Exam 1 NUR 325

Metabolism

All of the chemical reactions that occur within an organism - changes the into a potent form of the drug - primarily takes place in the liver -biotransformation

A nurse is performing a mental status examination (MSE) on a client who had a new diagnosis of dementia. Which of the following components should the nurse include? Grooming long-term memory support systems affect presence of pain

Grooming, Long-term memory, affect

Tolerance

body's decrease response to a drug it receives over a period of time

A nurse is planning care for a client who is postoperative. Which of the following statements about pain management should the nurse consider when implementing client care? - Use of analgesics will eventually lead to addiction - Each client's expression of pain may be different and individualized. - Patient-controlled analgesia (PCA) offers a constant level of opioids within therapeutic range - Pain level and pain tolerance can be assessed using a scale from 0-10. - The client will express the feeling of pain both verbally and nonverbally.

- Each client's expression of pain may be different and individualized. - Patient-controlled analgesia (PCA) offers a constant level of opioids within therapeutic range - Pain level and pain tolerance can be assessed using a scale from 0-10. - The client will express the feeling of pain both verbally and nonverbally.

untreated chronic pain

fear, anger, depression, anxiety, difficulty maintaining relationship - ↓gastric motility, urine output, tidal volume , impaired cognitive function , vital signs normalize

what factors affect distribution to different parts of the body?

-Movement of drug by circulatory system to intended site of action -permeability of cell goes back to blood brain barrier -rich blood supply →highest level of drug (liver, kidneys, heart) - Non-rich→ non-high levels of blood (bones)

pain

-Pain is whatever the experiencing person says it is, existing whenever he/ she says it does - Patient report is the most reliable and accepted indicator of pain - pain is always SUBJECTIVE

brand-name drug

-Starts with a capital letter -commercial name - Tylenol

generic-name drug

-a drug that contains the same active ingredients as a brand-name drug -all lower case -acetaminophen

adverse drug reaction

Any unexpected, unintended, undesired, or excessive response to a drug given at therapeutic dosages

A nurse is caring for a client who requires cold applications with an ice bad to reduce the swelling and pain of an ankle injury. Which of the following actions should the nurse take ? - Apply the bag for 30 min at a time - reapply the bag for 10 min after removing it - allow room for some air in it. -Place the bad directly on the skin

Apply the bag for 30 min at a time - The nurse should leave the bad in place for 30 min, but should check the clients skin after 15 min to make sure there is no adverse effects.

A nurse is assessing a client who has ataxia. Which of the following actions should the nurse take to evaluate the client's ability to safely ambulate? A. observe for the presence of Kernig's sign B. Perform a Romberg's test C. Check the function of cranial nerve V D. INspect for the presence of clubbing

B. Perform a Romberg's test - The nurse should perform a Romberg's test to check the client's ability to maintain upright position without swaying when standing with feet close together, with eyes open and with eyes closed. The nurse must stand close enough to prevent the client from falling

A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen? A. Take the medication with an aspirin to increase effectiveness B. Take the medication with food C. Taking the maximum dose will offer stroke prevention D. sustained- release forms may be crushed for easier administration

B. Take the medication with food

A nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? A. Expect ringing in your ears B. Take the medication with food C. Store the medication in the fridge D. Monitor for weight loss

B. Take the medication with food.

A nurse is caring for a client who has dementia. Which of the following interventions should the nurse include in the plan for care? A. provide a cognitively stimulating environment B. rotate staff to prevent caregiver role strain C. Limit the client's choices for daily activities D. Use the confrontation to manage negative behavior

C. Limit the client's choices for daily activities

A nurse is caring for a client who is cognitively impaired. Which of the following rooms will provide a therapeutic environment for this client? A. A room adjacent to the nurse station B. A room without a window C. a room with dim lighting D. A room containing personal belongings

D. A room containing personal belongings

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect. A. Decrease auditory and visual acuity B. Decreased display of emotions C. Personality traits that are opposite or original traits D. Forgetfulness gradually progressing to disorientation

D. Forgetfulness gradually progressing to disorientation

Rates of release: EC ER SR/XR XL

EC- extended release/ enteric coats (intestines) ER- extended release(over a period of time) SR/ XR- sustained release XL- extended length sustained action

A nurse is caring for a group of clients on a med-sug unit. Which of the following situations requires that the nurse wear gloves. A. Emptying urine from an indwelling urine collection bag B. providing oral care C. changing ostomy pouch D. delivering a food try to a client who has AIDS E. Placing oral medication tablets into a clients hand

Emptying urine from an indwelling urine collection bag, providing oral care, changing ostomy pouch

A nurse is caring for a client who has rheumatoid arthritis and ask if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? - Report of recent migraine headaches - History of gastric ulcers - Current diagnosis of glaucoma - Prior reports of amenorrhea

History of gastric ulcers

What are the 3 ways that a drug can be delivered parenterally?

IV- intravenous (fastest) Sub Q- subcutaneous IM- intramuscular *action varies depending on the absorption, water soluble, and good circulatory flow

Why is it important to understand peak and trough levels?

In order to maintain constant therapeutic effect. -often used with blood thinners

Describe the most severe type of adverse drug reaction and how the patient could present in this case (clinical manifestations)

Most severe: Anaphylactic shock : exaggerated response of the body's immune system to a drug - previous exposure →increase sensitivity

Trough level

Point in time when the drug it at its lowest level in the body

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment. - Blood pressure - Apical heart rate - Respiratory rate - Temperature

Respiratory rate

A nurse is monitoring a client who is postoperative and unable to respond to questions. Which of the following nonverbal behaviors should the nurse identify as an indication that the client has pain? ( select all that apply) -restlessness -grimacing -moaning -clenching -drowsiness

Restlessness, Grimacing, Clenching

A nurse is caring for a client who is receiving heat applications using an aquathermia pad. Which of the following actions should the nurse take when applying the pad? -Set the pad's temperature to 47.2 degrees C (114F) - Stop the treatment if the client's skin become red - Leave the pad in place for at least 40 min. - Use safety pins to keep the pad in place

Stop the treatment if the client's skin becomes red - Reactions such as unusual pain or redness are indications for removing the pad and notifying the provider.

Clinical Manifestations of anaphylactic shock

Swelling of eyes, face, mouth, throat, difficulty breathing, wheezing, rapid HR, low BP ABC, epinephrine, Benadryl

What are the different types of oral medications forms?

Tablet capsule powder liquid

Onset

The amount of time it takes for a drug to demonstrate therapeutic response

Pharmacokinetics

The process by which drugs are absorbed, distributed within the body, metabolized, and excreted.

A nurse is caring for a client who is postoperative. The nurse should base her pain management interventions primarily on which of the following methods of determining the intensity of the client's pain? - Vital sign measurement - The clients self-report of pain severity -Visual observation for nonverbal signs of pain

The client's self report of pain severity. - Nurses cannot measure pain objectively , it is standard practice to accept that pain is what the client says it is and to intervene accordingly.

Therapeutic effect

The desired or intended effect of a particular drug.

Peak Level

The maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring. (highest level in body)

Absorption

The movement of the drug from the site of administration into the bloodstream and various tissues of the body -How the drug is administered affects the absorption

Peak

Time it takes for a drug to demonstrate its full therapeutic response

additive effect

Two drugs with similar actions are taken for an increased effect 1+1=2

off-label

Use of prescription drug to treat a condition for which the drug has not received U.S. FDA approval - Use of medication for intended purpose but still has therapeutic effect induced ex: Benadryl as a sleep aid

Precautions/Contraindications

a precaution for a drug is an adverse effect which might come with the drug and there has to be a decision on if it is worth it to take the drug. Contraindication is when the patient does not suggest the drug because of the serious effects of it.

What does the nurse need to consider when giving an opioid antagonist to a patient who is opioid-dependent?

abstinence syndrome: withdraw -hypertension -vomiting -tremors

transdermal administration

application of a drug in patch form, which is then absorbed into the blood through the skin ex. skin, eyes, ears, lungs, rectum, nose, vaginal

teratogenic

can cause fetal malformation A,B,C,D,X

cumulative effect

condition that occurs when the body cannot metabolize a drug before additional doses are administered - The condition in which repeated administration of a drug may produce effects that are more pronounced than those produced by the first dose

Contraindications

drugs that a provider should not prescribe because they have potential to cause serious or life-threatening adverse drug reactions

precautions

drugs that have potential to cause adverse drug reactions in certain populations, or in combination with other drugs or certain foods.

synergistic effect

interaction of two or more medicines that results in a greater effect than when the medicines are taken alone 1+1 = >2

Duration

length of time the drugs therapeutic effect last, without additional doses

Rates of absorption

liquid (fastest)→suspension→ powder→ capsule →tablet →coated tablet → enteric- coated tablet

Differentiate between pain classifications

nociceptive and neuropathic pain

Drug-Food Interactions

occur when a drug reacts with a food - grapefruit juice can decrease enzymatic metabolism of certain drugs, increasing potency and risk for toxicity ex: grapefruit juice- Zoloft Wine/ processed meats- Marplan

antagonistic effect

one drug interferes with the action of another 1+1= <2

excrete

to pass waste products of metabolism out of the body -feces, urine, sweat,exhaled air, vomit

Toxicity

when a client receives drugs in excessive dosages, resulting in negative physiological effects. - provide lowest effective dose when possible to achieve therapeutic effects - may be irreversible or life-threatening

Biotransformation

when a drug is chemically altered during metabolism → metabolite metabolism in the LIVER- excrete in the KIDNEYS

drug-drug interactions

when the effect of a medication is changed, enhanced, or diminished when taken with another drug, including herbal substances

untreated acute pain

↑ vitals, ↑cortisol

A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? - "I signed up for my swimming class" - "I've been taking an antacid to help with my indigestion" - "I've lost 2 lbs since my appointment 2 weeks ago" - "The naproxen is easier to take when I crush it and put it in applesauce"

"I've been taking an antacid to help with my indigestion"

A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? - Initiate oxygen therapy to support respiratory function - administer epinephrine to increase blood pressure -Give diphenhydramine to stop histamine release - Establish and maintain an open airway to ensure oxygenation -Administer a drug agonist to neutralize the allergic reaction

- Initiate oxygen therapy to support respiratory function - administer epinephrine to increase blood pressure -Give diphenhydramine to stop histamine release - Establish and maintain an open airway to ensure oxygenation

A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? - clients can achieve desired effects with the use of lower dosages - taking 2 drugs together can reduce the effects of 1 or both drugs - taking 2 drugs together can potentiate the effects of 1 or both drugs - the 2 drugs can produce an action neither would have produced alone - both drugs have similar actions

- clients can achieve desired effects with the use of lower dosages - both drugs have similar actions

recognize when an individual has pain

- grimace, fidgeting, guarding, restlessness, change in activity, crying Pain assessment scales: - location - intensity - quality - onset/duration - alleviating factors - effect on function - comfort

What physiological factors are important to consider when administering drugs to the aging patient?

-most drugs are metabolized in the liver and kidney and older patient have more impairments to those organs - all the drugs they take and those adverse effects that come with them - decrease in muscle mass, ↓ circulation, ↓digestion and metabolism

What is the difference between first and second generation NSAIDs?

1st gen inhibit the action of COX-1 and COX-2 -has patient who have GI bleeds 2nd gen inhibit COX-2 effects -there is an ↑ in vasodilation leading to heart attacks or strokes -decreased gastric effects ---would use for patients who have history of GI bleed

A nurse is performing a neurological assessment for a client who has head trauma. Which of the following assessments will give the nurse information of cranial nerve III? A. Instruct the client to look up and down without moving his head B. Observe the client's ability to smile and frown C. have the client stand with his eyes closed and touch his nose D. Ask the client to shrug his shoulders against passive resistance

A. Instruct the client to look up and down without moving his head

A nurse is caring for a client who has late-stage alzheimer's disease and is hospitalized for treatment of pneumonia. During the night shift, the client is found climbing into the bed of another client who becomes upset and frightened. Which of the following actions should the nurse take first? A. assist the client to the correct room B. place the client in restraints C. reorient the client to time and place D. Move the client to a room at the end of the hall

A. assist the client to the correct room

A nurse is caring for a client who is 1 day postoperative following gynecologic surgery and reports incisional pain. Which of the following actions should the nurse first take? -determine the time the client last received pain medication -measure the client's vital signs, including temperature - ask the client to rate their pain on a scale 0-10

Ask the client to rate her pain on a scale from 0-10 -using evidence based practice, the nurse should first determine the severity of the client's pain by using a standard of pain scale. Then the nurse can plan the appropriate interventions.

A nurse is applying a cold compress for a client who has pain and minor swelling in a sutures laceration on the forearm. Which of the following assessments should the nurse use to determine whether the treatment is effective? - inspecting the site for reduced swelling -monitoring the client's pulse rate - asking the client to rate the pain

Asking the client to rate the pain -Pain is a subjective experience. The nurse should encourage the client to quantify the pain on a pain scale before, during, and after cold application to determine its effectiveness.

A nurse is caring for a group of older adult client's. Which of the following manifestations indicates one of the client's is experiencing delirium? A. A client wants to know the current time while there is a clock on the wall B. A client attempts to climb out of bed and repeatedly states she must get home C. a client requires extra blanket when the thermostat in the room indicates it is 75 F D. A client refuses to get out of bed and has no motivation to attend to daily hygiene

B. A client attempts to climb out of bed and repeatedly states she must get home

A nurse is caring for a client who had a history of dementia. The client is alert and oriented to person, place, and time, and has advance directives. The client is scheduled for a procedure that requires informed consent. Which of the following persons should sign the informed consent? A. The client's partner B. The client C. The client's daughter, who is the primary caregiver D. The client's soon who is durable power of attorney

B. The client

Pharmacodynamics

Biochemical changes that occur in the body because of taking a drug

You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a patient's postoperative pain. Which of the following describes the action of an agonist on a receptor? A. Destroys the receptor B. Competes with the receptor C. Activates the receptor D. Block the receptor

C. Activates the receptor

You are helping a client learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning? A. verbally quiz a family member. B. instruct the client to complete a written test C. have the client demonstrate an insulin injection D. ask the client several key questions about the procedure.

C. have the client demonstrate an insulin injection

A nurse is completing a client's history and physical examination. Which of the following information should the nurse consider subjective data? A. Blood pressure B. Cyanosis C. Nausea D. petechiae

C. nausea

A nurse is caring for a client who requests prescription pain medication. Which of the following should the nurse perform first? - Reposition the client - Administer the medication - Determine the location of the pain - Review the effects of the pain medication

Determine the location of pain

neuropathic pain

NO DIRECT CAUSE, nerve pain , CNS - amputation, chronic , burning , shooting, tingling

nociceptive pain

NORMAL PAIN - localized, feels in the body - types: somatic visceral, cutaneous - physiology: transduction, transmission, perception, modulation

A nurse is preparing to administer morphine IV to a client. Which of the following medications should the nurse plan to have available? - Flumazenil - Naloxone - Protamine - Neostigmine

Naloxone

A nurse is performing a pain assessment for a client who is alert. The nurse should recognize that which of the following measures is the most reliable indicator of pain? -vital signs -self-report of pain - severity of the condition

Self-report of pain

first pass effect

The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream. - decrease bioavailability, goes through the liver during during first pass and makes the drug less potent - ONLY ORAL DRUGS

Primary care providers prescribe drug dosages for children using which of the following information? A. body surface area B. age C. weight D. developmental level E. drug properties

A. body surface area B. Age C. weight E. drug properties

A nurse is teaching a client who has a new prescription for aspirin to treat rheumatoid arthritis. The nurse should include to monitor for which of the following adverse effects of this medication? A. Constipation B. Bleeding C. Blurred vision D. Insomnia

B. Bleeding Aspirin can cause bleeding, tinnitus, gastric ulceration, nausea, and heartburn. Should monitor for black tarry stools.

The nurse is making a home visit with a client diagnosed with Alzheimer's disease and the clients partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain? A. The partner has placed locks at the top of the doors leading to the outside B. the partner has hired a house cleaner C. The partner has lost 20 lb in the past 2 months D. The partner redirects the client when the client is frustrated

C. The partner has lost 20 lb in the past 2 months

You are talking with a client about taking tetracycline along with an antacid. You tell the client not to take these two drugs at the same time because the antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is A. an allergic reaction B. a synergistic effect C. an antagonistic effect D. an adverse reaction

C. an antagonistic effect

The family of an older client brings him to an emergency department after finding him wandering outside. During the initial assessment the nurse notes that the client flinches when she palpates him abdomen yet responds to questions only by nodding and smiling. Which of the following factors should the nurse identify as a likely explanation for the clients behaviour? A. He is hard of hearing B. pain C. confusion D. Language barrier

C. confusion

A nurse is caring for a client using active listening skills. Which of the following actions should the nurse take ? A. sit side-by-side with the client B. have a pen and paper handy C. use intermittent eye contact D. lean back in the chair

C. use intermittent eye contact

A client is taking aspirin, what should the nurse include in the teaching? A. take the tablets on an empty stomach B. expect stools to turn black C. anticipate the tablets to smell like vinegar D. Monitor for tinnitus

D. Monitor for tinnitus

A client asks you about the difference between generic drug and a trade or brand-name drug. Which of the following are true regarding generic drugs? - Have the potential for abuse and dependence - have the same chemical composition as the brand-name drug - may have several brand names -may have several generic names -are usually less expensive than a brand-name drug

- have the same chemical composition as the brand-name drug -may have several brand names -are usually less expensive than a brand-name drug

risk factors for experiencing pain

- infants and children (nonverbal/ little verbal) -older adults (tolerance, medication, not wanting to be a burden) -specifical populations - gender, social factors, cultural/ religion, abuse disorders ---inadequate treatment of pain - women - chronic conditions - acute or traumatic injury - medical procedures - individuals who can't communicate pain

The nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take ? - offer the client a back rub -remind the client to use incisional splinting -identify the client's pain level -assist the client to ambulate -change the client's position

- offer the client a back rub -remind the client to use incisional splinting -identify the client's pain level -change the clients position

What safety issues should the nurse be aware of related to opioid agonists? (specific focus on dependence, withdrawal, and abuse)

- use opioids as needed and as prescribed, take when needed -dependency, increase vital signs, orthostatic hypotension, fall risk, lower BP, nausea , take with food, drowsy, no driving or heavy machinery

What must be considered about drug levels in the body if a patient has decreased liver and/or kidney function?

-adverse of toxic effects of the drug -how people take the drug -who takes the drug

Pain management- Non-pharmacological interventions

-massage -positioning -splinting -thermal interventions -mind-body therapies -exercise -TENS Transcutaneous electrical nerve stimulation -acupuncture - breathing techniques

acute pain

-pain that is felt suddenly from injury, disease, trauma, or surgery - new -spiked vital signs

A client is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine ? -take it with food -rise slowly from sitting or reclining -take it on a fixed schedule -increase fluid and fiber intake -do not take it before driving

-take it with food -rise slowly from sitting or reclining -increase fluid and fiber intake -do not take it before driving

half-life

-time it takes for a drug that enters the body to decrease in amount by half -represents how quickly and effectively a drug metabolizes and excretes - meds with short half lives need higher doses (dosage and frequency is influenced by this)

breakthrough pain

-when pain has been managed with pain medication, then the pain breaks through - does become very common when closer to next does of medication and when it becomes available - acute exacerbation of existing pain - when it goes up uncharacteristically

A nurse is caring for a client who had dementia. When performing a Mental Status Examination (MSE) the nurse should include which of the following data? Ability to perform calculations Coping skills Recall ability long-term memory level of orientation

Ability to perform calculations Recall ability Recall ability long-term memory level of orientation

A nurse is caring for a group of clients. The nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following? A. keeping an appointment with a client B. allowing a new mother to hold her stillborn infant C. confirming that a client going for surgery has signed a consent form D. refusing to disclose infromation about a client to the media

A. keeping an appointment with a client

An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with age? A. reduced hepatic blood flow B. increase glomerular filtration rate C. reduced body fat D. increased gastric motility

A. reduced hepatic blood flow

A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain the glaucoma is a contraindication for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their potential for which of the following? A. Serious adverse reactions B. Drug tolerance C. Drug dependence D. Interactions with other drugs

A. serious adverse reactions

A nurse is teaching the family of an older client who had a new diagnosis of dementia. Which of the following statements should the nurse include in the teaching ? A. "Dementia is characterized by a sudden onset of confusion" B. " An altered level of consciousness is associated with dementia C. " The signs of dementia are progressive and irreversible" D. "Dementia can be triggered by a high fever or dehydration"

C. " The signs of dementia are progressive and irreversible"

A nurse is caring for a client who has dementia due to Alzheimer's disease and was admitted to a long-term care facility following the death of her partner of 40 years. The client states "I want to go home; my husband is waiting for me to cook dinner." Which of the following responses by the nurse is appropriate? A. "This is where you live now" B. "This is a safer place for you to live here" C. "Tell me what you like to cook for dinner"

C. "Tell me what you like to cook for dinner"

A nurse in an acute care facility is admitting an older adult client who has dementia due to Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his wife. Which of the following interventions is the nurse's priority? A. Recommend that the partner place the client in a long-term care facility B. Suggest that the partner see a counselor to help him cope with his exhaustions C. Ask the partner to talk about his difficulties in caring for the client D. Tell the partner to call a family meeting to get help.

C. Ask the partner to talk about his difficulties in caring for the client

A nurse in a long-term facility is caring for a client who has late stage Alzheimer's disease. Which of the following actions should the nurse include in the plan of care? A. Post a written schedule of daily activities B. use an overhead loud speaker to announce events C. provide a consistent daily routine D. Allow the client to choose free-time activities

C. provide a consistent daily routine

A nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication? A. Tinnitus B. Muscle pain C. hyperglycemia D. jaundice

D. Jaundice

A nurse is planning to administer butorphanol to a client who is in labor. Which of the following medications should the nurse plan to have available to reverse the action of this medication. A. Protamine B. Diphenhydramine C. Atropine D. Naloxone

D. Naloxone

A nurse on a long-term care unit is creating a plan of care for a client who has alzheimer's disease. Which of the following interventions should the nurse include in the plan? A. Rotate assignment of daily caregivers B. Provide an activity schedule that changes from day to day C. Limit time for the client to perform activities D. Talk the client through tasks one step at a time

D. Talk the client through tasks one step at a time

A nurse is monitoring a client who took an overdose of acetaminophen 72 hr ago. The nurse should identify which of the following findings as a manifestation of acetaminophen poisoning? A. constipation B. Xerostomia C. Tinnitus D. Vomiting

D. Vomiting

A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? A. tolerance to the drug B. drug interaction C. drug toxicity D. dependence on the drug

D. drug toxicity - develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. dosage should be reduced if toxicity occurs.

a provider prescribes prednisone for a client who has type 1 diabetes mellitus. Recognizing the risk for an adverse drug reaction to the prednisone , which of the following precautions should the primary care provider take for this client ? A. reduce the insulin dose B. increase carbohydrate intake C. reduce the prednisone dose D. increase serum glucose monitoring

D. increase serum glucose monitoring

A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin? A. dyspnea B. constipation C. calf pain D. petechiae

D. petechiae

chronic pain

episode of pain that lasts for 6 months or longer; may be intermittent or continuous -persistent pain - gradual