CH 3 PREPU

Some clients are excessively responsive to either the primary or secondary effects of a drug. This is known as hypersensitivity, and it may result from a pathological or underlying condition. Which are examples of hypersensitivity? Select all that apply. - a pregnant client who takes phenytoin and delivers a child with birth defects - A client who has chronic renal failure and is taking diphenhydramine - A client on postoperative day 2 from a prostatectomy who takes ipratropium - an anaphylactic reaction to seafood

- A client who has chronic renal failure and is taking diphenhydramine - A client on postoperative day 2 from a prostatectomy who takes ipratropium

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.) - a 29-year-old client receiving prenatal care in her first trimester of pregnancy - a 65-year-old client being treated in the intensive care unit for multi-organ dysfunction syndrome - a 37-year-old client who is taking fertility drugs - a 51-year-old post-menopausal client who is immunocompromised following bone marrow transplant - an 88-year-old client with chronic heart failure and peripheral edema

- a 29-year-old client receiving prenatal care in her first trimester of pregnancy - a 37-year-old client who is taking fertility drugs

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of: A. poisoning. B. allergies. C. anaphylaxis. D. hypersensitivity.

A. poisoning.

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of: A. secondary actions. B. drug allergy. C. hypersensitivity. D. primary actions.

A. secondary actions.

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response? A. "I'll make sure to pass that information along to the pharmacy." B. "Do you remember what happened the last time you received penicillin?" C. "We'll make sure that none of your antibiotics are similar to penicillin." D. "Are there other antibiotics that have worked well for you in the past?"

B. "Do you remember what happened the last time you received penicillin?"

What does the nurse need to do when there is any indication of an allergic reaction in clients? A. Reduce the risk of adverse effects during drug therapy. B. Maintain the client's safety during drug therapy. C. Obtain early warning of noncompliance in drug therapy. D. Increase the effectiveness of a specific medication.

B. Maintain the client's safety during drug therapy.

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug? A. Atropine-like (cholinergic) effects B. Stevens-Johnson syndrome C. Neuroleptic malignant syndrome (NMS) D. Parkinson-like syndrome

B. Stevens-Johnson syndrome

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? A. The man may be allergic to aspirin B. The man may be experiencing nephrotoxic effects of aspirin C. The man may be experiencing a paradoxical effect of aspirin D. The man may be experiencing liver toxicity from the aspirin

B. The man may be experiencing nephrotoxic effects of aspirin

A nurse is alert for any adverse effects of a medication on a client. This alertness in assessment is essential in providing for: A. decrease in effectiveness of medication. B. client safety. C. increase in non-compliance. D. decrease in effectiveness of the drug regimen.

B. client safety.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body? A. decreased gastric motility. B. decreased activity. C. decreased glomerular filtration rate. D. decreased cognition.

C. decreased glomerular filtration rate.

The pharmacology instructor explains to the students that adverse effects can be extensions of: A. anticholinergic responses to the drug. B. anaphylaxis. C. primary action of a drug. D. fourth level effects.

C. primary action of a drug.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do? A. Facilitate cardiac monitoring. B. Prepare the client for dialysis. C. Place the client on protective isolation. D. Monitor laboratory blood values.

D. Monitor laboratory blood values.

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess? A. Dry mouth and urinary hesitation B. Hypoglycemia C. Hyperthermia D. Parkinsonian symptoms

D. Parkinsonian symptoms

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's: A. liver enzyme levels. B. renal function. C. cognition. D. potassium levels.

D. potassium levels.

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration? A. hypoglycemia B. hyperkalemia C. liver injury D. renal injury

D. renal injury

What would lead the nurse to suspect that a client has developed a blood dyscrasia related to drug therapy? (Select all that apply.) - anemia - thrombocytopenia - headache - leukocytosis - dilute urine - sore throat

- anemia - thrombocytopenia - sore throat

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? (Select all that apply.) - drowsiness after taking an antihistamine - spontaneous bleeding after taking an anticoagulant - dizziness after starting an antihypertensive - diarrhea after taking an antibiotic

- spontaneous bleeding after taking an anticoagulant - dizziness after starting an antihypertensive

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects? A. Be sure to drink plenty of fluids to prevent dehydration. B. Avoid strenuous exercise to minimize calorie loss C. Eat a low-fiber diet to prevent constipation. D. Try to stay as warm as possible to prevent chilling.

A. Be sure to drink plenty of fluids to prevent dehydration.

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding? A. The client is allergic to the penicillin and should stop taking it immediately. B. The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays. C. This is a normal reaction for anyone who takes antibiotics and is nothing to be concerned about. D. The client had a reaction to something in the environment while working in the yard and should take an antihistamine.

B. The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action? A. monitoring the client's vital signs at least every five minutes B. protecting and maintaining the patency of the client's airway C. administering intravenous antihistamines as prescribed D. providing reassurance to the client

B. protecting and maintaining the patency of the client's airway

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug? A. hyperthermia B. urinary hesitancy C. urinary urgency D. profuse sweating

B. urinary hesitancy

Preoperative atropine belongs to what classification of drugs? A. benzodiazepine B. cholinergic C. diuretic D. anticholinergic

D. anticholinergic

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a: A. basis for the nursing care plan. B. prominent part of client teaching. C. basis for planning the medication regimen. D. contraindication for the use of certain medications.

D. contraindication for the use of certain medications.

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could: A. affect the eighth cranial nerve of the fetus. B. affect the liver of the fetus. C. affect the kidneys of the fetus. D. damage the immature nervous system of the fetus.

D. damage the immature nervous system of the fetus.

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize? a. Initiate emergency resuscitation measures. b. Provide supportive care to manage fever and inflammation. c. Administer naloxone as prescribed. d. Administer subcutaneous epinephrine as prescribed.

b. Provide supportive care to manage fever and inflammation.

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform? A. Ask the client, "What happens when you take a dose of tetracycline?" B. Document an allergy to tetracycline in the client's health record C. Ask the client, "Are you allergic to any other antibiotics, or just tetracycline?" D. Educate the client about antibiotics that are alternatives to tetracycline.

A. Ask the client, "What happens when you take a dose of tetracycline?"

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do? A. Discontinue the drug immediately as ordered. B. Encourage the use of MedicAlert identification. C. Administer antipyretics as ordered. D. Administer prescribed epinephrine subcutaneously.

A. Discontinue the drug immediately as ordered.

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? A. Drugs cause unexpected or unacceptable reactions despite screening and testing. B. Any effect results from the alteration of several chemical factors. C. Many drugs are potentially harmless if used correctly. D. Most reactions occurring with present-day therapy are less severe than before.

A. Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan? A. Safety measures B. Educating about the signs and symptoms of stroke C. The importance of a low-stimulation environment D. The need for follow-up blood tests

A. Safety measures

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client? A. Techniques for providing safe and effective mouth care B. The importance of sitting upright while eating and for 30 minutes afterwards C. The rationale for prophylactic antibiotics D. The rationale for taking probiotics for the duration of treatment

A. Techniques for providing safe and effective mouth care

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion? A. The client's blood urea nitrogen level and creatinine clearance rate B. The client's body mass index and hydration status C. The client's albumin, bilirubin, AST and ALT levels D. The client's fasting blood glucose level

A. The client's blood urea nitrogen level and creatinine clearance rate

Which skin condition would be most likely to cause increased systemic absorption of a topical medication? A. severe sunburn B. port wine stain of the face C. rosacea D. multiple nevi

A. severe sunburn

A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection? A. "I've been exhausted and overworked for the past several weeks." B. "I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess." C. "I've been taking aspirin several times a day for the past few months for my back pain." D. "For the last 2 months I have been taking a water pill that the doctor prescribed."

B. "I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse? A. "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately." B. "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression." C. "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately." D. "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication."

B. "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects? A. 40-year-old male client who has a history of intravenous drug use and who has endocarditis B. 60-year-old female client who is tetraplegic and who has developed a sacral pressure ulcer C. 20-year-old female client who has been diagnosed with a chlamydial infection D. 6-year-old girl who has a urinary tract infection and who is accompanied by her parents

C. 20-year-old female client who has been diagnosed with a chlamydial infection

A client with a history of schizophrenia was admitted during a psychotic episode and has received several doses of haloperidol. The client's cognitive status has stabilized but assessment reveals clammy skin, respiratory rate of 31 breaths per minute, and heart rate of 102 beats per minute. What is the nurse's best action? A. Arrange for cardiac monitoring. B. Check the client's most recent potassium level. C. Assess the client's blood glucose level. D. Perform a mental status assessment.

C. Assess the client's blood glucose level.

A client comes to the clinic reporting tinnitus and difficulty hearing. What medication in the client's current regimen should the nurse suspect as causing the symptoms? A. Hydrochlorothiazide B. Acetaminophen with codeine C. Erythromycin D. Insulin

C. Erythromycin

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels? A. It is necessary to regularly test for blood-drug incompatibilities that may develop during treatment. B. It is needed in order to confirm the client's adherence to the drug regimen. C. It is necessary to ensure that the client's drug levels are therapeutic but not toxic. D. It is needed to determine if additional medications will be needed to potentiate the effects of lithium.

C. It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing? A. Ototoxicity B. Nephrotoxicity C. Neurotoxicity D. Hepatotoxicity

C. Neurotoxicity

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform? A. Check the client's urine output. B. Assess the client's level of orientation. C. Review the client's most recent potassium level. D. Check the client's blood glucose level.

C. Review the client's most recent potassium level.

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time? A. The client probably has the onset of Alzheimer disease. B. All elderly clients have dementia at some point in life, and the medication is making it worse. C. This may be coincidental, and the memory loss may be attributed to changes with aging. D. The nurse should not be concerned. Medication is not the cause of the client's confusion.

C. This may be coincidental, and the memory loss may be attributed to changes with aging.

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity? A. visual disturbances B. ringing noise in the ears C. a decrease in urine output D. yellowing of the skin

C. a decrease in urine output

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration? A. protocols B. body system affected C. adverse effects D. route of administration

C. adverse effects

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low? A. loss of appetite B. increased urination C. cold, clammy skin D. fruity breath odor

C. cold, clammy skin

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication? A. additive B. toxic C. synergistic D. anaphylactic shock

D. anaphylactic shock

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? A. the cost of the brand-name drug compared with the generic form B. a list of pharmacies where the drug can be obtained C. statistics related to phase III of testing for the prescribed drug D. measures to alleviate any discomfort associated with adverse effects

D. measures to alleviate any discomfort associated with adverse effects

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client? A. immunotoxicity from the ibuprofen B. anaphylactic reaction to the ibuprofen C. allergic reaction to the ibuprofen D. ototoxicity from the ibuprofen

D. ototoxicity from the ibuprofen