Abrams Clinical Drug Therapy prep-u final exam review

For which clients would it be appropriate for the nurse to administer a laxative?

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

the nurse prepares to administer gentamicin IV q8h to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity?

-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 2-3 L of noncaffeinated oral fluids daily

Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis?

-Sennosides (Senokot) -Bisacodyl (Dulcolax)For

what home remedies are effective for mouth dryness and cough (select all that apply)

-adequate fluid intake -humidification of the environment -sucking on hard candy or throat lozenges

what effects are exerted by aspirin?

-analgesic -antipyretic -anti-inflammatory

what should a nurse recognize as a property of ibuprofen/motrin?

-anti-inflammatory -analgesic -antipyretic

A client recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. what response demonstrates the nurses 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

to decrease the risk of injury to a client taking an opioid, what should the nurse do?

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

a nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if what occurs?

-blood is noted in the stool -diarrhea worsens -client reports severe abdominal pain -diarrhea is not relieved

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

-butorphano -nalbuphine -pentazocine

Repeated lab work shows positive cultures for a client prescribed drug therapy for TB over 4 weeks ago. what are the likely reasons for this failure to achieve treatment goals?

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

TB caused by drug resistant organisms should be considered in which clients?

-clients who have no response to therapy -clients who have been treated in the past

Linezolid can be used to treat which of the following infections?

-community acquired pneumonia -Vancomycin-resistant Enterococcus Faecium -MRSA -nosocomial pneumonia

a nurse is teaching a group of older adults about non-pharmacologic strategies for preventing constipation. the nurse should recommend what practices?

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

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

-drowsiness -dizziness

A 21-year old female is admitted after taking 25 aspirin tablets at one time. The health care provider diagnoses the client with salicylate poisoning. What can be used as treatment for salicylate poisoning?

-gastric emptying -administration of activated charcoal -life support, if indicated

a male client newly diagnosed with TB asks the nurse if medications will make him better. the nurse informs 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 HIV

which of the following anti-TB drugs are used during the continuation treatment phase of tuberculosis? select all that apply

-isoniazid -rifampin

Lactulose is prescribed for a client. the nurse knows that which of these statements regarding lactulose are correct?

-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?

-location -intensity -what factors improve or worsen the pain -what medications the client takes for the pain

A nurse should recognize which situations necessitate the need for an opioid antagonist. Which situations necessitate the need for an opioid antagonist?

-postoperative acute respiratory depression -reversal of opioid induced hypotension -suspected acute opioid overdose

an adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction?

-rectal suppository -enema

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

-report dyspnea, chest tightness, bronchospasms...etc -administer prescribed bronchodilator aerosolized...etc -assess for improvement in coughing up mucus, rp less than 26, pulse ox less than 90

the client is brought to the emergency department in respiratory arrest after overdosing on heroine...After being administered one dose of naloxone, the client begins to breath spontaneously but remains non-responsive to stimuli so another dose is prescribed. The nurse should monitory for was S&S of acute narcotic abstinence syndrome?

-tachycardia -hypertension -vomiting

while caring for a client who is prescribed an opioid antagonist for the treatment of respiratory depressiong caused by opioid therapy, the nurse would assess the client for which adverse reaction?

-tachycardia -tremors -nausea

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?

-take a laxative -keep the room well lit during 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 instructions should the nurse include in the teaching plan for the client and family?

-take the drug with food or milk -continue therapy for at least 1 week -notify the provider in case of fevers, chills, or cough

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?

-what S&S were displayed with the reaction -how many doses were administered before the reaction occurred -had the medication ever been prescribed before the reaction occurred

which of the following can occur if the nurse administers naloxone (narcan) as a rapid IV bolus?

-withdrawal -intense pain -vomiting

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

1-2 hours

the nurse should counsel a client to discontinue use of OTC 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?

2-3 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 a cesarean delivery is experiencing abdominal pain. The client received a bolus dose of morphine IV. The nurse would recommend that the mother refrain from breast feeding the baby for how long?

4-6 hours

patients are often given a daily dose of aspirin for prohpylaxis of myocardial infarction, transient ischemic attacks, and cerebrovascular accident. What is the recommended daily dose for this purpose?

81-325 mg

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

Acetaminophen is appropriate

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

Acetylsalicylic acid

A client is taking a NSAID. Which instruction should the client be given in regard to administration?

Administer the medication with food

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

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

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 providers 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

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

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 clients underlying condition affect the pharmacokinetics of the drug?

Duration of action will be prolonged

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

E. Coli

determining the cause of diarrhea in a patient is important. the nurse recognizes that a green, liquid stool may be from which of the following?

E. Coli.

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

the nurse is admitting a 12-year old child to the acute care facility and notices discolored secondary teeth. What question should the nurse ask?

Have they ever received tetracycline

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

High fowlers

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

INH, rifampin, pyrazinamide, ethambutol

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

IV sodium bicarbonate

Although naloxone (Narcan) 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 clients 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

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 drops

A post-surgical client has been provided with a morphine patient controlled analgesic but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond?

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

What is a contraindication to use a fluoroquinolone?

Lactation

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

a 23-year old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. She has been experiencing these symptoms for the last three months on a weekly basis. These are symptoms of?

Migraine headache

The client returns to the unit following surgery..........What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids?

Naloxone (Narcan)

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

Nausea, vomiting, and diarrhea

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

Prostaglandin inhibition is limited to the central nervous system

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

Renal Impairment

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

A client is in the hospital recovering from surgery and is using a PCA pump. The clients adult child tells the nurse that they are worries about the possibility of a morphine overdose because their parent keeps pressing the PCA button. What is the nurses 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 on overdose, because acetaminophen is a very common ingredient in OTC cold remedies

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. Cephalosporins are a poor choice for this client because?

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

a client is taking psuedoephedrine 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

a client received erythromycin before dental surgery. The client has a past history of cardiac surgery. What does the nurse teach the client about this medication?

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

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

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

administer the medication as prescribed and monitor the clients pain

a postsurgical client has been prescribed morphine to address the pain that is anticipated over the next 24-48 hours. what is the most effective strategy to manage a clients postsurgical pain for the initial 24-48 hours?

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

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

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

better mobility

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

How do opioid analgesics relieve moderate to severe pain?

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

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 nurses assessment of the client should prioritize what system

cardiovascular

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

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

constipation is characterized by hard, dry stools

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

decongestant analgesic antihistamine

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 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

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

electrolyte replacement

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 out that it has been 5 1/2 hours since the client last received pain meds. What would the nurse do?

give the client 5 mg of morphine PO

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

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, what should the nurse instruct the patient about the drug therapy?

he could wear glasses during the therapy

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

hepatic coma

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 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 OTC 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

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?

ioperamide

What nursing intervention would NOT be effective in assisting the client in stopping their migraine headaches?

keeping the room well lit

which medication is prescribed parenterally for severe pain?

ketorolac

a 2-year old client from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the families arrival in the United States 3 weeks ago. The mother comments on her child's newfound love for ice cream. This history supports what possible cause of the child's diarrhea?

lactase deficiency

Acetaminophen overdose has the potential to cause fatal:

liver damage

a 75 year old client is prescribed magnesium hydroxide for constipation............Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the clients:

medication history

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

muculytic

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

polyethylene glycol electrolyte solution

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

pyridoxine

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 med

refrigerate the solution until its 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

a client is treated for HIV with NNRTI's. the client develops TB 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

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 for diarrhea. the nurse recognizes that this drug is effective against diarrhea because of what action?

slows peristalsis by acting on the smooth muscles of the intestine

a nurse is preparing to teach a client about the adverse effects of NSAID therapy. the nurse plans to focus on the most common adverse reactions caused by this group of drugs. what effects would the nurse include as being involved?

stomach

A 43 year old man is taking pseudoephedrine (Sudafed) for sunusitis. He calls the clinic to report that t 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

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 take docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this clients statement?

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

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

the fluoroquinolones 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 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

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

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

clients diagnosed with chronic pain should be given what information regarding opioid's effectiveness?

they should be given on a regular schedule, around the clock

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 postoperative surgical client, prescribed BID 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 days

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

to inhibit platelet aggregation

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