ati pharm proctored exam, ATI Pharmacology Proctor 2019

• Tolerance

body develops natural resistance to drug effects, need to increase dosage

Methylcellulose (Citrucel)

bulk-forming agent with minimal Side Effects (SE)

Psyllium (Metamucil

bulk-forming agent with minimal Side Effects (SE)

A client who has hyperthyroidism (Graves' disease) is taking oral propylthiouracil (PTU). Which of the following client statements indicates effective teaching regarding this medication?

"It may take two to three months for the thyroid levels to stabilize."

A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally 12 hr. available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trialing zero.)

7.5 mL

Which statement is made by a client who is experiencing an adverse reaction to levothyroxine (Synthroid)?

"I feel like my heart is pounding."

A client is prescribed estrogen for the reversal of menopause symptoms. The nurse recognizes the need for further teaching when the client states,

"I should immediately report any leg pain or redness, numbness or stiffness, or swelling to my primary care provider."

An adult female client is placed on cyclosporine (Neoral) after receiving a kidney transplant. Which of the following client statements indicates that the nurse's teaching about this medication was effective?

"I will contact my doctor immediately if I have a fever or sore throat."

. A client is prescribed diphenoxylate/atropine (Lomotil) for severe diarrhea. Which of the following statements made by the client indicates a need for further nursing instruction regarding the self- administration of the medication?

"I will continue to take the medication as long as necessary until my diarrhea is resolved."

A nurse has just completed teaching a 71-year-old client about the flu vaccine. Which of the following client statements indicates that the nurse's teaching was effective?

"I will make an appointment for the flu vaccine in late October or early November."

A client is being discharged with a prescription for warfarin (Coumadin) following treatment for deep vein thrombosis (DVT). The nurse recognizes that teaching has been effective when the client states,

"I will not take any aspirin for pain while I am on warfarin. I will take acetaminophen instead."

A client recently diagnosed with peptic ulcer disease (PUD) is prescribed antacids by the primary care provider. The client is being instructed by the nurse on when to take the antacids. Which of the following responses by the client indicates a correct understanding of when to take the antacids?

"I will take my antacid at 1 and 3 hr after each meal and at bedtime."

A client is receiving diuretics as part of the pharmacologic therapy for heart failure. Which of the following client statements indicates the need for further instruction?

"I will take the diuretic if I experience difficulty breathing or chest pressure."

A client who was prescribed oral contraceptives comes to the clinic for her 4 week follow-up visit. After discussing the use of oral contraceptives with the client, the nurse recognizes a need for further client education when the client states,

"If I miss a dose, I should take two pills the next time the dose is due."

A client reports taking large amounts of vitamins because she believes they increase her energy level and will prevent various diseases. Client teaching should include which nursing response?

"Large amounts of fat-soluble vitamins can be toxic."

A client is prescribed intravenous (IV) heparin by a primary care provider. Which of the following client statements shows understanding of the rationale for the IV heparin that was prescribed by the primary care provider?

"My right leg swelled when I got a blood clot after surgery."

When a client is prescribed an aminoglycoside, such as gentamicin (Garamycin), which instruction should be included in the teaching plan?

"Report to your health care provider any ringing in your ears."

A client takes ethinyl estradiol/norgestimate (Ortho Tri-Cyclen) birth control pills. She calls the clinic and relates that she missed her medication yesterday. Which instructions will the nurse give?

"Take two pills today then continue on a daily basis."

Which of the statements by the nurse most accurately describes the effects of declined plasma albumin levels in older adults?

"There is an increased risk for adverse effects."

A home health client tells the nurse that she is taking triamterene (Dyrenium) for fluid retention. She tells the nurse she is using a salt substitute so she will not retain so much water. What is the most appropriate nursing response?

"Using a salt substitute with this medication could cause you to have too much potassium."

A client whose asthma has been poorly controlled is prescribed cromolyn sodium (Intal) for inhalation. Client teaching should include which statement by the nurse?

"Using this drug regularly will reduce the frequency of acute attacks."

Client teaching for the use of sublingual nitroglycerin tablets to relieve angina should include which nursing instruction:

"You can take up to three doses, five minutes apart, if needed."

Math problem: a nurse is preparing to administer 4000 units of heparin available is 10,000 units

0.4

A nurse is preparing to administer 4000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units. How many mL of heparin should the nurse administer? (Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) a. 0.4 mL

0.4 mL

A client with a diagnosis of gastroesophageal reflux disease (GERD) is prescribed famotidine (Pepcid) 20 mg twice a day. When teaching this client about the proper self- administration schedule for this medication, the nurse should inform the client that famotidine should be taken

1 hr before meals.

nurse is preparing to administer methylprednisolone sodium succinate 80 mg IV bolus. the nurse reconstitutes the 125 mg in the vial in powder form to 2 mL. How many mL should the nurse administer?

1.3

a nurse is planning to administer medications to a client who weighs 198 lb. he prescription reads "filgrastim 5mcg/kg, subcutaneous, daily". available is filgrastim 300 mcg/mL. how many ml should the nurse plan to give with each dose?

1.5

At 1130, a nurse administers aspart insulin (NovoLog) to a client with diabetes mellitus. When is the client at greatest risk for hypoglycemia?

1345

A nurse should anticipate that the primary care provider may prescribe polystyrene sulfonate (Kayexalate) for a client who has a serum potassium of

5.4 mEq/L and burn injuries.

A nurse working on a gynecological-obstetrics unit is preparing equipment in anticipation for prescriptions from the primary care provider for Pitocin (oxytocin) administration to several of the clients on the unit. For which of the following clients should the nurse anticipate oxytocin administration? (Select all that apply.)

A client admitted for augmentation of labor A client admitted for induction of labor A client with postpartum uterine hemorrhage

charge nurse is observing a newly licensed nurse provide care to a group of clients. Which of the following action by the newly licensed nurse requires the charge nurse to complete an incident report?

A client who has a lithium level of 1.8 receives her morning dose

Before prescribing a cephalosporin, the nurse practitioner asks if the client is allergic to penicillin. Why is this important to assess?

A client who is allergic to penicillin can have a cross sensitivity to cephalosporins.

A client with a diagnosis of cystic fibrosis is prescribed acetylcysteine (Mucomyst).

A nurse understands that the primary reason for giving this medication to the client is to thin respiratory secretions.

A nurse is caring for a client who requires a re-insertion of a short peripheral venous catheter. in which of the following locations should the nurse place the catheter?

A vein on the client's wrist

a nurse is evaluating a client who has tuberculosis and has been taking rifampin for 1 month. which of the following laboratory tests should the nurse review to evaluate for an adverse effect of this medication?

ALT

• Lorazepam (ativan)

[benzodiazepine]: SE: adbrupt cessation can →seizures RT physical addiction

• Prednisone (Deltasone)

[corticosteroid] suppresses endogenous cortisol production, so abrupt stopping of drug can result in acute adrenal insufficiency can occur

. A primary care provider has prescribed enoxaparin (Lovenox), 60 mg subcutaneously. The nurse should select which of the following as the recommended site to administer this medication?

Abdomen at least 1in away from belly button

a nurse is caring for a client who is receiving a continuous IV infusion of magnesium sulfate for preterm labor. the nurse should discontinue the infusion and prepare to administer claim gluconate if the client demonstrates which of the following findings? (Select all that apply)

Absence of deep-tendon reflexes Urine output 80 mL/hr Decreased LOC

Mafenide acetate (sulfamylon) Interventions:

Admin PRN analgesics 30 min prior to tx; apply after daily tubbing to remove previous cream; Monitor fluid & electrolyte/acid-base balances; schedule wound care > 1 hr before meals; wear sterile gloves when applying

A nurse is teaching a client who has multiple allergies about using an epinephrine auto-injector. Which of the following instructions should the nurse include?

Administer the medication through clothing if necessary

• Succinylcholine

[depolarizing NMBA] common SE: muscular pain/stiffness

A client with a history of alcoholism is taking acetaminophen (Tylenol) for headaches. The nurse reviews the client's laboratory report. For which of the following laboratory values should the acetaminophen use be discontinued immediately?

An elevated serum bilirubin

The parents of an adolescent male client question the nurse about the possibility of androgen therapy for their son. The nurse responds appropriately with which of the following statements?

Androgens are useful for male clients when puberty will not take place."

Development of a chronic cough is an adverse effect associated with which class of anti-hypertensive drugs?

Angiotensin converting enzyme (ACE) inhibitors

Antacids should be given one hour apart from most other drugs. Which is the rationale?

Antacids may interfere with absorption of drugs taken at the same time.

Oral diazepam (Valium), a benzodiazepine, has been prescribed for a client who has anxiety and muscle spasms. Which nursing intervention is appropriate for the care of this client?

Assess for incoordination and daytime drowsiness.

Furosemide (Lasix

[loop diuretic] Intervention: check BP before giving to determine baseline; can cause ↓ BP by ↓ circulatory volume or by relaxing venous smooth muscle

Thrombocytopenia

Assess: platelet count

Orders are written for anticholinergic drugs for each of the following clients. Which order should the nurse question?

Atropine combined with opioid analgesics to relieve pain in a 30-year-old client with urinary calculi.

a nurse is providing discharge teaching to a client who is receiving warfarin. Which of the following statements is appropriate to make?

Avoid eating large amounts of cabbage and broccoli

Levothryoxine (T4) Indication

hypothyroidism RT dysfxn of hypothalamus, pituitary, or thyroid gland

A postoperative client has a prescription for oxycodone (OxyContin) to be administered for postoperative pain. In monitoring the client and reviewing the clientʼs chart prior to the first administration of the medication, which of the following should give the nurse the most cause for concern?

Benign prostatic hypertrophy (BPH)

A client is receiving the thrombolytic medication streptokinase (Kabikinase). Which of the following findings indicates that the client is experiencing an adverse reaction to the medication that should be reported to the primary care provider?

Bleeding from a previous injection site

A client diagnosed with bipolar disorder and stabilized with lithium is admitted to the hospital through the emergency department. The primary care provider's diagnosis includes accidental overdose of lithium. What is the most important information the nurse can provide the client with about precautions associated with the administration of lithium?

Blood levels must be monitored to keep lethal levels from accumulating.

The nurse assesses a client shortly after an intravenous infusion of the osmotic diuretic mannitol is started. Which finding represents an early adverse effect of mannitol?

Bounding pulse

Fluconazole (Diflucan) is prescribed for the client with a fungal infection in the toenails. The nurse should instruct the client to contact the nurse practitioner immediately if which adverse effect occurs?

Bruising or sore throat

When a client is receiving intravenous fluid with supplementary potassium chloride, it is especially important for the nurse to monitor for which potential adverse effect?

Cardiac dsyrhythmias

Mannitol

Caution with pts with heart disease (can precipitate CHF and pulmonary ededa)

Diphenoxylate & Atropine (Lomotil)

Caution: With Renal impairment ↓ elimination of atropine → ↑ anticholinergic effects of atropine like confusion

When a client is using a sympathomimetic (adrenergic) bronchodilator such as albuterol, the nurse would expect which effect?

Central nervous system stimulation

a nurse is providing teaching to a client who has a new prescription for phenelzine. which of the following foods should the nurse instruct the client to avoid?

Cheddar cheese

A client diagnosed with migraine headaches is prescribed sumatriptan (Imitrex). The nurse is reinforcing client teaching regarding side effects of the medication and advises the client to seek immediate medical attention for which of the following symptoms?

Chest discomfort, pressure, and tightness

A medication order is written for ciprofloxacin (Cipro). For which client should the nurse question use of this medication?

Child age 10

a nurse is caring for a client who has heart failure. the nurse administered furosemide 60 mg IV bolus 30 min earlier. for which of the following findings should the nurse notify the provider?

Client reports difficulty hearing

After giving a dose of dextromethorphan, an antitussive, which data reflects evaluation of the drug's effectiveness?

Client states that cough has been relieved.

Isotretinoin (Accutane)

Contra: pregnancy w/ 2 forms of birth control due to teratogenic effects

Medroxyprogesterone (Provera);

Contra: smoking/tobacco products; Risks: Thromboembolism & Cardiovascular complications; Interventions: use additional contraceptive measures w/antibiotic therapy

Which statement by the nurse best explains why nausea, vomiting, and bone marrow suppression are common adverse effects of cytotoxic antineoplastic drugs?

Cytotoxic drugs affect the most rapidly dividing cells."

Which of the following assessment findings in a client receiving transdermal nitrate therapy for angina indicates an adverse effect?

Dizziness when the client stands up

• Ventricula dysrhythmias

in emergency setting—drug of choice: lidocaine hydrochloride (Xylocaine

Urofollitropin (Fertinex)

Dosage: admin. IM based on dose in preceding cycles SE: ovarian hyperstimulation syndrome.

• Dopamine (Intropin)—

Dose for cardiac shock: Intermediate doses ↑ CO; other uses: low doses ↑ renal perfusion & urine output; high doses (>10mcg/kg/min) α effects predominate→vasoconstriction & ↑BP

Zidovudine (AZT

Dose: take at the times prescribed to prevent resistance development SE: bone marrow suppression, hepatotoxic, nephrotoxic

a nurse is providing teaching to a client who has a new prescription for paroxetine. the nurse should instruct the client to monitor for which of the following adverse effects?

Drowsiness Nausea drowsiness, dizziness, trouble sleeping, loss of appetite, weakness, dry mouth, sweating, blurred vision, and yawning may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Which of the following instructions should be included in the discharge teaching plan for a client taking tetracycline (Tetracyn) to prevent the development of the suprainfection, Candida albicans?

Eat a container of yogurt with active cultures daily.

Synergistic drugs

Effect of giving both drugs > than the drugs individually

A client receives a prescription for calcium channel blockers. The nurse should expect which of the following diagnostic tests to be prescribed to obtain baseline data prior to starting the medication?

Electrocardiogram (ECG)

A nurse is administering medications to a client. which of the following medications should the nurse plan to administer by a parental route?

Fondaparinux

• Substance abuse

inappropriate, excessive, self-admin of drug for non-medical purposes

In a walk-in clinic, clients are often given intramuscular injections. Which drug should be readily available in case a client has an anaphylactic reaction?

Epinephrine

a nursing is caring for a client who reports that his current pain medication is no longer relieving her pain. Which of the following medications requires the nurse to obtain a written rather than a verbal prescription from the provider?

Fentanyl

a nurse is wanting to report a n infusion reaction for a client who is receiving a dose via IV of amphotericin B. which is the following findings that indicate to the nurse that the patient is experiencing an acute infusion reaction?

Fever

A nurse is planning care for a group of clients. which of the following client's medications should be monitored by the nurse for hearing loss related to a medication interaction?

Furosemide and Amikacin

• Proton pump inhibitors for treatment of:

GERD

Prior to giving a client a dose of digoxin, the nurse counts the apical pulse. If the rate is 62 bpm and regular, which is the appropriate nursing action?

Give the drug and document the heart rate.

A client is receiving naproxen (Aleve) 375 mg 3 times/day by mouth. The nurse observes the client's stools are becoming darker with a tarry consistency. Which of the following nursing interventions is most appropriate?

Give the medication with milk or food

A nurse is reviewing a client's medical history before administering a new prescription of atropine. Which of the following client conditions is contraindicated?

Glaucoma

A client who has received an injection of regular insulin at 0800 complains of feeling sweaty, weak, hungry, and shaky two hours after the injection. Which drug is indicated for this client?

Glucagon

When reviewing medication teaching with a client, a nurse reinforces that which of the following food and medication interactions can lead to medication toxicity?

Grapefruit juice and nifedipine (Procardia) also a calcium channel blocker

A nurse is assessing a client who takes levothyroxine for hypothyroidism. the nurse should identify that which of the following findings indicates the need for an increase in dosage? Select all that apply

Heart rate 46 Cold intolerance Impaired short-term memory

The presence of Helicobacter pylori is confirmed in a client with peptic ulcer disease. The nurse may anticipate the use of multiple antibiotics because:

Helicobacter pylori commonly develop resistance to single drugs.

The nurse is assessing a client who takes glipizide for the treatment of type 2 diabetes mellitus. Which of the following findings indicates effectiveness of the medication?

Hgba1c 6.5%

A nurse is reviewing a client's medical record before administering acetaminophen 650 mg PO every 6 hr. Which of the following findings indicates a need for the nurse to notify the provider?

History of alcohol use disorder

A client is taking metoprolol (Lopressor) for heart failure. The nurse notes that the client's heart rate is 50 beats/min, and the client has a systolic blood pressure of 90 mm Hg. Which of the following should the nurse do first?

Hold the client's medication.

• Antitussive

Indic: used to suppress a cough

A nurse is caring for a client with heart failure who is receiving spironolactone. The nurse should monitor for which of the following electrolyte imbalances related to side effects from this aldosterone antagonist?

Hyperkalemia also during Eletrocardio Gram (EKG look for peaked T waves as an indication of increased K+++

The nurse practitioner prescribed anhydrous theophylline (Theo-Dur) for the client with chronic bronchitis. With which disorder would the nurse practitioner reconsider the use of this medication?

Hypertension

A client who has been on furosemide (Lasix) for one year reports weakness in her legs, constipation, palpitations, and lethargy. Her bowel sounds are hypoactive. The nurse should suspect which complication?

Hypokalemia

An older adult client treated for recurring episodes of heart failure has been on long- term thiazide diuretic therapy. Which of the following findings should the nurse report as an adverse effect of these medications?

Hypokalemia

A nurse is assessing a client who is in labor and is receiving epidural anesthesia. which of the following findings should the nurse identify as the priority?

Hypotension

• Decongestant

Indic: used to treat nasal congestion

• Mucolytic

Indic: ↓ viscosity of mucus plugs making them easier to expel

Compared to other beta adrenergic blockers, cardioselective beta adrenergic blockers:

are less likely to cause bronchoconstriction.

for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

I should stay upright for 15 minutes after taking this medication.

a nurse is providing teaching to a client who has a new prescription for nitroglycerin. which of the following client statements indicates an understanding of the teaching?

I will call 911 if pain is not relieved after taking the medication

a nurse is teaching the parent of a toddler who is to begin taking ferrous fumarate. which of the following statements by the parent indicates an understanding of the teaching?

I will rinse my child's mouth with water after she takes the medicine

a nurse is teaching a client who has a new prescription for nitroglycerin patches. the nurse should identify which of the following statements as an indication that the client understands the teaching?

I will rotate application site to avoid skin irritation

Testosterone IM

If use to correct delayed puberty→assess bone maturation with bi-annual x-rays of hand and wrist; monitor liver fxn (can ↑ hypoglycemia, potentiate sleep apnea, exacerbate heart failure due to fluid retension.

A nurse should recognize that which of the following findings indicates the most serious side effect of vancomycin (Vancocin)?

Impairment of hearing

a nurse is caring for a client who has a alcohol use disorder and is experiencing withdrawals. Which of the following interventions is a priority at this time?

Implement seizure precautions

A nurse is reinforcing teaching for a client who has colorectal cancer and is receiving the platinum compound oxaliplatin (Eloxatin). The client should be taught about which of the following nutritional interventions?

Increase the amount of fiber in the diet, such as whole grains.

A client is admitted to the emergency department by an ambulance for a heroin overdose. The client is currently taking methadone (Methadose) that was prescribed through an outpatient clinic for opioid detoxification. The client is unresponsive and is administered naloxone (Narcan). The nurse evaluates for which of the following desired responses to this medication?

Increased respiratory rate

A client who has Graves' disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

Increased sleeping

Allopurinol (Zyloprim)

Ind. Gout; MofA: ↓ serum uric acid levels & urinary uric acid secretion; Precaution: avoid foods that acidify urine such as corn

Acetazolamide (Diamox)

Indic.: edema, epilepsy, acute mountain sickness, glaucoma (↓ intraocular pressure by ↓ amount of aqueous humor in the eye) Contra: allergy to sulfonamides

Chloroquine phosphate (Aralen):

Indic.: malaria prevention; Use: take weekly starting 1 week before departure and continued for 4 weeks after return.

• Antihistamines

Indic: allergy-induced symptoms

Montelukast (Singulair)

Indic: prevent asthma exacerbations;Dose: daily at bedtime; SE: well tolerated

Acetylcysteine (Mucomyst)

Indic: prevent liver damage following acetaminophen (Tylenol) overdose. Most effective if given shortly after ingestion; some protection up to 24 hrs.

Auranofin (Ridaura)

Indic: slows the progression of rheumatoid arthritis; takes 4-6 months of therapy to achieve therapeutic effect; SE: renal toxicity (less toxic through oral route than IM route), severe blood dyscrasias, GI rxns,

Epoetin Alfa (Procrit)

Indic: treat anemia; SE: headache, HTN, seizures RT Hct rises too quickly

Cyclosporine (Neoral)

Intervention: Mix w/ orange juice or milk to ↑ palatability; mixed & dispense in a glass container(since drug binds to plastic); grapefruit juice ↑ cyclosporine levels & ↑ risk of toxicity; administer immediately after mixing (can separate & settle)

IV medications

Intervention: assess site for redness/swelling before administration

Why is carbidopa-levodopa preferred over levodopa alone?

It decreases the amount of levodopa needed.

A nurse is teaching a client who is to begin cyclophosphamide therapy to treat cancer. Which of the following adverse effects of this medication should the nurse include in the teaching?

Leukopenia

A nurse is assessing a client who has been taking lithium for one year. Which of the following client reports is the nurse's priority?

mild thirst

a nurse is caring for a client who is to start therapy with lovastatin. the nurse should prepare the client for which of the following diagnostic assessments?

Liver function test

A nursing is providing teaching to a client who has a prescription for omeprazole. which of the following instructions should the nurse include in the teaching?

Long term use increases risk of fractures

A 12-year-old client is to receive oral cefaclor (Ceclor) for otitis media. A nurse monitors the client for which of the following symptoms that may indicate an allergic reaction to the medication?

Maculopapular rash and pruritus

A client is undergoing general anesthesia administered by inhalation for a cholecystectomy. The nurse in the operating room observes that the client has a temperature of 40° C (104° F) and significant muscle rigidity. The nurse prepares to assist in the care of the client for which of the following medical emergencies?

Malignant hyperthermia

A client with active tuberculosis is started on a regimen of antitubercular medications. Which of the following is important for a nurse to stress to the client?

Medication resistance may develop if dose scheduling is irregular.

Which phase of pharmacokinetics is affected most by abnormal liver function?

Metabolism

Nurse in a provider's office is preparing to teach a middle adult client who has a new diagnosis of metabolic syndrome and an HbA1c of 6.5%. Which of the following medications should the nurse plan to teach the client about first?

Metformin

a nurse is providing teaching to a client who has a new prescription for phenelzine. the nurse instruct the client to avoid which of the following foods?

smoked salmon

• Narcotics

MofA: alter perception of pain at the spinal cord & higher levels in the CNS

• Vecuronium (Norcuron)

MofA: causes relaxation of muscles & total flaccid paralysis, but does not affect CNS, diminish pain, or consciousness

a nurse is planning care for a client who has a prescription for erythromycin lactobionate IV bolus. which of the following actions should the nurse include in the plan of care?

Monitor for hearing loss

• Ibuprofen (Motrin)—

Most common SE: GI distress

A client who has a history of thrombophlebitis is taking warfarin to prevent new clot formation. He should be cautioned not to take salicylic acid because:

aspirin increases the effects of warfarin.

A nurse is teaching a client who has a new prescription for ergotamine to treat vascular headaches. The nurse should inform the client that which of the following is a potential adverse effect of this medication?

Muscle pain

A client is started on haloperidol (Haldol) to control antipsychotic episodes associated with schizophrenia. The nurse should instruct the client to observe for which of the following potential adverse medication effects?

Muscle spasm and parkinsonian symptoms

a nurse is providing teaching to a client who has a new prescription for warfarin about potential interactions with over the counter products. which of the following products should the nurse instruct the client to avoid?

Naproxen

• Phenobarbital (Luminal

assess: respiratory depression

A male client comes to the clinic requesting sildenafil (Viagra). Viagra should not be combined with which of the following?

Nitroglycerin (Nitrogard) also head ache is a side effect of overdosing

A nurse in the emergency department is caring for a client who reports a severe headache. the client's blood pressure is 280/160 mm hg. the nurse should plan to administer which of the following medications?

Nitroprusside

A client is receiving ferrous sulfate orally. Which of the following findings reported by the client indicates that the medication is achieving its desired outcome?

No shortness of breath with exertion

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

Notify provider for the appearance of a skin rash

• Dantrolene sodium (Dantrium)

SE: hepatitis (highest risk for women 35yrs or taking lg doses)

A client who experiences motion sickness during airplane flights obtains a prescription for meclizine (Antivert). When is the best time to take the drug?

One hour before the flight

A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?

Orthostatic hypotension

Thiazides

SE: hyperuricemia (common SE); assess: uric acid levels

Simvastatin (Zocor)—

SE: muscle weakness/aches; Assess: Creatine Kinase (released w/severe muscle injury)

• Acyclovir (Zovirax)—

SE: nephrotoxicity (crystallization of drug in nephron→renal tubular obstruction)

• Narcotic (opiate) analgesic

SE: papillary constriction, ↓BP, ↓HR, ↓ GI mobility

A nurse is administering glucagon intramuscularly to a client. Which of the following actions will help the nurse evaluate the medication's effectiveness?

Performing a blood glucose fingerstick

• Anti-convulsant for infants/children

Phenobarbital (often admin w/ phenytoin)

A client is receiving the thrombopoietic growth factor oprelvekin (Interleukin-11). The nurse recognizes that this medication is being given to correct which abnormal laboratory finding?

Platelet count 22,000/mm 3

A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

Potassium 2.5 mEq/L

• Terbutaline (Brethine

SE: tachycardia

Estrogen (premarin)

SE: ↑ risk of Thromboembolism with s/s: SOB, severe headache, vomiting, sudden acute pain in the calves, legs, chest, abdomen.

• Parkinson's

associated with ↓ of dopamine in the substantia nigra (brain)

The nurse may administer baclofen (Lioresal) for the treatment of which condition?

Protracted muscle spasticity

• Barbiturate overdose

RT: respiratory depression

a nurse is obtaining a medication history from a client who has gout and is prescribed probenecid. the nurse should notify the provider that the client is taking which of the following over-the counter medications?

Salicylic acid

Diphenhydramine (Benadryl) Precaution

avoid other CNS depressants such as: alcohol, benzodiazepines, kava kava

To prevent oral fungal infections, the nurse should instruct the client who uses a beclomethasone inhaler to take which action?

Rinse the mouth after each use.

Anaphylaxis rxn S/S

S/S: bronchoconstriction, angioedema, hypotension

Hypertensive crisis

S/S: flushed skin, headache, visual changes

• Trimethoprim/Sulfamethoxazole (Bactrim)[sulfonamide antibiotic]

SE: crystalluria that can clog the kidneys; to prevent ↑ fluids to 2-3 liters per day unless contraindicated

ACE Inhib. Lisinopril (Zestril)

SE: dry/persistent cough for 1-2 wks from ↑ bradykinin

A nurse is assisting a client in planning a therapeutic diet to enhance the effectiveness of cholestyramine (Questran) and avoid possible adverse effects. Which of the following would be appropriate to incorporate into the plan?

Select from foods that are low in saturated fat and cholesterol.

Which adverse effect is common for a client being treated with the antidepressant fluoxetine (Prozac)?

Sexual dysfunction

Digoxin is started for a client with an atrial arrhythmia. Within three days, the client's heart rate has decreased from 94 to 74. What action of digitalis explains this change?

Slowed impulse conduction

Which group may represent an increased risk for substance abuse?

Socioeconomically advantaged clients

There are many agents that are useful in the treatment of gastric ulcers. Which agent reacts with hydrochloric acid to form a viscous protective barrier over the ulcer?

Sucralfate (Carafate)

A client newly diagnosed with peptic ulcer disease is started on the cytoprotective agent sucralfate (Carafate). What important information should the nurse provide the client regarding potential interactions of this medication?

Sucralfate should be taken on an empty stomach before meals and at bedtime.

Which nursing intervention is specifically important when a client is taking an alpha- blocker, such as doxazosin (Cardura) for hypertension?

Teach the client how to manage orthostatic hypotension.

The use of which class of antibiotics should be avoided in children?

Tetracyclines

A nurse is monitoring a client with a history of bulimia in regards to the use of the stimulant laxative, senna (Senokot). Which of the following client findings supports a suspicion of laxative abuse?

The client has no urge to defecate even though stools are in the rectal vault.

a new prescription for insulin glargine. which of the following expected outcomes should the nurse include in the plan?

The client will wear his reading glasses when drawing insulin glargine

Doxepin (Sinequan)

[anticholinergic] SE: urinary retension, constipation, drying of nasal/oral secretons, ↑HR

A nurse is administering oral levothyroxine (Levothroid) to an infant with congenital thyroid deficiency. Which of the following findings indicates a therapeutic response to this medication?

The infant's height and weight will be at the 50th percentile by age 2.

A primary care provider has prescribed dextromethorphan (Balminil DM) to a client with a persistent cough.

The nurse recognizes that the antitussive is used to stop or reduce the cough.

A primary care provider has prescribed phenytoin (Dilantin) 200 mg extended release capsule every day by mouth for a client.

The nurse recognizes that the client requires further instruction when the client states the medication can be chewed.

A client is prescribed alprazolam (Xanax) 0.25 mg three times a day.

The nurse should independently hold the evening dose if the client is displaying signs/symptoms of rage.

. A client with Parkinsonʼs disease is taking carbidopa-levodopa (Sinemet) daily. The client reports he is frustrated that he has "good" days with few symptoms and "bad" days where he has poor symptom control.

The nurse understands this phenomenon is seen in clients who need a higher medication dose to control symptoms.

Baclofen (Lioresal

Therapeutic action: ↓ frequency & severity of muscle spasms

A client who is scheduled for cataract surgery has an order for acetazolamide (Diamox) preoperatively. Is this an appropriate order and, if so, why?

This type of drug is commonly used before ophthalmic surgery to reduce intraocular pressure.

Which findings are most likely in the client who has taken a toxic dose of a salicylate (aspirin)?

Tinnitus and dizziness

Antihyperglycemic agents are prescribed for clients with:

Type 2 diabetes mellitus.

A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection?

Urticaria

Propanolol

Use. Dysrhythmia, HTN, angina; SE: bronchoconstriction/bronchospasm; can block glyconeogenesis

Collagenase (Santy

Use: Debride ulcers

Interferon

Use: Prevent viral replication

Sulfisoxazole (Gantrisin uses

Use: UTI

Loperamide (Imodium)

Use: anti-diarrheal (poorly absorbed from GI tract; difficulty crossing the blood-brain barrier)

Norgestrel (Ovrette)

Use: contraception; SE: excess progestin →weight gain from ↑ appetite; deficiency of progestin: late breakthrough bleeding, amenorrhea; excess estrogen → edema

Methylphenidate (Concerta)

Use: marcolepsy Precaution: avoid caffeine use

Clopidogrel (Plavix

Use: reduce long-term risk of clotting w/ atherosclerosis and recent MI of CVA

• Bulk-forming laxatives (Metamucil)

Use: take w/lg amounts of water to prevent a gel-like mass to ↑ constipation

• Asthma therapy

Use: use albuterol (sympathomimetic drug) first to open up airways and allow other inhaled drugs to be dispersed further down the bronchial tree

Heparin (anticoagulant)

Use: w/alteplase for acute MI

Sumatriptan (Imitrex):

Use: when migraine symptoms appear and again in 1 hr if symptoms persist

Warfarin (Coumadin)

Use:long-term prophylaxis of thrombosis [antidote—Vit K]

Hexacholorphene (pHisoHex

[antiseptic solution] Caution: CNS stimulation if sufficient amts are absorbed through skin or mucous membranes; avoid if pregnant/breastfeeding

• Triazolam (Halcion)

[benzo]—use: do not take with alcohol

a nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. which of the following laboratory values indicates an adverse effect of this medication?

WBC 3000

a nurse is reviewing the laboratory data of a client who is receiving filgrastim. which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment?

WBC count

On my ATI exam the question for lithium was about what to monitor for and the correct answer was?

Weight gain

a nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease. which of the following statements is appropriate for the nurse to make?

You will need to take two or more medication to treat your disease

Spironolactone (Aldactone)

[K sparing diuretic]—avoid foods w/ ↑ K such as salt substitutes

• Fluoxetine (Prozac)

[SSRI]—Teach: effects may not be seen for weeks; Dosage starts at 20mg, can be increased after 2 wks gradually up to 80mg/day divided into 2 doses

• Gentamicin (Garamycin)

[aminoglycoside antibiotic]; SE: nephrotoxicity & ototoxicity

Albuterol (Proventil)

[sympathomimetic/ adrenergic beta-2 agonist] Contraindicated: with MAOIs (can↑ action of albuterol and → HTN crisis); β-blockers can inhibit the therapeutic effects Use: invert canister, shake before use, rinse mouth after use, w/new inhaler perform test spray

• Amitriptyline (Elavil)

[tricyclic antidepressant] SE: orthostatic hypotension, sedation, & confusion

Metoprolol (Lopressor)

[β-blocker] Hold dose for dyspnea (sign of exacerbation of CHF)

The nurse would describe a penicillinase to a client receiving this medication as:

a bacterial enzyme that can inactivate many penicillins.

a nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. which of the following client information is the priority for the nurse to report to the provider?

a client with a history of severe Penicillin allergy

A nurse recognizes that a client is experiencing an adverse reaction to a nebulized dose of ipratropium (Atrovent) if the client reports

a dry, scratchy throat.

A client with Type I diabetes mellitus is given an injection of neutral protamine hagedorn (NPH) insulin at 7:00 a.m. In order to prevent a hypoglycemic reaction, the client should have:

a mid-afternoon snack.

• Triaterene/hydrochlorthiazide (maxzide)—

a thiazide diuretic that is ineffective when ureine output is low or renal dysfnx is present

A nurse is providing teaching to a client who has a new prescription for theophylline a sustained-released capsule. Which of the following statements by the client indicates an understanding of the teaching? a. "I can take my medication in the morning with my coffee." b. "I may sprinkle the medication in applesauce." c. "I should limit my fluid intake while on this medication." d. "I will need to have blood levels drawn."

a. "I can take my medication in the morning with my coffee."

A nurse is providing teaching to a client about the administration of omeprazole. Which of the following should the nurse include? a. "You cannot take this medication with an antacid." b. "You should reduce your intake of calcium while taking this medication." c. "You should take this medication before meals." d. "You can take a second dose if symptoms persist up to 2 hours after the first dose."

a. "You cannot take this medication with an antacid."

A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended release. Which of the following information should the nurse include in the teaching? a. "You will need liver function tests before beginning therapy." b. "Avoid consuming dairy products while taking this medication." c. "You may crush the medication and mix it with applesauce." d. "You should take the medication in the morning."

a. "You will need liver function tests before beginning therapy."

A nurse is preparing to administer filgrastim 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

a. 325 mcg

A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication? a. Alcohol use disorder b. Chronic kidney disease c. Hepatitis B vaccine within the last week d. Diabetes mellitus

a. Alcohol use disorder b. Chronic kidney disease

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take? a. Apply firm pressure to the injection site following administration b. Administer the medication into the client's muscle c. Expel the air bubble from the syringe prior to injection d. Insert the syringe needle halfway into the client's skin

a. Apply firm pressure to the injection site following administration

A nurse is providing discharge dietary teaching to a client who has a something and is taking medication theophylline and to provide general instructions the nurse should include? a. Avoid caffeinated beverages b. Take the medication with meals c. Restrict milk products d. Limit sodium intake

a. Avoid caffeinated beverages

a nurse is caring for a client who is postoperative following a thyroidectomy and is receiving morphine for pain. Which of the following findings should the nurse recognize as an adverse effect of morphine? a. Bladder distention b. Productive cough c. Gastrointestinal bleeding d. Decrease deep tending reflexes

a. Bladder distention

A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine. Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine? a. Eggs b. Shellfish c. Peanuts d. Milk

a. Eggs

A nurse is caring for 4-year-old child following an orthopedic procedure. When assessing the child for pain. Which of the following pain scales should the nurse use? a. FACES b. Numeric c. CRIES d. Word graphic

a. FACES

A nurse manager is planning an in-service about pain management with opioids for client who has cancer. Which of the following information should the nurse manager include? a. IM administration is recommended if PO opioids are ineffective b. Respiratory depression decreases as opioid tolerance develops c. Meperidine is the opioid of choice for treating chronic pain d. Withhold PRN pain medication for the client who is receiving opioids every 6 hr

a. IM administration is recommended if PO opioids are ineffective

a nurse is reviewing the medications of a client is experiencing orthostatic hypotension. The nurse should identify this finding as an adverse effect of which of the following medications? a. Imipramine b. Levothyroxine c. Montelukast d. Omeprazole

a. Imipramine

A nurse is receiving a medication prescription by telephone from a provider. The provider states "Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain." How should the nurse transcribe the prescription in the client's medical record? a. Morphine 6 mg IV push every 3 hr PRN acute pain b. MSO 6 mg IV push every 3 hr PRN acute pain c. MS 6 mg IV push every 3 hr PRN acute pain d. Morphine 6.0 mg IV push every 3 hr PRN acute pain

a. Morphine 6 mg IV push every 3 hr PRN acute pain

A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the nurse use to place the peripheral IV catheter? a. Nondominant dorsal venous arch b. Dominant distal dorsal vein c. Nondominant forearm basilic vein d. Dominant antecubital vein

a. Nondominant dorsal venous arch

A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right placing them in the order of performance. Use all the steps.)

a. Obtain the client's apical heart rate b. Remove the medication from the dispensing system c. Open the medication package d. Compare the client's wristband to the medication administration record e. Document administration of the medication

A nurse is consulting a formulary about a client's new prescription for raloxifene. The nurse should identify that this medication is used to treat which of the following conditions? a. Osteoporosis b. Hypothyroidism c. Urinary tract infection d. Deep vein thrombosis

a. Osteoporosis

A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA) a. Polypharmacy b. Increased rate of absorption c. Decreased percentage of body fat d. Multiple health problems e. Decreased renal function

a. Polypharmacy c. Decreased percentage of body fat d. Multiple health problems e. Decreased renal function

A nurse is planning care for a client who is receiving morphine via continuous epidural infusion. The nurse should monitor the client for which of the following? a. Pruritus b. Cough c. Tachypnea d. Gastric bleeding

a. Pruritus - Sign of allergic reaction to morphine

A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements. Which of the following supplements should the nurse advise the client to avoid? a. St. John's Wort b. Ginger root c. Black cohosh d. Coenzyme Q10

a. St. John's Wort

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following predisposes this client to developing digoxin toxicity? a. Taking a high ceiling diuretic b. Having a 10-year history of COPD c. Having a prolapsed mitral valve d. Taking an HMG CoA reductase inhibitor

a. Taking a high ceiling diuretic

A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following outcomes indicates that the client is adhering to the medication regimen? a. The client has a negative sputum culture b. The client tests negative for HIV c. The client has a positive purified protein derivative test d. The client's liver function test results are within the expected reference range

a. The client has a negative sputum culture

A nurse is reviewing the laboratory results of a client who is taking amitriptyline which of the following laboratory values should the nurse report to the provider? a. Total bilirubin 1.5 mg/dL b. Potassium 4.2 mEq/L c. Hct 0.44% d. WBC count 5000/mm3

a. Total bilirubin 1.5 mg/dL

A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection? a. Urticaria b. Bradycardia c. Pallor d. Dyspepsia

a. Urticaria

A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report? 000/mm3 a. ePTT 90 seconds b. Hgb 16 g/dL c. INR 1.6 d. WBC 6000/mm3

a. ePTT 90 seconds

A nurse is reviewing a client's 0800 laboratory values at 1100. the nurse notes that the client received heparin at 1000. which of the following laboratory values warrants an incident report?

aPtt 90

"A disease process characterized by the continued use of a specific psychoactive substance despite physical, psychologic, or social harm" is the definition of:

addiction.

If corticosteroids are discontinued abruptly, a problem that may develop is:

adrenal gland shut-down.

Vaccine

adv. of live vs attenuated/killed vaccine: long-lasting active immunity vs partial (passive)

• Oral Iron supplement

adverse SE: gastric irritation→anorexia, nausea, vomiting, constipation

Cephalosporins (Keflex

allergy to cephalosporins is considered a precaution for taking penicillins

• Antidysrhythmic agents—

alter the dysfunction in the electrical system of the heart.

Digoxin (lanoxin)

anti dysrhythmic] SE: blurred/double vision

Nausea tx

antiemetic plus cool, damp cloth to forehead, neck, and wrists.

Alteplase (Activase)

antithrombolytic] Use: Acute MI/CVA (has short half-life)

a nurse is providing teaching to a client who has a new prescription for carbamazepine for the treatment of seizures. The nurse should instruct the client to monitor for which of the following adverse effects? a. insomnia b. Blurred vision c. Tachypnea d. Metallic taste

b. Blurred vision

A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication? a. Hypoglycemia b. Bradycardia c. Red man syndrome d. Hypotension

b. Bradycardia CNS effects: drowsiness sedation, depression ,confusion, anxiety, double vision, ataxia, cognitive impairment, nystagmus ii. Gingival hyperplasia, skin rash, dysrhythmias, hypotension

A nurse is assessing a client following the administration of ondansetron (Zofran). Which of the following findings should indicate to the nurse that the ondansetron has been effective? a. Client reports a decrease in pain b. Client reports a decrease in nausea c. Client reports a decrease in coughing d. Client reports a decrease in diarrhea

b. Client reports a decrease in nausea

Anurse in the emergency department is reviewing a medication record for client who reports vomiting blood. The nurse should anticipate the provider will discontinue which of the following medications? a. NPH insulin b. Clopidogrel c. Furosemide d. Pantoprazole

b. Clopidogrel

A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess? a. Decreased bowel sounds b. Distended neck veins c. Bilateral muscle weakness d. Thread pulse

b. Distended neck veins

A nurse is planning teaching for a client who is trying to quit smoking. Which of the following instructions about nicotine replacement options should the nurse include? a. Change the nicotine patch every other day b. Do not drink beverages while sucking on a nicotine lozenge c. Chew nicotine gum for 10 min before spitting it out d. Administer 2 sprays of nicotine nasal spray in each nostril with each dose

b. Do not drink beverages while sucking on a nicotine lozenge

A nurse is caring for a client who received neostigmine 1 hour ago and is experiencing muscarinic response. Which if the following manifestations should the nurse expect? a. Headache b. Excessive salivation c. Fever d. Myoclonic seizure

b. Excessive salivation

A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective? a. Absent Chvostek's sign b. Improved cognition c. Decreased vomiting d. Cardiac arrhythmias absent

b. Improved cognition

the nurse is mixing regular insulin and NPH into a syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take first? a. Withdrawal NPH from the vial b. Inject air into the NPH vial c. Inject air into the regular vial d. Withdrawal regular insulin from the vial

b. Inject air into the NPH vial

A nurse is caring for a client who has a prescription for total parental nutrition (TPN). Which of the following routes of administration should the nurse use? a. Subcutaneous b. Intraosseous/intravenous c. Central venous access device d. Midline catheter

b. Intraosseous/intravenous

A nurse is teaching a client about oral contraceptive. Which of the following information should the nurse include in the teaching? a. Abdominal pain is an expected adverse effect of oral contraceptives b. It can take up to 1 year to become pregnant after stopping an oral contraceptive c. Some herbal supplements can decrease the effectiveness of an oral contraceptive d. A pelvic examination is needed prior to starting an oral contraceptive

b. It can take up to 1 year to become pregnant after stopping an oral contraceptive

A nurse is planning to administer medication to an older adult client who has dysphagia. Which of the following actions should the nurse plan to take? a. Tilt the client's head back when administering the medications b. Mix the medications with a semisolid food for the client c. Administer more than one pill to the client at a time d. Place the medications on the back of the client's tongue

b. Mix the medications with a semisolid food for the client

A nurse is preparing to administer medication to a client and discovers a medication error. The nurse should recognize that which of the following staff members is responsible for completing an incident report? a. The quality improvement committee b. The nurse who identifies the error c. The nurse who caused the error d. The charge nurse

b. The nurse who identifies the error

A nurse is caring for a client who is to receive potassium replacement. The provider's prescription reads. "Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min." which of the following reasons should the nurse clarify this prescription with the provider. a. Potassium chloride should be diluted in dextrose 5% in water. b. The potassium infusion rate is too rapid c. Another formulation of potassium should be given IV d. The client should be treated by giving potassium by IV bolus

b. The potassium infusion rate is too rapid

A client is in a clinic for an annual physical exam. During the medication review the client reports daily use of loratadine (Claritin) and occasional use of diphenhydramine (Benadryl) for allergy relief. The nurse recognizes the potential for medication interactions when the client reports use of

barbiturates for sleep.

• Unconscious type 1 diabetic

best intervention: admin glucagons IM

A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching? a. "Discard any tablets you do not use every 6 months." b. "Take one tablet each morning 30 minutes prior to eating." c. "Keep the tablets at room temperature in their original glass bottle." d. "Place the tablet between your cheek and gum to dissolve."

c. "Keep the tablets at room temperature in their original glass bottle."

A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? a. "Diarrhea is a common adverse effect of this medication." b. "Ringing in the ears is an expected adverse effect of this medication." c. "Notify your provider if you develop a fever while taking this medication." d. "You might experience weight loss while taking this medication."

c. "Notify your provider if you develop a fever while taking this medication."

A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (SATA) a. "Soak the inhaler in water after use." b. "Have your child take one inhalation as needed for shortness of breath." c. "Shake the device prior to administration." d. "A spacer will make it easier to use the device." e. "Rinse your child's mouth following administration."

c. "Shake the device prior to administration." d. "A spacer will make it easier to use the device." e. "Rinse your child's mouth following administration."

A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following? a. A client who has a referral for social services b. A client who is transdermal to radiology c. A client who is transferal to a step-down unit d. A client who has a consultation for physical therapy

c. A client who is transferal to a step-down unit

A nurse is teaching a client who has pernicious anemia to self-administer cyanocobalamin. Which of the following information should the nurse include in the teaching? a. Use nasal decongestion 15 mins before the medication if you have a stuffy nose b. Lie down for 1 hour after administering the medication c. Administer the medication into one nostril once per week d. Plan to self-administer this medication for the next 6 months

c. Administer the medication into one nostril once per week

A nurse is performing a return demonstration of an enoxaparin administration. Which of the following client actions indicates an understanding of the teaching? a. Messages the site to enhance absorption b. Injections the medication into a muscle c. Administers the medication into the abdomen d. Aspirates the medication after injection

c. Administers the medication into the abdomen

A nurse is assessing a client how has been taking digoxin and ...... which of the following findings to the nurse indicates this client has developed digoxin toxicity? a. Ringing in the ears b. Hyperkalemia c. Blurred vision d. hypertension

c. Blurred vision

A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer? a. Protamine sulfate b. Acetylcysteine c. Calcium gluconate d. Flumazenil

c. Calcium gluconate

A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer? a. Colchicine b. Cimetidine c. Colerain d. Chlorpromazine

c. Colerain - Colesevelam (Welchol)

A nurse is caring for a client who has major depression and a new prescription for citalopram. which of the following adverse effects is the priority for the nurse to report to the provider? a. Insomnia b. Bruxism c. confusion d. weight loaa

c. Confusion Bruxism - Bruxism occurs in < 1 % of patient with citalopram. This should be addressed but is no an immediate health concern.

A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first? a. Encourage the client to dangle the legs while sitting in a chair b. Teach the client about foods low in sodium c. Determine medication adherence by the client d. Notify the provider of the client's weight gain

c. Determine medication adherence by the client

A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red tinge. Which of the following actions should the nurse take? a. Check the client's liver function test results b. Instruct the client to increase his fluid intake c. Document this as an expected finding d. Prepare the client for dialysis

c. Document this as an expected finding

A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissue surrounding the insertion site. Which of the following actions should the nurse take? a. Flush the IV catheter b. Apply pressure to the IV site c. Elevate the extremity d. Slow the infusion rate

c. Elevate the extremity

A nurse is reviewing the list of current medication for a client who is to start prescription for carbamazepine. The nurse should identify that which of the following medications interacts with carbamazepine? a. Nicotine transdermal system b. Diphenhydramine c. Estrogen-progestin combination d. Beclomethasone

c. Estrogen-progestin combination (Non-hormonal forms of contraception)

A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances? a. Hypocalcemia b. Hypokalemia c. Hyponatremia d. Hypomagnesemia

c. Hyponatremia

A nurse us caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect? a. Oxygen saturation 96% b. PaCO2 30 mm Hg c. Increase in BP d. Decrease in protein

c. Increase in BP

Evidence of effective treatment with a nucleoside reverse transcriptase inhibitor (NRTI), such as zidovudine is:

decreased HIV RNA level.

A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to client who has diabetes mellitus following actions should the nurse take first? a. Withdraw the regular insulin from the viral b. Withdraw the NPH insulin form the vial c. Inject air into the NPH vial d. Inject air into the regular insulin vial

c. Inject air into the NPH vial

A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction? a. Nausea b. Cardiac dysrhythmia c. Laryngeal edema d. Insomnia

c. Laryngeal edema b. Cardiac dysrhythmia Amoxicillin side effects include: Renal impairment, hyperkalemia, dysrhythmias, hypernatremia Allergic reaction: Urticaria, rash, hypotension, dyspnea, swelling of face/lips/tongue

A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia? a. Constipation b. Decreased urine output c. Positive Trousseau's sign d. Headache

c. Positive Trousseau's sign

a nurse is teaching a client who has a new prescription of Alendronate for osteoporosis. What instructions should the nurse include? a. Take the medication immediately after breakfast b. Take the medication with an antacid c. Sit upright for at least 30 mins after taking the medication d. Drink orange juice with the medication

c. Sit upright for at least 30 mins after taking the medication

A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider? a. The client has a BUN of 18 mg/dL b. The client takes an aspirin daily c. The client has a history of a severe penicillin allergy d. The client reports a history of nausea with cefuroxime

c. The client has a history of a severe penicillin allergy

A nurse is caring for a client who has heart failure. The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider? a. Potassium 3.8 mEq/L b. The client reports dizziness upon standing c. The client reports difficulty hearing d. BUN 15 mg/dL

c. The client reports difficulty hearing

Vancomycin should not be used to treat minor infections because it:

can cause "red man syndrome", a hypertensive crisis that is almost always fatal.

Guaifenesin

can cause drowsiness

• Corticosteroids

can interfere with effect of a vaccine since they depress the immune system and can interfere with body's ability to produce antibodies

• Liver & kidney disease

causes increase in length of duration of action of medication

• Penicillin allergy may ↑ risk for allergy to

cephalosporins

A client is receiving long-term glucocorticoid therapy for an inflammatory condition. Which of the following findings should be reported to the primary care provider?

chills and fever

A pharmacy supplies a fluticasone (Flovent) inhaler for a client who is hospitalized. The nurse recognizes that this medication will be of the most benefit to the client with

chronic asthma who consistently uses the inhaler every 12 hr.

A client phones the primary care clinic and informs a nurse that he is having a "flare up" of his gout. He tells the nurse he has been prescribed several medications for his gout and questions which medication he should take. When reviewing the clientʼs medical record, the nurse notes the client has a history of migraine headaches. Based on this information, which of the following medications should the nurse anticipate the primary care provider will prescribe?

colchicine

a nurse is reviewing the medical record of a client who is receiving vancomycin daily. the nurse should review which of the following laboratory results prior to administering the next dose?

creatinine level

A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following instructions should the nurse include? a. "Discontinue the patch if you experience a headache." b. "Apply a new patch if you have chest pain." c. "Cover the patch with dry gauze when taking a shower." d. "Remove the patch prior to going to bed."

d. "Remove the patch prior to going to bed."

A nurse is teaching a newly license nurse about medication reconciliation. The nurse should instruct the newly license nurse for medication reconciliation for which of the following clients? a. Client who is transported to radiology b. A client who has a consultation for .... c. A client who has a referral for social services d. A client who has been transferred to a step-down unit

d. A client who has been transferred to a step-down unit

A client is caring for a client who develops an anaphylactic reaction to IV administration. After assessing the client's respiratory status and stopping the medication infusion. Which of the following actions should the nurse take next? a. Replace the infusion with 0.9% sodium chloride b. Give diphenhydramine IM c. Elevate the client's legs and feet d. Administer epinephrine IM

d. Administer epinephrine IM

A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take? a. Show the IV solution rate b. Initiate a new IV distal to the initial site c. Maintain the extremity below the level of the heart d. Apply a warm moist compress

d. Apply a warm moist compress

A nurse accidently administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take? a. Monitor the client's thyroid function levels b. Collect the client's uric acid level c. Obtain the client's HDL level d. Check the client's glucose level

d. Check the client's glucose level

A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following laboratory values should the nurse report to the provider? a. Sodium 137 mEq/L b. Hct 4.3% c. Hgb 15 g/dL d. Creatinine 2.5 mg/dL

d. Creatinine 2.5 mg/dL

A nurse is teaching a client who is to start taking Cromolyn. Which of the following information should the nurse include in the teaching? a. Cromolyn should take effect within 5 mins b. Cromolyn should dilate the bronchioles c. Cromolyn can be used after exercise d. Cromolyn is a long-term management medication

d. Cromolyn is a long-term management medication

A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. the medication is provided as hydromorphone 8 mg per tablets. Which of the following actions is appropriate for the nurse to take? a. Return the remaining medication to the facility's pharmacy b. Store the remaining half of the pill in the automated medication dispensing system c. Place the remaining half of the pill in the unit dose package d. Dispose of the remaining medication while another nurse observes

d. Dispose of the remaining medication while another nurse observes

A nurse is caring for a client who has breast cancer and reports pain. 1 hr after administration of prescribed morphine 10 mg IV. Which of the following medications should the nurse expect to administer? a. Naloxone IV b. Morphine tablet c. Lidocaine patch d. Fentanyl transmucosal

d. Fentanyl transmucosal c. Lidocaine patch

A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic. Which of the following medications puts the client at risk for developing hearing loss? a. Rifampin b. Ciprofloxacin c. Penicillin G d. Gentamicin

d. Gentamicin

A nurse is caring for a client who has heart failure and a new prescription for lisinopril. For which of the following adverse effects should the nurse monitor when administering lisinopril? a. Bradycardia b. Hypokalemia c. Tinnitus d. Hypotension

d. Hypotension

A nurse is assessing a client who is receiving heparin IV continuous IV. The client has an PPT of 90 seconds. They should monitor the client for which of the following changes in their vital signs? a. Decreased temperature b. Increased pulse rate c. Decreased respiratory rate d. Increased blood pressure

d. Increased blood pressure

A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings as a therapeutic effect of naloxone? a. Decreased nausea b. Increased pain relief c. Decreased blood pressure d. Increased respiratory rate

d. Increased respiratory rate

A nurse is preparing to administer subcutaneous heparin to a client. Which of the following should the nurse take? a. Massage the site after administering the medication b. Use a 21-gauge needle for the injection c. Aspirate before injecting the medication d. Insert the needle at least 5 cm (2 in) from the umbilicus

d. Insert the needle at least 5 cm (2 in) from the umbilicus

A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective? a. BUN 15 mg/dL b. Blood glucose 90 mg/dL c. Urine specific gravity 1.020 d. LDL 120 mg/dL

d. LDL 120 mg/dL

A nurse is assessing a client who is taking an osmotic laxative which of the following findings should the nurse identify as an indication of fluid volume deficit? a. Nausea b. Weight gain c. Headache d. Oliguria

d. Oliguria

A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider? a. Sodium 1.38 mEq/dL b. Magnesium 1.5 mEq/L c. BUN level 10 mg/dL d. Potassium 2.9 mEq/L

d. Potassium 2.9 mEq/L

A nurse is reviewing he laboratory results of a client who has a prescription for sodium polystyrene sulfonate (Kayexalate) every 6 hr. which of the following should the nurse report to the provider? a. Creatinine 0.72 mg/dL b. Sodium 138 mEq/L c. Magnesium 2 mEq/L d. Potassium 5.2 mEq/L

d. Potassium 5.2 mEq/L - Hyperkalemia (serum potassium level greater than 5.0 mEq/L) increases the client risk for fatal cardiac dysrhythmias. Kayexalate is used to decrease the serum potassium level so the PN should monitor the client's serum potassium level

A nurse is caring for a client who has a new diagnosis of benign prostate hypertrophy and a prescription for doxazosin. The client tells the nurse. "I do not take this medication. I would prefer a natural therapy." Which of the following supplements should the nurse suggest the client discuss with the provider? a. Black cohosh b. Garlic c. Feverfew d. Saw palmetto

d. Saw palmetto

A nurse is assessing a client how received a dinoprostone gel to stimulate the cervical ripening. Which of the following is the nurse's priority? a. Back pain b. Flushing c. nausea d. Uterine tachysystole

d. Uterine tachysystole

Anurse is assessing a who is receiving clindamycin. Which of the following findings should the nurse identify as an adverse effect of this medication? a. Agitation b. Report of blurred vision c. Hypertension d. Watery diarrhea

d. Watery diarrhea

Thiazide and loop (high ceiling) diuretics are similar in that both:

decrease tubular reabsorption of sodium and water.

• Eye drop administration:

depress the lower lid and place the medication in the lower conjunctival sac.

When oral iron supplements are prescribed, client teaching should include the fact that:

diarrhea or constipation may occur.

The combination of aluminum and magnesium in many antacids decreases the risk of:

diarrhea or constipation.

The drug of choice to treat a client with status epilepticus is:

diazepam (Valium).

One mechanism by which antihypertensive drugs lower blood pressure is to:

dilate peripheral blood vessels.

Drugs given for a systemic effect by any route must be capable of:

distribution throughout the body.

To administer eardrops to a child, the nurse should straighten the external ear canal by pulling the auricle:

down and toward the back of the head.

Erythromycin (Erythrocin)

drug class macrolide SE: liver toxicity

• Bipolar

drug of choice: lithium

• Metronidazole (Flagyl)

education: avoid alcohol (drug inhibits alcohol metabolism→accumulation)

• Transdermal patch

education: rotate the site each time you change the patch

• Synergistic effect

effect of combined drugs greater than either of drugs alone

• Dexamethasone (Decadron

effects on blood glucose: glucocortoid steroids & stress ↑ blood glucose

Prothrombin time

evaluate adequacy of extrinsic system&common pathway in clotting mechanism

The nurse may administer acetylcysteine (Mucomyst) inhalation to:

facilitate mucus expectoration.

A client is receiving amphotericin B intravenously. A nurse observes for what common side effects occurring within the first 1 to 3 hr of initiating the infusion?

fever and chills

• Status epilepticus

given via IV route

• Treatment for constipation in children

glycerine suppositories (↑ osmotic pressure-draws fluid into colon) castor oil-distasteful & ↓ absorption of fat-soluble vitamins;

Metoclopramide (Reglan

has increased sedation when given with Morphine

Clients receiving intravenous gentamicin (Garamycin) should be assessed closely for:

hearing loss.

Insulin

high dose (U-500) is 5 times stronger than U-100—divide dosage ordered by 5

When a client develops tolerance to a drug, the nurse would expect:

higher dose needed to achieve same effect.

The purpose of a spacer with a metered-dose inhaler is to:

increase the amount of drug delivered to the lungs.

The effects of epinephrine include:

increased pulse and blood pressure.

• Psuedoephedrine (Sudafed)

increases BP, HR, RR; Contraindication: HTN

• Cromolyn sodium (Intal

indication: asthma prophylaxis (mast cell stabilizer→↓ release of histamine, bradykinin, and serotonin that start a cascade of aqllergy symptoms)

• Fluticasone (Flovent

inhaled steroid]—Indic.: decrease inflammation of the bronchi

Phenobarbital [Barbiturates

interventions for anticonvulsant therapy: assess for resp. depression, excess sedation from toxic effects, IV at < 50mg/min, avoid extravasation (alkaline→skin damage)

Route—fastest/most effective:

intravenous

• Mannitol (Osmitrol)

is an osmotic diuretic and is not used in the treatment of HTN

The only drug commonly used both to prevent and to treat tuberculosis is:

isoniazid

a nurse is providing teaching to a client who has a new prescription for nitroglycerin sublingual. which of the following client responses indicates an understanding of the teaching?

keep tablets in dark container at room temperature

IM injection site

locate dorsogluteal site

• Aluminum hydroxide (amphojel)

long term use SE: constipation (antiacids w/Mg alone cause diarrhea; Often Al & Mg are combined to balance their side effects)

When a client is being treated with trimethoprim-sulfamethoxazole (Bactrim) for a urinary tract infection, it is important to:

maintain good hydration.

a nurse is preparing to administer nitroglycerin topical ointment to a client. which of the following actions should the nurse plan to take?

measure dosage on medication applicator paper

A client is admitted to the hospital with exacerbation of asthma and is receiving albuterol (Proventil) nebulizer treatments every 4 hr. If encountered, which central nervous system (CNS) side effect should the nurse attribute to this medication?

mild tremors

TB

multi drug tx: Isoniazid(INH), Rifampin, pyrazinamide, ethambutol—to deal w/ resistant strains

The antagonist for a client who has overdosed on morphine is:

narcan.

Histamine 2 receptor antagonists such as cimetidine (Tagamet) are used to treat peptic ulcers because they:

neutralize hydrochloric acid in the stomach.

A client is self-administering 5 units of lispro insulin (Humalog) every morning. The nurse should instruct the client that the best time to administer the lispro insulin is

no sooner than 15 min before breakfast.

• Tissue dependence---

occurs when actual changes in cells, secondary to physical addition causes body to need the drug for homeostasis

• Zidovudine (AZT

only anti-retroviral drug that reduces maternal-fetal transmission of HIV virus

• Insulin

oral hypoglycemic agents are contraindicated during pregnancy—use insulin instead

• Levothyroxine (synthroid)—

overdose s/s: those that mimic hyperthyroidism: tremor & wt loss ; undermedicated s/s: cold,dry,scaly skin; depression; slow cognitive ability

Glucocorticoids, such as prednisone (Deltasone), are given cautiously to clients with:

peptic ulcer disease.

• Addiction

physical or psychological need for a drug

A nurse is assessing a client who is receiving heparin therapy for deep-vein thrombosis. Which of the following findings should indicate to the nurse that the therapy is effective?

platelets within the expected range

Ticlopidine (Ticlid)

prevent coronary artery thombosis; Intervention: check platelet count

A 60-year-old client questions a nurse about her prescribed medication, raloxifene (Evista). Recognizing that this medication is a selective estrogen receptor modulator (SERM), the nurse replies that the medication

prevents postmenopausal osteoporosis.

An immunizing agent that confers active immunity protects by:

providing antibodies obtained from immune humans or animals.

• Diuretics

pt. education: take during the day, report any changes in daily wt.

The most serious adverse reaction to morphine is:

respiratory depression.

The best laxative for clients who have chronic constipation and cannot or will not consume adequate dietary fiber is a:

saline cathartic.

A nurse receives a prescription to give tobramycin to a client daily. Which of the following laboratory values should the nurse report to the provider?

serum creatinine 2.5

A nurse cautions a client with Parkinson's disease who is taking carbidopa/levodopa (Sinemet) against taking any monoamine oxidase (MAO) inhibitors because the drug interaction can cause:

severe hypertension.

An elderly client is prescribed a new drug. Because of the age-related changes in the kidneys and liver, it is most important that the nurse assess for:

signs of drug toxicity.

Two days after abdominal surgery, a client's bowel sounds are hypoactive and the abdomen is distended. The physician orders bethanechol (Urecholine), a cholinergic agonist, which acts to:

stimulate intestinal peristalsis and tone.

An antiulcer drug that forms a gel to coat and protect the ulcer so that healing can occur is:

sucralfate (Carafate).

A client who is taking one daily dose of a thiazide diuretic should be instructed to:

take the medication in morning to avoid nighttime voiding.

• Digoxin [cardiac glycoside]

that ↓ HR. Interv: assess apical HR for 1 min. Contact DR if HR < 60bpm

Narcan [opioid antagonist]:

therapeutic action: improvement of respiratory rate.

• Phenytoin (Dilantin)

therapeutic level: 10-20 mcg/mL

• Theophylline

therapeutic serum level: 10-20mcg/mL

The most serious adverse reaction to oral contraceptives is:

thromboembolism.

• Anti-tussive

treat cough

• Nasal congestion

treat with decongestant

• Tamoxifen citrate (Nolvadex)

type of hormonal antineoplastic agent: anti-estrogen

To administer heparin subcutaneously, the nurse should:

use a 26-gauge, 1⁄2-inch needle to minimize trauma.

• Atropine

use: severe symptomatic bradycardia

• Verapamil (Calan

use: ↓ HR

PRBC (packed red blood cells)

used as blood replacement when fluid overload is a concern

• Diltizem (Cardizem

used for SVT

• Furosemide (lasix)—

used for treatment of HTN in clients with renal dysfunction

• MAOI drugs

used in treatment of depression

• Tricyclic drugs

used in treatment of depression

• Mucolytic

used to decrease the viscosity of mucus plugs making them easier to expel

• Tocainide HCl (Tonocard)

used to prevent ventricular arrhythmias

• Propranolol (Inderal)

used to prevent/control SVT (esp. assoc. w/ excessive catecholamines

• Benztropine mesylate

used to treat extrapyramidal effects w/ use of phenothiazines

• IM site for 18 month old child

vastus lateralis

a nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. for which of the following data discovered after the medication was administered, should the nurse file an incident report.?

vile sat out for 2 hours at room temperature before administration

A client is receiving digoxin (Lanoxin) for heart failure. Which of the following clinical manifestations is an early rather than late sign of medication toxicity?

vommiting