Hesi Pharm

A male client reports to the nurse that he is experiencing gastrointestinal distress from a high dose of corticosteroid and is planning to stop taking the medication. In response to the clients statement, which nursing action is most important for the nurse to implement? A.) Advise the client that the medication should be stopped gradually rather than abruptly B.) encourage the client to take the medication with food to decrease GI distress C.) Assess the client for other indications of adverse effects of corticosteroid use D.) review the clients dosing schedule to ensure he is taking the prescribed amount

A.) Advise the client that the medication should be stopped gradually rather than abruptly

A client is receiving rifampin, an antitubercular medication. Which statement by this client should prompt the nurse to notify the healthcare provider of a potential problem? A.) Reports that the sclera are yellow B.) Voids urine that is orange colored C.) uses condoms for contraception D.) complains of persistent tinnitus

A.) Reports that the sclera are yellow

The nurse is planning discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. What action should the nurse plan to include in the discharge teaching? A.) Teach the client self injection skills for daily subcutaneous administration B.) provide information on increasing medication dosage if ketoacidosis occurs C.) demonstrate how to select dose based on before meal blood sugar readings D.) explain to the family how to inject this medication for severe hypoglycemia

A.) Teach the client self injection skills for daily subcutaneous administration

A client is receiving orlistat as a part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication? A.) body mass index B.) depression screening C.) daily calorie count D.) serum protein levels

A.) body mass index

An adolescent with major depressive disorder has been taking duloxetine for the past 12 days. Which assessment finding requires immediate follow-up? A.) describes life without purpose B.) states is often fatigued and drowsy C.) complaint of nausea and loss of appetite D.) exhibits an increase in sweating

A.) describes life without purpose

Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home health nurse . How should the nurse respond? A.) determine if the full course of the initial prescription of medication was taken B.) advise that the infection has additional medications will be needed C.) explain that the diarrhea may be an adverse effect that requires further evaluation D.) offer instructions about the use of an over-the-counter antidiarrheal medication

A.) determine if the full course of the initial prescription of medication was taken

An older adult client with restlessness syndrome begins taking melatonin at bedtime. When evaluating the effectiveness of the herb, which client assessment should the nurse complete? A.) determine sleep patterns B.) palpate pedal pulse volume C.) assess anxiety level D.) observe for peripheral edema

A.) determine sleep patterns

Before administering a laxative to a bed fast client, it is most important for the nurse to perform which assessment ? A.) determine the frequency and consistency of bowel movements B.) observe the skin integrity of the clients rectal and sacral areas C.) assess the clients strength in moving and turning the bed D.) evaluate the clients ability to recognize the urge to defecate

A.) determine the frequency and consistency of bowel movements

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching? A.) ensure a negative pregnancy test result 2 weeks before therapy B.) begin therapy 1 week before the next normal menstrual cycle C.) use condoms and a back up method of birth control to prevent pregnancy D.) call the healthcare provider immediately if there is a chance of conception

A.) ensure a negative pregnancy test result 2 weeks before therapy

To evaluate the effectiveness of a clients prescription for rosuvastatin, which action should the nurse implement ? A.) evaluate the clients serum cholesterol level results B.) measure skin folds for body mass index calculations C.) obtain the clients heart rate and blood pressure D.) review the clients daily food and weight log

A.) evaluate the clients serum cholesterol level results

The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and is now prescribed adalimumab. Which instructions should the nurse provide the client? A.) have a chest x-ray prior to your first dose B.) avoid crowds and people who are sick C.) obtain routine vaccinations as scheduled D.) undergo annual eye examinations

A.) have a chest x-ray prior to your first dose

The nurse assesses a client with intermittent claudication who is receiving pentoxifyline. Which assessment should the nurse perform to determine the effectiveness of the medication? A.) monitor numeric pain scale B.) auscultate bowel sounds C.) measure hourly urinary output D.) evaluate level of consciousness

A.) monitor numeric pain scale

A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug ? A.) notify your healthcare provider immediately if involuntary movements develop B.) check blood pressure daily and notify the healthcare provider if it increases C.) wear sunscreen when going outside to prevent effects of sun sensitivity D.) drink water frequently throughout the day as the medication increases thirst

A.) notify your healthcare provider immediately if involuntary movements develop

The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first? A.) respiratory rate B.) blood pressure C.) pulse rate D.) temperature

A.) respiratory rate

The healthcare provider prescribes Ceftazidime 1,500 mg IV every 12 hours. The available vial is labeled, " Ceftazidime 1 gram", and the instruction for reconstitution state, "For IV use add 10mL sterile water for injection. Concentration after reconstitution = 100mg/mL. How many mL should the nurse administer?

15

A client receives a prescription for ciprofloxacin 400mg IV every 12 hours, which is to be infused over an hour. The IV bag contains ciprofloxacin 400mg in dextrose 5% in water (D5W) 200 mL. How many mL/hr should the nurse program the infusion pump to deliver ?

200mL/hr

The nurse is caring for an older client with multiple comorbidities. Which medication should the nurse recognize as increasing the clients risk for fractures? A.) metformin B.) Lansoprazole C.) amlodipine D.) simvastain

B. Lansoprazole

The nurse if providing discharge instructions to a client who has been prescribed gabapentin 300mg by mouth three times a day for post-herpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider? A.) sexual dysfunction B.) gastric irritation C.) rapid weight gain D.) photosensitivity

B.) gastric irritation

A client is taking clozepam, benztpropine, haloperidol, and divalproex. The nurse suspects that the client is experiencing akathisia because the client is rocking back and forth in the chair and having difficulty still. Which medication is most likely to be the cause of this condition? A.) benzotropine B.) haloperidol C.) clonazepam D.) divalproex

B.) haloperidol

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report? A.) nausea B.) involuntary movements C.) diarrhea D.) unusual irritability

B.) involuntary movements

When caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor? A.) calcium B.) osmolality C.) glucose D.) platelets

B.) osmolality

A client is receiving tamsulosin, an alpha adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide? A.) use a twice a week dosing schedule B.) stand and sit up slowly C.) take the medication early in the day D.) reduce daily fluid intake

B.) stand and sit up slowly

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the clients history requires follow up by the nurse ? A.) metal hip prosthesis was placed twenty years ago B.) Takes metformin hydrochloride for type 2 diabetes millitus C.) CT scan that was performed six months earlier D.) report of clients sobriety for the last five years

B.) tales metformin hydrochloride for type 2 disbetes millitus

Which assessment data indicates to the nurse that a client is having an anaphylactic reaction to a medication ? A.) insomnia and irritability B.) wheezing and dyspnea C.) tinnitus and diplopia D.) urticaria and pruritis

B.) wheezing and dyspnea

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The clients vital signs are temperature 99 (37.2c), heart rate 48bpm, respirations 16 bpm, and blood pressure of 150/90 mmHg. Which actions should the nurse take? A.)Administer the dose and monitor the clients BP regularly B.) withhold the scheduled dose and notify healthcare provider C.) assess for orthostatic hypotension before administering the dose D.) apply a telemetry monitor before administering the dose

B.) withhold the scheduled dose and notify healthcare provider

A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the clients history, the nurse determines that the client has been self-administering St. Johns Wort, an herbal preparation, on the advise of a friend.What information is most significant about this finding? A.) the client probably used this herb to treat depression B.) wort can decrease plasma concentrations of cyclosporine C.) adding the herb can decrease the need for corticosteroids D.) ingestion of wort can reduce the clients intake of sodium

B.) wort can decrease plasma concentrations of cyclosporine

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? A.) Decreased blood urea nitrogen B.) Reports of photophobia C.) Hearing has decreased D.) White blood cell count of 6,000/mm3

C.) Hearing has decreased

The nurse is administering IV fluconazole to a client who has a systemic candidiasis. After reviewing the clients diagnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST, also called SGOT). Which action should the nurse implement? A.) hold the dose and notify the pharmacy to stop dispensing the next premixed dose B.) begin the infusion and submit a drug reaction report to the nursing supervisor C.) Hold the dose and notify the healthcare provider of the changes in the laboratory findings D.) Begin the infusion and monitor the clients BUN, serum creatinine and liver function test

C.) Hold the dose and notify the healthcare provider of the changes in the laboratory findings

A postoperative has a prescription for ketorolac 30 mg IV every 6 hours. Which intervention should the nurse implement to determine if the expected outcome of the medication has been achieved? A.) observe wound drainage for change in appearance B.) Measure the clients intake & output C.) Preform a pain assessment using numeric scale D.) assess the clients calves for inflammation

C.) Preform a pain assessment using numeric scale

A client is receiving pilocarpine hydrochloride opthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide? A.) the drug can cause the lens to become more opaque B.) The drops increase the fluid in the eyes and cloud the visual field C.) The eye drops slow pupil response to accommodate for darkness D.) the medication causes pupils to dilate, which reduces night vision

C.) The eye drops slow pupil response to accommodate for darkness

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the clients upper back and the client denies pain. Which action should the nurse take? A.) remove the patch and consult with the healthcare provider about the clients pain resolution B.) administer an oral analgesic and evaluate its effectiveness before applying the new patch C.) apply the new patch in a different location after removing the original patch D.) place the patch on the clients shoulder and leave both patches in place for 12 hrs

C.) apply the new patch in a different location after removing the original patch

A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse ? A.) Use a stool softener as needed B.) take medication with meals C.) discontinue when spasms cease D.) avoid the ingestion of alcohol

C.) discontinue when spasms cease

A client has a prescription for clopidogrel bisulfate 75mg by mouth daily at 0900. In which situation should the nurse hold this medication? A.) the clients platelet level is high B.) breakfast has not been eaten C.) elective surgery is scheduled in two hours D.) an abdominal sonogram is scheduled

C.) elective surgery is scheduled in two hours

A male client with a new diagnosed seizure disorder starts a prescription of clonazepam. One week later, the nurse observes that his speech is slurred and has a ataxic gait. Which action should the nurse implement ? A.) advise the client to discontinue the medication immediately B.) report these side effects to the healthcare provider C.) explain the need to refrain from alcohol use while taking the drug D.) document the clients continued seizure activity

C.) explain the need to refrain from alcohol use while taking the drug

During a home visit, the nurse assess a client with Alzheimers disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. What action should the nurse take? A.) instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety B.) advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed C.) explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started D.) notify the healthcare provider that the dosage of the medication may need to be increased to manage the clients insomnia

C.) explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started

A client who uses transdermal contraceptive, calls the clinic because she forgot to apply a new patch 3 days ago. Which instruction should the nurse provide to the client? A.) wait until the last day of your menstrual period to apply the patch B.) if a pregnancy test is negative. apply the next patch immediately C.) wait until Saturday to apply the new patch and use the same site D.) apply the new patch today and use back up method for 7 days

D.) apply the new patch today and use back up method for 7 days

Based on a clients serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement? A.) give digoxin B.) check acid base and electrolyte values C.) administer potassium to stabilize the heart rate D.) begin cardioversion to stabilize heart rhythm

D.) begin cardioversion to stabilize heart rhythm

The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client requires intervention by the nurse? A.) administer into the fleshy outer thigh B.) inserts the injection pen though clothing C.) holds the one in place after the injection D.) cleanses the injection pen for reuse

D.) cleanses the injection pen for reuse

Before administering the initial dose of sumatriptan succinctness to a client with a migraine headache, it is most important to determine if the clients history includes which problem? A.) type 2 diabetes millitus B.) seasonal allergic rhinitis C.) irritable bowel syndrome D.) coronary artery disease

D.) coronary artery disease

A client with emphysema is complaining of difficulty breathing and is exhibiting audile wheezing. The nurse administers albuterol as prescribed for the third time within the last 12 hours. Which assessment finding warrants immediate intervention by the nurse? A.) throat irritation B.) uncontrollable shaking C.) increased anxiety D.) irregular rapid heart beat

D.) irregular rapid heart beat

Which action should the nurse implement to assess the effectiveness of the calcium channel blocker amlodipine? A.)Note the clients serum calcium levels B.) Monitor the clients serum electrolytes C.)Review the clients intake and output D.)Measure the clients blood pressure

D.)Measure the clients blood pressure

During a home visit, the nurse assess a client with Alzheimers disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take ? A.) instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the clients safety B.) advise the caregiver that the purpose of the medication is to promote sleep, so change in medication may be needed C.) explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started D.) notify the healthcare provider that the dosage of the medication may need to be increased to manage the clients insomnia

C.) explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started

The nurse is preparing a client with chronic obstructive pulmonary disease (COPD) and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptoms? A.) prednisone B.) tiotropium C.) guaifenesin D.) salmeterol

C.) guaifenesin

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? ( select all that apply.) A.) use NSAIDs to relieve mild joint aches and pains caused by the medication B.) crush and mix the tablets with pudding if you have trouble swallowing the tablets C.) increase fluid intake while taking this medication D.) limit exposure to sunlight and avoid tanning beds E.) report any tendon pain or swelling to the healthcare provider immediately

C.) increase fluid intake while taking this medication D.) limit exposure to sunlight and avoid tanning beds E.) report any tendon pain or swelling to the healthcare provider immediately

A client recently diagnosed with multiple sclerosis, who self administers beta-1a interferon, reports feeling increasingly depressed. Which action should the nurse implement? A.) assess the client for feelings of increasing fearfulness B.) teach the client strategies for coping with chronic illness C.) notify the healthcare provider for the findings immediately D.) encourage the client to seek counseling for depression

C.) notify the healthcare provider for the findings immediately

Hormone replacement therapy with levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much of the hormonal agent, levothyroxine? A.) Intolerance to cold B.) Constipation C.) restlessness D.) decreased appetite

C.) restlessness

A client receives a prescription to itraconazole. Which information provide by the client requires additional instruction by the nurse? A.) monitor for changes in stool color B.) report any difficulty with breathing C.) take the medication with antacids D.) avoid the consumption of grapefruit juice

C.) take the medication with antacids