354 ATI Pharm II PRACTICE

A nurse is providing teaching for a client who has a new prescription for an antibiotic. Which of the following statements should the nurse make?

"Check with your provider before taking over-the-counter medications."

A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority?

"He has so many new bruises on his body."

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

"Heparin does not dissolve clots. It stops new clots from forming."

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

"I feel nauseated and have no appetite."

A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of following statements by the nurse indicates an understanding of the teaching?

"I should report a cough to my provider."

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching?

"I will avoid drinking grapefruit juice."

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching?

"I will reduce my intake of vitamin K-rich foods."

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

"I'll be glad when I can stop taking this medicine."

A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching?

"It might take up to 3 days for the medication to work."

A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include?

"Sit upright or stand for at least 30 minutes after taking this medication."

A nurse is caring for a client who is at the end of life. The client's partner is concerned about using opioid narcotics to manage the client's pain. Which of the following statements should the nurse make?

"The dosage of the opioid narcotic is unlimited."

A nurse is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understanding of the teaching?

"Vomiting is an indication of toxicity."

A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

"We will monitor your lithium levels closely while you are taking this medication."

A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include?

"You should avoid grapefruit juice."

A nurse is preparing to teach a client about his prescription of lithium for the treatment of bipolar disorder. Which of the following statements should the nurse include in the teaching?

"You will need to stop this medication if you experience diarrhea."

A client is to receive enoxaparin 30 mg subcutaneously. Available is enoxaparin 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.75 m

A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

42 units

A nurse is caring for a client who is to receive liquid medications via a gastrostomy tube. The client is prescribed phenytoin 250 mg. The amount available is phenytoin oral solution 25 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

50

A nurse is reviewing the medical record of a client who is to receive the first dose of cefoxitin via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive cefoxitin and report to the provider?

A severe allergy to amoxicillin

A nurse in the emergency department is caring for a client who has acute toxicity from acetaminophen overdose. The nurse should prepare to administer which of the following medications?

Acetylcysteine

A community health nurse is preparing a presentation about complementary and alternative therapies. Which of the following therapies should the nurse describe as a means of manipulating a series of channels to re-establish the flow of vital energy within the body?

Acupuncture

A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take?

Administer a saline solution after injection.

A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?

Alcohol increases the chance of phenytoin toxicity.

A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider?

Amoxicillin-clavulanate

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity?

Anorexia

A nurse is reviewing the medical record of a client who reports drinking three to four glasses of wine each night and taking 3,000 mg of acetaminophen daily. Which of the following laboratory values is the priority for the nurse to assess?

Aspartate aminotransferase (AST)

A nurse is preparing a presentation at a community center about complementary and alternative therapies. Which of the following therapies should the nurse describe as programming the mind to override the stress response?

Autogenic training

A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions?

Beans

A nurse is preparing a presentation at a community center about complementary and alternative therapies. Which of the following therapies should the nurse describe as the use of an electronic monitoring device to help clients learn to control physical responses to stress?

Biofeedback

A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)

Bounding pulse is correct. Fluid volume excess is due to excessive fluid intake or inadequate fluid excretion. Manifestations include increased blood pressure, pulse, and respirations. With fluid volume excess, the pulse is full and bounding.Pitting edema is correct. Excess extracellular fluid can lead to pitting edema in dependent areas of the body.Swelling at the IV site is incorrect. Edema at the IV site indicates a localized accumulation of fluid due to infiltration. Although this is a concern, this finding does not suggest fluid volume excess. This finding would suggest infiltration. The nurse should discontinue the IV and restarted at another site.Urine specific gravity greater than 1.030 is incorrect. Urine-specific gravity measures the concentration of all chemical particles in the urine. A therapeutic range is 1.005 to 1.030. A urine-specific gravity greater than 1.030 indicates dehydration, and a gravity of less than 1.010 indicates fluid volume excess.Crackles upon auscultation is correct. Pulmonary edema can occur with fluid volume excess.

A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition?

Breathlessness

A nurse is teaching a client at high risk for osteoporosis about dietary measures she can take to increase her calcium level. Which of the following foods should the nurse advise the client to increase in her diet?

BroccoliBroccoli

The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Carvedilol

A nurse is caring for a client who is receiving a continuous IV infusion of heparin. Which of the following actions should the nurse take?

Check the activated partial thromboplastin time (aPTT) every 4 hr.

A nurse is preparing to administer heparin subcutaneously to a client who has a deep vein thrombosis. Which of the following techniques should the nurse use?

Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding.

A nurse is teaching a class about the use of pain medications for clients who have an opioid addiction. Which of the following medications are a nonopioid analgesic?

Codeine is an opioid narcotic and is contraindicated in a client who has an opioid addiction. Acetaminophen is a nonopioid analgesic. It can be used to treat clients who have an opioid addiction. Ibuprofen is a nonsteroidal anti-inflammatory medication. It can be used to treat clients who have an opioid addiction. Fentanyl is an opioid narcotic and is contraindicated in a client who has an opioid addiction. Oxycodone is an opioid narcotic and is contraindicated in a client who has an opioid addiction.

A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

Decrease the infusion rate on the IV

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

Decreased blood pressure

A nurse is caring for an older adult client. The nurse should recognize the client is at risk for which of the following physiological changes? (Select all that apply.)

Decreased gastric motility, skin elasticity, increased pain threshold

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?

Difficulty starting the flow of urine

A nurse is assessing an IV infusion site on an infant's left hand. Which of the following findings should the nurse identify as an indication of an infiltration?

Edema in the palm of the hand

A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect?

Elevated central venous pressure (CVP).

A nurse is talking with a young adult client who has a family history of osteoporosis. Which health promotion activity should the nurse recommend as a possible preventive measure?

Engage in weight-bearing exercise regularly.

A nurse suspects that a coworker is diverting opioid analgesics. Which of the following is an adverse effect of opioid medications?

Euphoria

A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate?

Evaluating the client for nausea, vomiting, and anorexia

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

Experiencing diarrhea

A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Fab antibody fragments

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following medications should the nurse plan to administer?

Finasteride

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

Furosemide

A nurse is reviewing laboratory results for a client and notes a serum lithium level of 1.6 mEq/L. Which of the following manifestations should the nurse expect the client to report?

GI discomfort and poor coordination

A nurse in a public clinic is planning a health fair for older adult clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking their prescriptions?

Grapefruit juice

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Hacking cough

A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)

Inhaling deeply and then exhaling completely is the first step. Next, the client should place her lips firmly around the mouthpiece to direct the spray to the airways, then breathe in deeply over 2 to 3 seconds while pushing down on the canister. This slow, deep inhalation directs the medication down into the lower respiratory tract. Holding her breath for 10 seconds is next; it allows time for absorption of the medication. Then, pursed-lip breathing keeps the small airways open during slow exhalation. And finally, waiting 60 seconds between puffs allows for deeper penetration of the medication into the respiratory tract.

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?

Inject 20 units of air into the NPH insulin vial.

A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take?

Inject the medication into the abdomen above the level of the iliac crest.

A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse?

Instruct the client to call 911.

A nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication?

Jaundice

A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select all that apply.)

Jaw pain is correct. Alendronate can cause osteonecrosis of the jaw, so the client should report this adverse effect to the provider.Blurred vision is correct. Alendronate can cause ocular inflammation, so the client should report vision problems to the provider.Drowsiness is incorrect. Alendronate is unlikely to cause drowsiness. It can, however, cause headaches.Dysphagia is correct. Alendronate can cause esophagitis, so the client should report any difficulty or pain with swallowing.

A nurse is teaching about necessary baseline examinations with a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include in the teaching?

Liver function tests

A nurse is caring for a client who is withdrawing from opioids. Which of the following medications should the nurse prepare to administer?

Methadone

A nurse manager is providing an educational program on antibiotic sensitivity to bacterial infections. The nurse should include in the teaching that vancomycin is indicated for which of the following infections?

Methicillin-resistant Staphylococcus aureus

A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the following changes should the nurse include in the discussion? (Select all that apply.)

More difficulty seeing due to a greater sensitivity to glare is correct. Older adults have an increased susceptibility to glare, greater difficulty in seeing at low levels of illumination, and alterations in color perception.Decreased cough reflex is correct. Older adults have a decreased cough reflex, increased airway resistance, fewer alveoli, and a greater risk for respiratory infections.Decreased bladder capacity is correct. Older adults have a decreased bladder capacity and a reduction in renal blood flow.Decreased systolic blood pressure is incorrect. Older adults have increased systolic blood pressure, thickening of blood-vessel walls, and decreased peripheral circulation.Dehydration of intervertebral discs is correct. Older adults have dehydration of intervertebral discs, decreased muscle strength and mass, and decalcification of bones.

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect?

Muscle weakness

A nurse is reviewing discharge instructions with a client who has bipolar disorder and is taking lithium. Which of the following manifestations should the nurse include as an indication of mild toxicity?

Muscle weakness

A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity?

My vision seems to be yellow

A nurse is caring for a client who has opioid toxicity and has a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?

Naloxone

A nurse is preparing to administer morphine IV to a client. Which of the following medications should the nurse plan to have available?

Naloxone

A nurse is caring for a client who has a serum lithium level of 2.0 mEq/L. Which of the following is the priority action for the nurse to take?

Notify the primary provider the result indicates toxicity.

A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching?

Obtain a daily weight.

A nurse is caring for a client who has asthma and is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?

Oral candidiasis

A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect?

Peripheral edema

A nurse is discussing the different forms of complementary and alternative therapy with another nurse. Which of the following treatments would be considered in this list? (Select all that apply.)

Pet therapy is correct. Pet therapy is a form of complementary and alternative therapy. Complementary and alternative therapies are treatments for clients with interventions that are based in biomedical treatment instead of traditional medical treatment. These can be used in conjunction with traditional medicine for clients. Meditation is correct. Meditation is a form of complementary and alternative therapy. Complementary and alternative therapies are treatments for clients with interventions that are based in biomedical treatment instead of traditional medical treatment. These can be used in conjunction with traditional medicine for clients. Yoga is correct. Yoga is a form of complementary and alternative therapy. Complementary and alternative therapies are treatments for clients with interventions that are based in biomedical treatment instead of traditional medical treatment. These can be used in conjunction with traditional medicine for clients.

A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Potassium

A nurse is caring for a client who experienced an infection at the insertion site of her intravenous catheter. Which of the following findings should the nurse expect?

Purulent drainage is noted from the site.

A nurse is teaching a client about medications that prevent osteoporosis. The nurse should instruct the client that which of the following medications is prescribed to prevent osteoporosis?

Raloxifene

A nurse is caring for a client who is chemically impaired. Which of the following is a key topic in the cascade of care framework for opioid use disorder (OUD)?

Recovery

A nurse is preparing a presentation at a community center about complementary and alternative therapies. Which of the following therapies should the nurse describe as placing her hands on or above the client's body to transfer energy to the client?

Reiki

A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse suspect?

Renal stones

A nurse is assessing a client prior to the administration of morphine. The nurse should recognize that which of the following assessments is the priority?

Respiratory rate

A nurse is assessing a client who has opioid toxicity. Which of the following findings should the nurse expect?

Respiratory rate 10/min

A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? (Select all that apply.)

Sedentary lifestyle is correct. Immobility depletes bone.Obesity is incorrect. Women who are obese have a greater capacity for storing estrogen to help maintain acceptable levels of calcium.Aging is correct. Women lose bone due to estrogen depletion after menopause.Caffeine intake is correct. Excessive caffeine intake causes calcium loss in the urine.Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, both active and passive (secondhand) smoking.

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication?

Skin rash

A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements?

Sodium

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

Spironolactone

A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first?

Stop the infusion

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report?

Swelling of the tongue

A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen?

Take the medication with food.

A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

The client runs 4 miles outdoors every afternoon.

A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls?

The client takes alprazolam.

A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

The lithium level is at the toxic level.

A nurse is caring for a 6-week-old infant who has a ventricular septal defect (VSD).

The nurse should assess the apical pulse for 1 full min and assess the rhythm strip for a prolonged P-R interval because the infant is most likely experiencing digoxin toxicity. The manifestations of digoxin toxicity that are seen in infants most commonly include vomiting, poor feeding, and bradycardia. The P-R interval is also prolonged if digoxin toxicity is occurring. It is critical the nurse quickly identifies and reports these symptoms to the provider for treatment of digoxin toxicity. Furosemide is a potassium wasting diuretic and can cause hypokalemia. Hypokalemia increases the potential for digoxin toxicity. The nurse should continue to monitor the infant's heart rate and withhold digoxin per the provider's prescription. It may be necessary to treat the digoxin toxicity with the antidote digoxin immune fab fragment. It is important to continue to monitor digoxin level as treatment is initiated.

A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?

Thyroid hormone assay

A nurse is teaching a client about the causes of osteoporosis. The nurse should include which of the following types of medication therapy as a risk factor for osteoporosis?

Thyroid hormones

A nurse is caring for a client who is taking aspirin for arthritis. The nurse should identify which of the following findings as an adverse effect of this medication?

Tinnitus

A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

Vancomycin

A nurse is monitoring a client who took an overdose of acetaminophen 72 hr ago. The nurse should identify which of the following findings as a manifestation of acetaminophen poisoning?

Vomiting

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider?

White coating in the mouth

A nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following actions should the nurse take?

Withhold the medication

A nurse is caring for a client who has expressive aphasia following a cerebrovascular accident (CVA). Which of the following parameters should the nurse use first in order to assess the client's pain level?

a self-report pain rating scale

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)

• Inspect vials for contaminants: With the exception of NPH insulin, all insulin available today is supplied as a clear, colorless solution. Do not use insulin that is colored, cloudy, or has formed a precipitate. The first step is to observe the characteristics of the regular and NPH insulin to determine whether they are safe to use. • Roll NPH vial between palms of hands: Because NPH insulin is a suspension, the particles must be evenly dispersed by rolling the vial gently between the palms of the hands. This should be done gently because vigorous mixing may cause the solution to become frothy and cause inaccurate dosing. If granules or clumps are present after mixing, discard the solution. This should be done prior to withdrawing the solution into the syringe. • Inject air into NPH insulin vial: This creates a pressure in the vial for accuracy in measuring the amount prescribed. • Inject air into regular insulin vial: The amount of air injected into the vial of short-acting insulin is equal to the amount to be administered. • Withdraw short-acting insulin into syringe: When the prescription requires the administration of two types of insulin, it is preferable to mix the solutions into one syringe if they are compatible to prevent the client from receiving two injections. Of the longer-acting insulin available, only NPH insulin is mixed with short-acting insulin. When two insulins are to be mixed, withdraw the short-acting insulin first to avoid contaminating the stock vial with NPH insulin. • Add intermediate insulin to syringe: The mixture is stable for 28 days.