315 exam 3 test

A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include that which of the following is an adverse effect of this medication? A. Hot flashes B. Insomnia C. Increased appetite D. Constipation

A is correct, Hot flashes are a common adverse effect of tamoxifen. Other adverse effects include fluid retention and vaginal discharge. The nurse should advise the client these effects should subside when therapy is discontinued. B is incorrect, Although tamoxifen can cause light-headedness and depression, insomnia is not an adverse effect of this medication. C is incorrect, Loss of appetite is an adverse effect of tamoxifen. D is incorrect, Although tamoxifen can cause nausea and vomiting, constipation is not an adverse effect of this medication.

A nurse is caring for a client who has a prescription for olanzapine. The nurse should monitor the client for which of the following manifestation as an expected response to this medication? A. A decrease in resting blood pressure B. Control of seizure activity C. Decreased auditory hallucinations D. Increased energy level and involvement in activities

C is correct, Olanzapine is prescribed for the treatment of the manifestations of schizophrenia, one of which is auditory hallucinations. A is incorrect, Hypotension is an adverse effect of olanzapine. B is incorrect, Seizures are an adverse effect of olanzapine. D is incorrect, Fatigue is an adverse effect of olanzapine.

A nurse is providing teaching to a client who has renal failure and an elevated phosphorus level The provider instructed the client to take aluminium hydroxide 300 mg PO TID. For which of the following adverse effects should the nurse inform the client? A. Constipation B. Metallic taste C. Headache D. Muscle spasms

A is correct, Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed. B is incorrect, Clients report that antacids have a chalky, rather than metallic, taste. C is incorrect, Headache is not an adverse effect of aluminum hydroxide. D is incorrect, Muscle spasms are not an adverse effect of aluminum hydroxide.

A nurse is assessing a client who has schizophrenia and is taking apripiprazole. The nurse should notify the provider of which of the following findings? A. Muscle stiffness B. Insomnia C. Constipation D. Weight gain of 5 lb in 1 month

A is correct, Muscle rigidity is a manifestation of neuroleptic malignant syndrome, which is a potentially serious adverse effect of aripiprazole, and should be reported to the provider immediately. B is incorrect, Insomnia is an expected adverse effect of aripiprazole. C is incorrect, Constipation is an expected adverse effect of aripiprazole. D is incorrect, Weight gain is an expected adverse effect of aripiprazole.

A nurse caring for a client who ahs hypertension and asks the nurse about a prescription for propanolo. The nurse should inform the client that this medication is contraindicated in clients who have a history of the following conditions? A. Asthma B. Glaucoma C. Depression D. Migraines

A is correct, Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation. B is incorrect, Beta-blockers are contraindicated in clients who have cardiogenic shock, but are not contraindicated in a client who has glaucoma. C is incorrect, Beta-blockers are contraindicated in clients who have AV heart block, but are not contraindicated in clients who have depression. D is incorrect, Beta-blockers are used for prophylactic treatment of migraine headaches.

A nurse is providing discharge teaching to a client who is taking risperidone. Which of the following instructions should the nurse include in the teaching? A."Avoid becoming overheated while taking this medication." B. "This medication may increase your blood pressure." C. "Flu-like symptoms are an expected adverse effect of this medication." D. "Muscle twitches can occur the first few weeks while taking this medication."

A is correct, Risperidone increases the risk of heat stroke; therefore, the client should be instructed to avoid hot baths, hot tubs, hot showers, and prolonged time outside in hot weather. B is incorrect, Risperidone may cause orthostatic hypotension. C is incorrect, Flu-like symptoms may indicate neuroleptic malignant syndrome, a potentially fatal adverse effect of risperidone, and should be reported to the provider immediately. D is incorrect, Muscle twitching may indicate a serious adverse effect of risperidone and should be reported to the provider.

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? A. Hyperglycemia B. Adrenocortical insufficiency C. Severe dehydration D. Rebound pulmonary congestion

B, is correct Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency. A is incorrect Hyperglycemia is an adverse effect of prednisone, especially for clients who have a history of diabetes mellitus. Once the medication is discontinued, however, this adverse effect should not occur. C is incorrect Fluid retention is an adverse effect of prednisone. Once the medication is discontinued, however, this adverse effect should not occur. D is incorrect Fluid retention is an adverse effect of prednisone. Rebound pulmonary congestion should not occur with withdrawal of prednisone. Prednisone has no direct effect on the client's pulmonary congestion.

A nurse is admitting a client who has acute heart failure following MI. The nurse recognizes that which of the following prescriptions by the provider requres clarification? A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Laboratory testing of serum potassium upon admission C. 0.9% normal saline IV at 50ml/hr continuous D. Bmetanide 1 mg IV bolus every 12 hr

C is correct, 0.9% sodium chloride is isotonic and will not cause the fluid shift needed in this client to reduce circulatory overload. This prescription requires clarification. A is incorrect Morphine sulfate is administered to clients with acute heart failure to reduce anxiety, decrease cardiac preload and afterload, slow respirations, and manage pain associated with MI. This prescription does not require clarification. B is incorrect, Serum potassium is monitored due to the use of diuretic therapy in a client with acute heart failure. This prescription does not require clarification. D is incorrect, Bumetanide, a loop diuretic, is administered as a first-line drug of choice for the client in acute heart failure. This prescription does not require clarification.

A nurse is teaching a client who has a new prescription for amoxicillin-Clavulanate to treat pharyngitis. Which of the following statements by the client indicated an understanding of the teaching? A. "I will take this medication until my sore throat goes away." B. "I should take this medication on an empty stomach between meals." C. "I will stop taking this medication if I develop itching." D. "I will double my dose, if I miss one."

C is correct, Penicillin-derived medications are a common cause of medication allergic reactions. Manifestations of allergic reactions include rashes, hives, itchy and watery eyes, and swollen lips, tongue, or face. Anaphylactic reactions can develop within 1 hr of taking the dose, and include difficulty breathing, shortness of breath, stridor, and angioedema. The client should discontinue the medication and notify the provider if these manifestations occur. A is incorrect, The client should take the entire prescribed course of antibiotics to reduce the risk for drug resistance and dormant infections. The sore throat might disappear prior to the completion of the antibiotics. B is incorrect, The client should take amoxicillin-clavulanate with a light meal to increase absorption and reduce the risk for gastro-intestinal effects. D is incorrect, The client should not double a dose and take this medication as prescribed to reduce the risk for adverse effects.

A nurse is teaching a client who has a new presription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication? A. Metallic taste B. Diarrhea C. Skin rash D. Anxiety

C is correct, Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin. A is incorrect, Adverse effects of clarithromycin include an altered taste. Phenytoin can cause gingival hyperplasia. B is incorrect, Adverse effects of phenytoin include constipation. D is incorrect, Adverse effects of phenytoin include suicidal tendencies and aggression.

A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? A. "I won't pass gas as often now that I am taking this medication." B. "I will take this medication each morning with my breakfast." C. "I have an increased risk of getting pneumonia while taking this medication." D. "I will need to take a daily stool softener while taking this medication."

C is correct, The client taking esomeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur. A is incorrect, Flatulence is an adverse effect of this medication, so the client may experience an increase in passing gas. B is incorrect, The nurse should instruct the client to take esomeprazole at the same time each day and at least 1 hr before a meal. D is incorrect, Diarrhea and headache are the most common adverse effects of esomeprazole. The client should not routinely take a stool softener while taking this medication.

A nurse is collecting data on a client who has a new prescription for ampicillin. The nurse should recognizze which of the followings is a priority? A. Nausea B. Vomiting C. Wheezing D. Moniliasis

C is correct, When using the airway, breathing, circulation approach to client care, the nurse should determine the priority finding is wheezing. Wheezing is a manifestation of an anaphylactic allergic reaction due to bronchospasm and edema in the airway. Wheezing indicates a constriction of the airway and requires immediate intervention to support respiratory function. The nurse should advise the client to wear identification to indicate an allergy to this medication. A is incorrect, The nurse should encourage increase in fluid intake if the client is experiencing nausea to prevent dehydration and electrolyte imbalance; however, another finding is the priority. B is incorrect, The nurse should encourage increase in fluid intake if the client is experiencing vomiting to prevent dehydration and electrolyte imbalance; however, another finding is the priority. D is incorrect, The nurse should provide the client with a topical antifungal agent if the client experiences moniliasis to prevent itching and burning of the skin; however, another finding is the priority.

A nurse is caring for a client who has parkinson's disease and is taking diphenhydramine 25mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see? A. Delay in disease progression B. Improved bladder function C. Relief of depression D. Decreased tremors

D, clients who have Parkinsons disease often experience trembling, muscle rigidity, difficulty walking, and problems with balance and coordination. Antihistamines, like diphenhydramine, have a mild anticholinergic effect and may be helpful controlling tremors in the early stage of the disease A is incorrect, Diphenhydramine may be helpful in controlling symptoms in the early stage of the disease; however, it will not delay disease progression. B is incorrect Antihistamines, like diphenhydramine, have a mild anticholinergic effect and may cause urinary retention. C is incorrect Relief of depression is not associated with the use of antihistamines or anticholinergics.