ati pharm practice A

a nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. the nurse should identify which of the following findings as an indication of hypokalemia

presence of U waves

a nurse is preparing to administer ciproflaxin 15mg/kg PO every 12 hr to a child who weighs 44lb. How many mg should the nurse administer per dose?

300mg

a nurse is teaching a group of unit nurses about medication reconciliation. which of the following information should be included in the teaching

a transition in care requires the nurse to conduct medication reconciliation

a nurse is teaching a client about warfarin. the client asks if they can take aspirin while taking the warfarin. which of the following responses should the nurse make

aspirin will increase the risk of bleeding--aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. therefore, client should avoid taking aspirin because it increases the risk of bleeding

nurse is developing a teaching plan for a client who has a new prescription for simvastatin. which of the following instructions should the nurse include in the teaching plan

avoid taking the medication with grapefruit juice (when taken with grapefruit juice, simvastatin increases risk of muscle injury from elevations in creatinine kinase) report muscle pain to provider (myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis) expect therapy with this medication to be life long (if medication therapy is discontinued, cholesterol levels will return to their pre-treatment range within several weeks-months

a nurse is planning care for a client who is receiving mannitol via continuous IV infusion. the nurse should monitor the client for which of the following adverse effects

bibasilar crackles--mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema, therefore the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion

a nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. the nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects

constipation--common side effect of morphine, docusate sodium is a stool softener to promote easier evacuation of stool by increasing water and fat in the intestine

a nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. which of the following information should the nurse include in the teaching

decreased respirations might occur--respiratory depression is an adverse effect of the medication

a nurse is planning care for a client who has hypertension and is to start taking metoprolol. which of the following interventions should the nurse include the plan of care

determine apical pulse prior to administering--left-threatening bradycardia is an adverse effect that might effect this client --if pulse is less than 60/bpm, nurse should hold med and notify provider

a nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. the nurse should identify which of the following statements as an indication that the client understands the teaching

i should sit up for 30 min after taking risedronate--sitting upright for 30 min will reduce the adverse GI effects

a nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. which of the following client statements indicates and understanding of the teaching

i should tell my provider if i develop a sore throat--the client should report a sore throat because it can indicate neutropenia, a serious adverse effect. neutropenia can be reversed if it is identified early and the medication is promptly discontinued

a nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. which of the following actions should the nurse plan to take

monitor for constipation--notify provider as this can lead to fecal impaction

a nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. which of the following instructions should the nurse include

report yellowing of the skin--ranitidine can be hepatotoxic and cause jaundice. the nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider

a nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. which of the following instructions should the nurse include in the teaching

rinse your mouth after inhaling beclomethasone--client should rinse their mouth after using this glucocorticoid inhaler to prevent oropharyngeal candidiasis and hoarseness

a nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. for which of the following adverse effects should the nurse monitor

sedation--metoclopramide has multiple CNS adverse effects including dizziness, fatigue, and sedation

a nurse is assessing a client who has schizophrenia and is taking haloperidol. the nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)

temp of 39.7*C (103.5*F)--nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency, other manifestations can include respiratory distress, diaphoresis, and either hyper or hypotension

a nurse is caring for a client who is receiving heparin therapy via IV infusion to treat pulmonary edema. which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider

blood in the urine--this can be a manifestation of heparin toxicity, other manifestations include bruising, hematoma, hypotension, and tachycardia

a nurse is caring for a client who received 0.9% sodium chloride 1L over 4hr instead of over 8hr as prescribed. which of the following information should the nurse enter as a complete documentation of the incident

0.9% sodium chloride 1L IV infused over 4hr. Vital signs stable, provider notified--document type and amount of fluid, how long it took to infuse, provider notification, and clients physical status

a nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the clients medication bin. the nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report

0830

a nurse is reviewing the MAR fo a client who has hypocalcemia and a new prescription for IV calcium gluconate. the nurse should identify that which of the following medications can interact with calcium gluconate

digoxin--calcium gluconate can cause hypercalcemia which increases risk of digoxin toxicity

a nurse is assessing a client who is taking propylthiouracil for the treatment of Graves Disease. Which of the following findings should the nurse identify as an indication that the medication has been effective

increase in ability to focus--client with graves disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors, this med is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism

a nurse is caring for a client who is receiving filgrastim. which of the following findings should the nurse document to indicate the effectiveness of the therapy.

increased neutrophil count--filgrastim stimulates the bone marrow to produce neutrophils

a nurse is preparing to administer medication to a client who has gout. the nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. which of the following actions should the nurse take first

obtain the clients BP--when using the nursing process, the first action the nurse should take to prevent injury to client is to assess them for adverse effects of atenolol such as hypotension

a nurse is caring for a 20y.o. female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. before the client can obtain a refill, the nurse should advise the client that which of the following tests is required

pregnancy test--nurse should instruct client that isotretinoin has teratogenic effects, therefore, pregnancy must be ruled out before obtaining a refill

a nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. which of the following findings should the nurse identify as an adverse effect of the medication

sexual dysfunction--including decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of SSRIs

a nurse is assessing a client 1hr after administering morphine for pain. the nurse should identify which of the following findings as the best indication that the morphine has been effective

the client rates the pain as 3 on a scale of 0-10

a nurse is caring for a client who has acute acetaminophen toxicity. the nurse should anticipate administering which of the following medications

acetylcysteine--this is a specific antidote for acetaminophen toxicity. it can prevent severe injury when given orally or by IV infusion within 8-10 hrs

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

administer the medication outside the 5-cm (2in) radius of the umbilicus--the nurse should administer the heparin to the abdomen in an area that is above the iliac crest and at least 5 cm away from umbilicus

a nurse is in an emergency department caring for a client who has myasthenia graves and is in cholinergic crisis. which of the following medications should the nurse plan to administer

atropine--a cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. the nurse should plan to administer atropine an anticholinergic agent, to reverse cholinergic toxicity

a nurse is collecting a medication history from a client who has a new prescription for lithium. the nurse should identify that the client should discontinue which of the following over the counter medications

ibuprofen--most NSAIDs can significantly increase lithium levels