IM7-PharmQuiz3

What are the clinical indicators that a nurse expects when an intravenous (IV) line has infiltrated? Select all that apply. 1. Heat 2. Pallor 3. Edema 4. Decreased flow rate 5. Increased blood pressure

2, 3 & 4

A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurse take when administering this medication? 1. Push over 2 minutes. 2. Administer in the abdomen. 3. Rub site after administration. 4. Remove air pocket from prepackaged syringe before administration.

2. Administer in the abdomen.

What instructions about the use of nitroglycerin should the nurse provide to a client with angina? 1. "Identify when pain occurs, and place two tablets under the tongue." 2. "Place one tablet under the tongue, and swallow another when pain is intense." 3. "Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs." 4. "Place one tablet under the tongue when pain occurs, and use an additional tablet after the attack to prevent recurrence."

3. "Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs."

When a client is receiving dexamethasone for adrenocortical insufficiency, what action does the nurse take to monitor for an adverse effect of the medication? 1. Auscultate for bowel sounds. 2. Assess deep tendon reflexes. 3. Culture respiratory secretions. 4. Measure blood glucose levels.

4. Measure blood glucose levels.

A healthcare provider prescribes 250 mg of an antibiotic intravenous piggyback (IVPB). A vial containing 1 gram of the powdered form of the medication must be reconstituted with 2.8 mL of diluent to form a volume of 3 mL. How many mL of the solution should the nurse administer? Record your answer using one decimal place and leading zero if applicable. Do not include units in your answer. __mL

0.8

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply. 1. Weight loss 2. Negative nitrogen balance 3. Increased urine specific gravity 4. Excessive loss of potassium ions 5. Pronounced retention of sodium ions

1 & 4

The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How will the nurse respond? 1. "It is not advisable because bleeding will increase." 2. "If necessary it will be started to enhance circulation." 3. "If necessary it will be started to prevent pulmonary thrombosis." 4. "It is inadvisable because it masks the effects of the hemorrhage."

1. "It is not advisable because bleeding will increase."

A client with tuberculosis is to begin combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, "I've never had to take so much medication for an infection before." How will the nurse respond? 1. "This type of organism is difficult to destroy." 2. "Streptomycin prevents side effects of the other drugs." 3. "You'll only need to take the medications for a couple of weeks." 4. "Aggressive therapy is needed because the infection is well advanced."

1. "This type of organism is difficult to destroy."

A primary health care provider prescribes 1000 mL total parenteral nutrition (TPN) to be infused over 12 hours via a central venous access device. What is most important for the nurse to obtain when preparing the equipment? 1. An infusion pump 2. A steady intravenous (IV) pole 3. An infusion set delivering 60 gtts/mL 4. A set of hemostats to be taped at the bedside

1. An infusion pump

A client with phosphate-based urinary calculi asks why aluminum hydroxide gel has been prescribed. The nurse explains that the medication decreases serum phosphorus by which action? 1. Binding with phosphorus in the intestine 2. Preventing absorption of phosphorus in the stomach 3. Promoting excretion of excessive urinary phosphorus 4. Dissolving stones as they pass through the urinary tract

1. Binding with phosphorus in the intestine

When taking the blood pressure of a client who had a thyroidectomy, the nurse identifies that the client is pale and has spasms of the hand. The nurse notifies the health care provider. Which should the nurse expect the health care provider to prescribe? 1. Calcium 2. Magnesium 3. Bicarbonate 4. Potassium chloride

1. Calcium

A client with inflammatory bowel disease is receiving total parenteral nutrition (TPN) via an infusion pump. What is most important for the nurse to do when administering TPN? 1. Change the TPN solution bag every 24 hours, even if there is solution left in the bag. 2. Monitor the client's blood glucose level every 2 hours at the bedside with a glucometer. 3. Instruct the client to breathe shallowly when changing the TPN tubing using sterile techniques. 4. Speed up the rate of the TPN infusion if the amount delivered has fallen behind the prescribed hourly rate.

1. Change the TPN solution bag every 24 hours, even if there is solution left in the bag.

One week after being hospitalized for an acute myocardial infarction, a client reports loss of appetite and feeling nauseated. Which of the client's prescribed medications should be withheld and the healthcare provider notified? 1. Digoxin 2. Propranolol 3. Furosemide 4. Spironolactone

1. Digoxin

The nurse is preparing discharge instructions for a client who was prescribed enalapril for treatment of hypertension. Which instruction is appropriate for the nurse to include in the client's teaching? 1. Do not change to a standing position suddenly. 2. Lightheadedness is a common adverse effect that need not be reported. 3. The medication may cause a sore throat for the first few days. 4. Schedule blood tests weekly for the first 2 months.

1. Do not change to a standing position suddenly.

A client is admitted to the coronary care unit complaining of "viselike" chest pain radiating to the neck. Assessment reveals a blood pressure of 124/64 mm Hg, an irregular apical pulse of 64 beats per minute, and diaphoresis. Cardiac monitoring is instituted, and morphine sulfate 4 mg intravenous (IV) push stat is prescribed. What is the priority nursing care for this client? 1. Relief of Pain 2. Client teaching 3. Cardiac monitoring 4. Maintenance of bed rest

1. Relief of pain

A client who takes daily megadoses of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver due to vitamin toxicity. What type of toxicity does the nurse suspect? 1. Retinol (vitamin A) 2. Thiamine (vitamin B1) 3. Pyridoxine (vitamin B6) 4. Ascorbic acid (vitamin C)

1. Retinol (vitamin A)

A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication does the nurse conclude that the client probably is experiencing? 1. Salicylate toxicity 2. Anaphylactic reaction 3. Withdrawal symptoms 4. Acetaminophen overdose

1. Salicylate toxicity

A healthcare provider prescribes aspirin to be continued at home for a client with severe arthritis. What should the nurse teach the client about taking aspirin? 1. Take the medicine with meals. 2. See a dentist if bleeding gums develop. 3. Switch to acetaminophen if tinnitus occurs. 4. Avoid spicy foods while taking the medication.

1. Take the medicine with meals.

To begin the administration of total parenteral nutrition (TPN), a client has a right subclavian central venous access device inserted. Immediately after insertion of the catheter, what is the priority nursing action? 1. Obtain a chest x-ray to determine placement. 2. Auscultate the lungs to evaluate breath sounds. 3. Draw a blood sample to assess blood glucose level. 4. Assess the right upper extremity for neurologic deficits.

2. Auscultate the lungs to evaluate breath sounds.

A nurse is caring for a client who is scheduled to have an abdominal perineal resection for colorectal cancer. The client has type B negative blood. If a blood infusion is needed, which type is preferred for administration? 1. A + 2. B - 3. O - 4. AB +

2. B -

A client with myasthenia gravis has been receiving neostigmine and asks about its action. What information about its action should the nurse consider when formulating a response? 1. Stimulates the cerebral cortex 2. Blocks the action of cholinesterase 3. Replaces deficient neurotransmitters 4. Accelerates transmission along neural sheaths

2. Blocks the action of cholinesterase

A client will be discharged with a peripherally inserted central venous catheter (PICC) for administration of peripheral parenteral nutrition (PPN). What would be appropriate for the nurse to include in the client's discharge teaching? 1. Learning how to change the percutaneous catheter 2. Determining which days to self-administer the PPN solution 3. Arranging for professional help to monitor the alternative nutrition 4. Scheduling administration of the PPN solution around mealtimes

3. Arranging for professional help to monitor the alternative nutrition

Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client identifies which times for the medication schedule? 1. At bedtime with a snack 2. Three times a day with meals 3. In the early morning with food 4. One hour before or two hours after eating

3. In the early morning with food

A nurse identifies that an older adult has not achieved the desired outcome from a prescribed proprietary medication. When assessing the situation, the client shares that the medication is too expensive and that the prescription was never filled. What is an appropriate nursing response? 1. Ask the pharmacist to provide a generic form of the medication. 2. Encourage the client to acquire the medication over the Internet. 3. Inform the healthcare provider of the inability to afford the medication. 4. Suggest that the client purchase medical insurance that covers prescription medications.

3. Inform the healthcare provider of the inability to afford the medication.

Which insulin should the nurse prepare for the emergency treatment of ketoacidosis? 1. Glargine 2. NPH insulin 3. Insulin aspart 4. Insulin detemir

3. Insulin aspart

While on a hike, a rusty nail pierces the sole of a client's foot and he is brought to the emergency department of a local hospital. Tetanus immune globulin is prescribed because the client does not know when the last tetanus immunization was received. What information will the nurse include when teaching the client about this drug? 1. It will take about a week to become effective. 2. Immune globulin provides lifelong passive immunity. 3. It provides immediate, passive, short-term immunity. 4. Immune globulins stimulate the production of antibodies.

3. It provides immediate, passive, short-term immunity.

The nurse is caring for a client with a 30% total body surface area burn. Which assessment finding indicates to the nurse that the client's fluid replacement is adequate? 1. Increasing hematocrit level 2. Urinary output of 15 to 20 mL/hr 3. Slowing of a previously rapid pulse rate 4. Central venous pressure progressing from 5 to 1 mm Hg

3. Slowing of a previously rapid pulse rate

A client with Crohn disease who weighs 155 lb (70.3 kg) is to receive an infusion of infliximab 5 mg/kg. What is the correct dose in milligrams that the client should receive? Record your answer using a whole number. ___ mg

352

The nurse provides education to a client about the side effects of furosemide. Which client statements indicate that the teaching is understood? Select all that apply. 1. "I must not eat citrus fruits." 2. "I should wear dark glasses." 3. "I should avoid lying flat in bed." 4. "I should change my position slowly." 5. "I must eat a food that contains potassium every day."

4 & 5

A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? 1. "Eliminating fluids with meals will prevent pain." 2. "I will increase my food intake to avoid an empty stomach." 3. "Taking an aspirin with milk will relieve my pain and coat my ulcer." 4. "Taking an antacid preparation will decrease pain due to gastric acid."

4. "Taking an antacid preparation will decrease pain due to gastric acid."