecting date from a client who reports taking several herbal supplements. which of the following supplements should the nurse tell the client can increase sedation in clients who take CNS depressant medication?
valerian valerian is taking to promote sleep and decrease mild anxiety. However, the nurse should inform the client that valerian can potentiate the sedation of antianxiety medication. the nurse should also report the client's use of valerian and other herbal supplements to the provider.
the nurse is reinforcing teaching with a client who is prescribed olanzapine. For which of the following adverse effects should the nurse instruct the client to monitor?
weight gain olanzapine is atypical antipsychotic medication used in the treatment of schizophrenia. a common adverse adverse effect is increased appetite and significant weight gain.
a nurse is reinforcing discharge teaching for a client who will continue to take lithium carbonate at home to manage bipolar disorder. which of the following instructions should the nursing include when reinforcing the teaching?
withhold dose if having a find hand tremor clients who are taking lithium carbonate should monitor for and report a find hand tremor. the client should withhold the dose and contact the provider as soon as possible to have an evaluation of blood lithium levels and possible adjustment of dose.
the nurse is reinforcing teaching with a client who has parkinson's disease. the client tells the nurse that he gets nausea when he takes his prescribed levodopa/carbidopa. Which of the following foods should the nurse recommend the client take with the medication?
1 cup ( 8 oz ) of applesauce. the client should take levodopa/carbidopa with food to decrease nausea and vomiting but should avoid food high in protein because it interferes with absorption and decreases the therapeutic response. 1 cup of applesauce contains less that one half a gram of protein.
A nurse is reinforcing teaching with a client who is to start taking calcium carbonate as a calcium supplement. Which of the following should the nurse instruct the client to consume to increase the absorption of calcium?
2% cottage cheese 1/2 cup four ounces
The nurses are in person teaching for a client who is the person has a prescription for fluoxetine 20mg PO twice daily. Dinner should I do that which of the following statements by the client demonstrates understanding of the teaching?
Call me to report weight loss or gain to my provider while taking this medication Fluoxetine Can cause anorexia, nausea, and vomiting earlier and treatment, possibly causing weight loss. Over the course of therapy, waking is common. The client should monitor weight regularly and report significant change to the provider.
The nurse is caring for a client who has schizophrenia and is receiving clozapine. Which of the following findings should the nurse monitor to determine if the medication is having a therapeutic effect?
Decreased auditory hallucinations. Clozapine is a second generation antipsychotic patient that is effective in managing both positive and negative manifestation of schizophrenia, including reduction of hallucinations, delusions, disordered thinking, and lack of motivation.
A nurse is reinforcing teaching to a client who has a fractured ulna and is to start taking cyclobenzaprine. The nurse should instruct the client to expect which of the following therapeutic effects?
Decreased muscle spasms Cyclobenzaprine is a centrally acting muscle relaxant that relieves painful muscle spasms due to acute musculoskeletal injury.
A nurse is reinforcing teaching with a client who takes diazepam. Which of the following information should the nurse include?
Diazepam can cause drowsiness Diazepam has sedative properties, so the client should not engage and potentially hazardous activities after receiving the medication.
The nurse is reinforcing teaching with a client who is taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?
Difficulty voiding The nurse should instruct the client to report difficulty voiding as an adverse effect of benztropine, which may indicate urinary retention. Benztropine is an anti-cholinergic medication that helps decrease rigidity and tremors of Parkinson's disease.
A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse review with the client. select all that apply
Do not drink alcohol beverage-because hepatotoxicity and alcohol ingestion can increase the risk of liver damage. Reports unexplained bruising to the provider-Causes thrombocytopenia. Clients sugar for bruising or Petachiae as they might indicate a low platelet count. Avoid people who have infection-Class is bone marrow suppression and increase the risk for infection.
The nurse is reinforcing teaching with a client who is about to start therapy with methotrexate to treat rheumatoid arthritis. Which of the following instruction should the nurse include? Select all that apply.
Do not drink alcohol beverages- alcohol ingestion can increase the risk of liver damage Report unexplained bruising to the provider- can cause thrombocytopenia. Client should I report bruising or petechiae as they might indicate low platelet count Avoid people who have infection- causes bone marrow suppression and increase the risk for infection.
A nurse is preparing to administer your drops to a two year old child. The nurse should pull auricle In which of the following directions when instilling the medication?
Down and backward The nurse should pull her auricle down and backward in order to straighten the ear canal to facilitate the flow of the medication.
A nurse is reinforcing teaching with a client who has rheumatoid arthritis about taking methotrexate. Which of the following instructions should the nurse include?
Drink 2 to 3 L of fluid per day to promote its excretions. Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of fluid to maintain adequate hydration to promote excretion of the medication.
A nurse is reinforcing teaching with a client who reports having migraine headaches. The nurse should identify that the client can use which of the following herbal supplements prophylactically to manage for migraine headaches?
Feverfew Clients can use feverfew prophylactically to decrease how often my green secure and the severity of symptoms such as nausea, photophobia, and pain. This action might result from preventing Vasoconstruction and the brain and suppressing release of serotonin from platelets and leukocytes
A nurse is caring for a client who has Austria process and is taking calcium carbonate. The nurse should monitor the client for which of the following adverse effects?
Flank pain The nurse should monitor the client for flank pain, which can indicate renal calculi, an adverse effect of calcium carbonate.
The nurse is reinforcing teaching with a client who reports constipation and wants to use an herbal supplement. The nurse should identify that the client can use which of the following are boss supplement to treat constipation.
Flaxseed Flax seeds provide soluble plant fiber and will mimic the action of a bulk forming laxative to treat constipation. In addition, flaxseed reduces total cholesterol and LDL cholesterol levels but has no effect on HDL cholesterol or triglycerides.
A nurse is preparing a presentation for coworkers about the various herbal remedies clients might report using. Which of the following should she include as an herbal supplement clients might use to help boost their memory?
Ginko biloba Causes vasodilation and does improve blood flow to the brain improving memory
The nurse is collecting data from a female client who has Osteo arthritis in her purse she is thinking about taking aspirin for pain control. Which of the following data and the clients history should the nurse realize might be a contraindication to taking aspirin and should be reported to the provider?
History of vitamin K deficiency Aspirin inhabits platelets aggregation and should not be taken by clients who have bleeding disorders, such as history of vitamin K deficiency. Vitamin K must be present in order to synthesize several clotting factors and a deficiency of the vitamin causes bleeding tendencies. The nurse should report a history of vitamin K deficiency to the provider.
a nurse is reinforcing teaching with a client who has chronic open angle glaucoma. the client has been prescribed pilocarpine ophthalmic solution. which of the following statements by the client demonstrates an understand of the teaching?
I should expect to have blurred vision for up to two after hours after using this medication. clients who use pilocarpine experience blurred vision for 1-2 hours after use and should time activities accordingly.
A nurse is administering risperidone To a client who has schizophrenia. For which of the following adverse effects for the nurse monitor?
Increase triglyceride level Turn nurse should monitor for increased total cholesterol, LDL cholesterol, and triglycerides as well as decreased HDL cholesterol. Risperidone can lead to weight gain, diabetes, and dyslipidemia, which increase the clients risk for cardiovascular disease.
A nurse is collecting data from a client who has severe dementia and a fractured femur due to a fall. Which of the following manifestations should the nurse understand as a physical finding an acute pain?
Increased pulse rate Due to some pathetic nervous system stimulation, a client who experiences acute pain is likely to have increased pulse rate, blood pressure, shallow rapid respiration, diaphoresis, pallor, and increased muscle tension.
A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects for the nurse include in the teaching?
Jaw pain - can cause osteonecrosis of the job, so the nurse should instruct the client to monitor for dropping and report this finding to the provider. Blurred vision- causes ocular adverse effect such as blurred vision conjunctivitis and eye pain. Dysphasia- causes esophageal ulceration, causing the client to have trouble and swallowing. The nurse should instruct the client to remain upright 30 minutes after dosing to prevent esophageal irritation.
A nurse is caring for a client who begins showing signs of alcohol withdrawal delirium. Which of the following medications should a nurse administer?
Lorazepam The nurse should administer lorazepam to decrease the clients manifestation of a car withdrawal such as restlessness, irritability, anorexia, insomnia, cognitive function, and mild perceptual changes. In addition, lorazepam will stabilize vital signs and prevent seizures and delirium tremens.
A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for an extended period of time to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?
Monitor for a compression fractures of the back and the neck The client who is taking high doses of glucocorticoids for extended period of time can have a one loss, especially first in the back and neck, within weeks after starting the medication. This bone loss can result in fractures. There is increase in parathyroid hormone which causes calcium to move out of the bones.
A nurse is caring for a postoperative client who is receiving fentanyl. Which of the following medication should the nurse plan to administer to the client if manifestation of fentanyl toxicity occurs?
Naloxone Fentanyl is an opioid analgesic. The nurse should have the opioid reversal agent naloxone and resuscitation equipment available in the event that the client develops manifestation of opioid toxicity such as sedation.
A nurse is administering meperidine 100mg IM For a client who is admitted with a pelvic fracture. Following to injection, which of the following data is the priority for the nurse to check?
Respiratory rate Meperidine, and opioid can cause respiratory depression. The nurse should apply to a ABC priority setting framework. This framework emphasizes The basic core of human functioning, having an open airway, being able to breathe in adequate amount of oxygen, and circulating oxygen to the bodies organs via the blood. And alteration in any of these can indicate a Threat to life, and is therefore the nurses priority concern. When applying the ABC priority setting framework, airway is the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second highest priority in the ABC Priority setting framework because adequate until later afraid is essential in order for oxygen change to occur. Circulation is the third highest priority in the ABC priority setting framework because delivery of oxygen to critical organs can occur if the heart and blood vessels are capable of efficiently caring oxygen to them.
A nurse is collecting data from client who has just began therapy with alprazolam to treat anxiety. The nurse should observe the client for which of the following adverse effects of this medication?
Sedation Sedation and drowsiness are common adverse effects of alprazolam
A nurse is reinforcing teaching a client who has a new prescription of phenytoin. The nurse should instruct the client to monitor and report which of the following adverse effects of this medication?
Skin rash. Phenytoin is an antiepileptics medication used to treat partial seizures and generalized tonic clonic seizures. A skin rash can indicate Steven Johnson syndrome or toxic epidermal necrolysis (TEN), potentially life-threatening disorders. If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.
A nurse is reinforcing teaching with a client who has a new prescription for lithium carbonate to treat bipolar disorder. The nurse should make sure the client understands that he must maintain consistency in his intake of which of the following dietary elements?
Sodium Lithium as a salt. If sodium level falls, the client will remain with them and have an increased risk for lithium toxicity.
A nurse is preparing a presentation for coworkers about the various herbal remedies clients my report using. Which of the following should she include as an herbal supplement clients might use to treat the symptoms of depression?
St. John's wort. clients can use St. John's wort To manage mild to moderate depression. Clients can also use it or Aleve for pain and inflammation and apply it topically to manage local infection. This action might result from blockade of uptake of serotonin, norepinephrine and dopamine.
A nurse is collecting data from a client who has schizophrenia and recently stopped taking chlorpromazine after eight years. The nurse notes choreiform Movements, lip smacking, and spastic facial distortion. The nurse should document these findings as indicating which of the following conditions.
Tardive dyskinesia These findings indicate tardive dyskinesia, An adverse effect that occurs with long-term use of chlorpromazine, Which persist even when the client stops taking the medication
The nurse is reinforcing teaching with a client who has multiple sclerosis and a new prescription for baclofen. Which of the following information should the nurse include in the teaching?
This medication will relieve your muscle spasms The nurse should explain baclofen is a skeletal muscle relaxant can reduce the spasticity of the muscle associated with multiple sclerosis by suppressing resistance to passive movements.
The nurses are in person teaching with a client who takes lithium carbonate for bipolar depression. For which of the following findings should the nurse monitor as an adverse effect of lithium carbonate?
Thyroid enlargement Clients taking lithium carbonate can develop a goiter as a result of hypothyroidism.
A nurse in an urgent care center is collecting data from a client who reports taking an excessive amount of aspirin. Which of the following findings should the nurse identify as an indication of Salicylism?
Tinnitus A client can develop saliclyism when aspirin levels except therapeutic levels. Clinical manifestation includes tinnitus, Sweating, headache, dizziness, and hyperventilation.
A nurse is preparing A presentation for coworkers about the various herbal remedies client my airport using. Which of the following should she include as in herbal supplement clients are used to treat insomnia?
Valerian All the evidence of any conclusive, client can use valerian to promote sleep and decrease Restlessness from the anxiety. This action might result from increasing gamma-aminobutyric acid (GABA) at CNS synapses or as a direct GABA agonist.
A nurse in an urgent care center is collecting data from a client who reports taking an excessive amount of acetaminophen. Which of the following findings should the nurse identify as an indication of acute acetaminophen and toxicity.?
Vomiting with acute acetaminophen toxicity, The client is at serious risk for heroic necrosis. Early signs include nausea, vomiting, abdominal distress, diarrhea, and sweating.
A nurse is cotton data from a client who is postoperative from a mastectomy and administered hydromorphone 1 hr ago. The nurse should identify that which of the following findings is an adverse effect of this medication
Vomiting. An adverse effect of opioid analgesic, which includes Hydromorphone, is nausea and vomiting. The nurse can reduce the emetic effects of this medications by having the client lie still or administering an antiemetic medication prior to the administration of an opioid analgesic.
A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder. Which of the following instruction should the nurse include?
Wait up to three weeks to see for effects of the medication. Although some effects of the medication occur 5 to 7 days of treatment, it can take 2 to 3 weeks for the medications for the medications full effect.
A nurse is reinforcing teaching with a client who is to start taking Hydrochloriquine To treat rheumatoid I tritest. Which of the following information should the nurse include in the teaching?
Wear sunglasses when out in the bright sunshine The nurse should instruct the client to wear sunglasses to decrease photophobia. The client should have an ophthalmologic examination before a treatment and every six months because the medication can cause retinopathy.
A nurse is collecting data from a client admitted to a inpatient mental health unit and has a new prescription for disulfiram. Which of the following information is most important for the nurse to obtain before administering this medication?
When the client last drink alcohol The greatest risk to this client is the injury from acetaldehyde Syndrome, which can be life-threatening. The client can experience respiratory depression, cardiovascular collapse, convulsions and death if she has consumed alcohol within the last 12 hours. Therefore, the priority action for the nurse to take is to determine when the client last drink alcohol.
a nurse is caring for a client who is post operative and receiving fentanyl via pt controlled analgesia. The client has a prescription for naloxone. the nurse understands that the purpose of naloxone is which of the following?
block the effects of opioids on the central nervous system naloxone is a narcotic antagonist that combines competitively with opiate receptors and blocks or reverse the action of narcotic analgesics. By blocking the effects of narcotics on the central nervous system, it prevents CNS and respiratory depression.
a nurse is caring for an older adult client who is 5 days postoperative following a total hip arthroplasty is receiving meperidine for pain. while the nurse is taking morning vital signs, the client begins to experience a seizure. which of the following should the nurse recognize as the possible cause for this seizure?
cumulative effect a cumulative effect occurs with repeated doses of a medication are given the rate of administration exceeds the rate of metabolism or excreation. due to older adults decreased kidney function, meperidine can quickly reach a toxic level when given over several days, which can cause seizures.
a nusring is collecting data from a client who self-administers pilocarpine ophthalmic drops. which of the following findings by the nursing indicated a systemic adverse effect of this medication?
diarrhea systemic effects of pilocarpine are due to muscarinic stimulation and include diarrhea
a nurse is reinforcing teaching with pediatric client and his and family about the purpose of methylphenidate to manage ADHD. The nurse should explain that the purpose of this medication therapy to do which of the following.
increase focus methylphenidate acts on the cerebral cortex to create a stimulating effect that helps increases focus on metal activities and tasks.
a nurse is reinforcing teaching for a client who is about to start therapy with alendronate to treat osteoporosis. For which of the following findings should the nurse instruct the client to monitor and report as an adverse of the medication?
jaw pain - causes osteonecrosis of the jaw. blurred vision - causes ocular inflammation leading to blurred vision. dysphagia - causes esophagitis, so the client should report any difficulty or pain with swallowing.
a nurse is reinforcing teaching with a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following info should the nurse include in teaching.
sit upright or stand for at least 30 min after taking the medication. the nurse should instruct the client to sit or stand for 30 min after administration of the medication to reduce prolonged contact of the medication which can cause esophagitis.
a nurse in a providers office is reinforcing teaching with a client who is taking multiple medications. the nurse should instruct the client to avoid performing hazardous activities while taking which of the following medications that can cause daytime sedation?
triazolam orally at bedtime triazolam is a benzodiazepine that is used to treat insomnia. it can cause sleepiness the day after the client takes it to induce sleep.
a nurse is reinforcing teaching with a client who is to start taking perphenazine. Which of the following information should the nurse include in the teaching?
you should change position slowly while you taking this medication. the client should change from a lying or siting to a standing position slowly to prevent orthostatic hypotension. If the client feels lightheaded or dizzy, he should sit or lie down.
