ATI Pharm 2020 B

A nurse is reinforcing teaching with a client who is to start therapy with a nitroglycerin transdermal patch. Which of the following statements by the client indicates an understanding of the teaching?

a. "while using the patch, i will be careful when rising from a chair" Nitroglycerin can cause orthostatic hypotension, which can result in dizziness. The client should change positions slowly to reduce the risk for injury

A nurse is reinforcing discharge teaching with a client who has a prescription for a metered-dose inhaler (MDI). Which of the following information should the nurse include in the teaching?

"Take a slow, deep breath lasting 3 to 5 seconds after releasing the medication." The client should take a slow, deep breath lasting 3 to 5 seconds to allow the medication to be distributed deeply into the lungs.

A client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has a prescription for morphine 15 mg orally every 4 hr. The client's adult children express concern that the client is receiving too much of the medication. Which of the following responses should the nurse make?

"The dose should remain constant to prevent breakthrough pain." Fixed or scheduled dosing around the clock offers the best pain control for clients who have severe and persistent pain.

A nurse is preparing to administer phenobarbital 3 mg/kg PO twice a day to a school-age child who weighs 44 lb. Available is phenobarbital elixir 20 mg/5 mL. How many mL should the nurse plan to administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

15 mL

A nurse is preparing to administer cefazolin 1 g in 100 mL 0.9% sodium chloride to infuse over 30 min. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

50 gtt/min

A nurse is caring for a client who has genital herpes. Which of the following medications should the nurse expect to administer?

Acyclovir The client should receive acyclovir, an antiviral medication, to treat genital herpes by reducing manifestations and the rate of viral shedding.

A nurse is caring for a client who is having an acute asthma attack. Which of the following medications should the nurse administer first?

Albuterol According to evidence-based practice, the nurse should administer a short-acting beta, agonist with a rapid onset when a client is experiencing an acute asthma attack. Therefore, the nurse should administer the albuterol prior to the other medications for prompt relief of airway constriction.

A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse they do not want to take the medication now. Which of the following actions should the nurse take?

Dispose of the medication with a second nurse as a witness. The nurse is legally required to have a witness when disposing of a controlled substance.

A nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia. Which of the following laboratory tests should the nurse plan to obtain prior to administering the first dose?

Fasting Blood Glucose Level The development of hyperglycemia can be an adverse effect of risperidone. The nurse should obtain a fasting blood glucose level prior to administration of the first dose and periodically during treatment.

A nurse is reviewing the medication administration record for a client who has a new prescription for tobramycin to treat a pulmonary infection. Which of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin?

Furosemide Tobramycin is an aminoglycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time.

A nurse is reviewing the medication administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxazole-trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client?

Furosemide A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.

A nurse is assisting with collecting data for a client who is in preterm labor and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse identify as an indication of magnesium toxicity?

Hyporeflexia Magnesium sulfate depresses neuromuscular activity, causing muscle weakness and paralysis. Therefore, the nurse should identify hyporeflexia as an indication of magnesium toxicity and report it to the charge nurse.

A nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chickenpox or its vaccine. The nurse should withhold the vaccine and collect additional data when the client makes which of the following statements?

I am allergic to neomycin A hypersensitivity to neomycin is a contraindication for receiving the varicella vaccine.

A nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority?

Implement seizure precautions The greatest risk to the client is injury from seizures and falls. Grand mal seizures can occur during severe alcohol withdrawal. Therefore, the nurse's priority is to implement seizure precautions to reduce the risk of injury if the client experiences a seizure.

A nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective?

Improved social interactions Clients who have schizophrenia typically have difficulty interacting with others and maintaining relationships. Manifestations can include dull affect and speech deficiency. Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.

A nurse is reinforcing teaching with a client who recently began taking furosemide. Which of the following instructions should the nurse include in the teaching?

Increase dietary potassium while taking the medication. The nurse should reinforce with the client to increase dietary intake of potassium because furosemide causes potassium to be excreted in the urine. Increasing dietary potassium will help prevent hypokalemia.

A nurse is caring for a client who has kidney failure and has been taking epoetin. Which of the following is a therapeutic effect of this medication?

Increased Hgb

A nurse in a provider's office is reviewing the immunization records of a 12-month-old infant who is immunocompromised. Which of the following vaccines should the nurse identify as contraindicated for this client?

Measles, mumps, rubella (MMR) Although most infants should receive the MMR vaccine between the ages of 12 months and 15 months, the nurse should identify that the MMR vaccine is composed of live viruses and is contraindicated for an infant who is immunocompromised.

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis? (Select all that apply.)

Muscle pain Hyperventilation Dizziness

A nurse is collecting data from a client who has been taking levodopa/carbidopa. Which of the following findings should indicate to the nurse that the medication is effective?

The client is able to wash his face -Levodopa works by activating dopamine receptors, restoring nerve transmission for clients who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the intestine and periphery. These therapeutic effects assist the client with moving freely and resuming ADLs.

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self-administer NPH insulin. Which of the following client actions indicates an understanding of the teaching?

The client wipes the cap with alcohol prior to filling the syringe. The client should wipe the cap with alcohol prior to filling the syringe to reduce the risk for contamination.

A nurse is collecting data from a client who has been taking digoxin for 1 month. The nurse should identify which of the following finding manifestation of digoxin toxicity?

Vomiting The nurse should identify vomiting as an early manifestation of digoxin toxicity.

A nurse on a medical-surgical unit is preparing to administer medications to a client. Which of the following questions should the nurse ask the client to verify the client's identity?

What is your phone number? Acceptable client identifiers include the client's name, telephone number, facility identification number, date of birth, and other client-specific identifiers. The nurse must use at least two identifiers to verify the client's identity and should compare the information to what is on the client's wristband or in the medical record

A nurse is caring for a client who is receiving methylprednisolone. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.)

White blood cell count Serum potassium Blood glucose

A nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately?

abdominal pain The greatest risk to this client is the development of pancreatitis as an adverse effect of exenatide; therefore, the nurse should withhold the medication and immediately notify the provider of the client's abdominal pain. Manifestations of pancreatitis include severe, persistent abdominal pain with possible emesis

A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?

apical pulse 52/min The nurse should check the client's apical pulse prior to administering digoxin because it can cause bradycardia. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.

A nurse is monitoring a client who is 2 hr postoperative and has a prescription for opioid analgesics. Which of the following actions provides the nurse with the priority data to determine the client's need for analgesia?

ask the client to rate their pain According to evidence-based practice, the nurse should first ask the client to rate their pain level to provide a verbal report of pain, which is the priority indicator of the need for pain medication.

A nurse is reviewing a client's medical history before administering hydromorphone for postoperative pain. The nurse should notify the provider of which of the following findings before administering this medication?

benign prostatic hyperplasia A client who has benign prostatic hyperplasia is at increased risk for developing acute urinary retention while taking opioids. Therefore, the nurse should notify the provider about this finding before administering hydromorphone.

A nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. Which of the following conditions in the client's medical record should the nurse report to the provider?

benign prostatic hyperplasia Clients who have benign prostatic hyperplasia might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.

A nurse is reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

chest tightness The nurse should instruct the client to report chest pain or tightness to the provider because this can be a manifestation of a vasospastic response.

A nurse is collecting data from a client who has bacterial pneumonia and is taking ceftriaxone. Which of the following findings indicates a therapeutic effect of the medication?

clear bilateral breath sounds The nurse should identify that wheezing and crackles are findings of bacterial pneumonia. A decrease in these manifestations indicates a therapeutic effect of the medication.

A nurse is collecting data from a client who is taking oral amoxicillin to treat a respiratory infection. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

diarrhea The nurse should monitor the client for diarrhea, which is an adverse effect of antibiotics, such as amoxicillin.

A nurse erroneously administered zolpidem to the wrong client. Which of the following actions should the nurse take?

document the notification of the clients provider In the medical record of the client who received the zolpidem, the nurse should document the objective facts of the error, including follow-up actions and notification of the provider.

A nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication?

drowsiness The nurse should identify drowsiness as an adverse effect of baclofen. Other adverse effects include dizziness, weakness, and fatigue.

A nurse is reinforcing teaching with a client who is receiving enalapril 20 mg PO daily. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

dry cough The nurse should identify that a persistent dry or nonproductive cough is an adverse effect of enalapril. The underlying cause of the dry cough is the accumulation of bradykinin from the medication. The client should notify the provider of this adverse effect.

A nurse is collecting data from a client who has angina and a new prescription for sublingual nitroglycerin. Which of the following manifestations should the nurse expect as an adverse effect of this medication?

headache The nurse should expect the client to have headaches as a common adverse effect of taking sublingual nitroglycerin because it causes vasodilation.

A nurse is monitoring a client who has been receiving long-term hydrochlorothiazide therapy for recurring episodes of heart failure. Which of the following findings should the nurse identify as an adverse effect of this medication?

hypokalemia Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia due to excessive potassium excretion in the urine.

A nurse is evaluating a client who is receiving amphotericin B via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication?

hypotension The nurse should identify that amphotericin B is considered a high-alert medication due to potentially serious adverse effects, such as hypotension. Therefore, the nurse should report this or other adverse effects of amphotericin, such as nephrotoxicity, hypokalemia, and cardiac dysrhythmias.

A nurse is reinforcing teaching with a client who has a prescription for scopolamine transdermal patches to prevent motion sickness. Which of the following statements by the client indicates an understanding of the teaching?

i should place the patch behind my ear The nurse should reinforce with the client to place the scopolamine patch on a hairless area of skin behind the ear.

A nurse is reinforcing teaching with a client who has a new prescription for timolol eye drops to treat glaucoma. Which of the following client statements indicates an understanding of the teaching?

i will look up when putting the medication into my eyes The nurse should reinforce with the client to look up during administration of eye drops to protect the cornea and minimize blinking.

A nurse is reinforcing teaching with a client who has a new prescription for a fluticasone inhaler. Which of the following client statements indicates an understanding of the teaching?

i will rinse my mouth after i use this inhaler The client should rinse their mouth after using inhaled glucocorticoids to reduce the risk for the development of oral thrush. Therefore, should identify this statement as indicating an understanding of the teaching.

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse include in the teaching?

increase fluid intake Clients who are taking methotrexate should increase fluid intake to reduce the risk for renal damage and to increase medication excretion.

A nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching?

massage your nose gently after medication administration The nurse should instruct the client to massage their nose gently to increase absorption of the medication.

A nurse is collecting data from a client who is taking tobramycin. Which of the following findings should the nurse report to the provider immediately?

oliguria Oliguria indicates the client is at greatest risk for nephrotoxicity. Therefore, the nurse should report this finding to the provider immediately.

A nurse is reinforcing teaching with a client who is newly diagnosed with hypertension and is taking metoprolol. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

peripheral edema The nurse should instruct the client to monitor for and report the development of peripheral edema because this can be an indication of heart failure, which is an adverse effect of metoprolol.

A nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. Which of the following adverse reactions is the priority finding to report to the provider?

respiratory depression When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is respiratory depression, which can indicate the client is experiencing acetaldehyde syndrome, a life-threatening event.

A nurse is collecting data from a client who received morphine IV for pain relief. Which of the following findings is the nurse's priority to report to the provider?

respiratory rate 11/min When using the airway, breathing, and circulation approach to client care, the priority finding is a respiratory rate of 11/min, which indicates respiratory depression.

A nurse is collecting data from a client who is taking lithium to treat bipolar disorder. Which of the following findings should the nurse report to the provider?

slurred speech The nurse should recognize that slurred speech is a manifestation of lithium toxicity and should be reported to the provider.

A nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication?

sore throat The nurse should monitor for sore throat and fever because these are early indications of agranulocytosis, which is an adverse effect of propyithiouracil.

A nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine. Which of the following foods should the nurse include in the teaching as an appropriate food choice?

yogurt Clients taking phenelzine should avoid consuming tyramine, which can cause high blood pressure. Yogurt contains little or no tyramine. Therefore, the nurse should instruct the client that yogurt is an appropriate food choice.