IV Test 1 Pharmacology
Phenobarbital (mechanism, use, side effects)
-Use: simple, complex, and tonic-clonic seizures; 1st line in neonates -Adverse effects: sedation, tolerance, dependence, cardiorespiratory depression
A nurse is assisting with preparing to administer a hydromorphone IV infusion to a client for pain. Which of the following actions should the nurse take? A. Administer the medication over 4 to 5 minutes B. Place the client in a high-Fowler's position C. Assess the client's pain level after administering the medication D. Review the client's last set of vital signs
A The nurse should administer the IV injection of this opioid medication over 4 to 5 minutes to prevent the adverse effects of the medication such as respiratory depression and cardiac arrest. Incorrect Answers: B. The nurse should place the client in a supine position during the administration of the medication to help prevent hypotension. C. The nurse should assess the client's pain level before administering the pain medication and then 30 minutes to 1 hour after administering the medication to evaluate its effectiveness. D. The nurse should obtain a current set of vital signs prior to administering opioids. If the client's respiratory rate is below 12/min, the blood pressure is low, or the pulse differs greatly from the client's baseline, the nurse should withhold the medication and contact the client's provider.
A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. Which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? A. Status epilepticus B. Bleeding gums c. Disorientation D. Severe nausea
A The nurse should reinforce with the client that abruptly discontinuing phenytoin can cause status epilepticus. Incorrect Answers: B. Abruptly discontinuing phenytoin will not cause bleeding gums. However, a common adverse effect of phenytoin therapy is gingival hyperplasia C. Abruptly discontinuing phenytoin will not cause disorientation. However, phenytoin therapy can alter cognitive function. D. Abruptly discontinuing phenytoin will not cause nausea. However, phenytoin therapy can cause nausea and vomiting.
A nurse is planning to administer diphenhydramine hydrochloride to an older adult client. Which of the following actions should the nurse take prior to administration? A. Review the client's medical record for a history of glaucoma B. Plan to administer the medication 30 minutes before a meal C. Explain to the client that he will need to restrict his fluid intake once he takes the medication D. Remind the client that his appetite might increase when starting the medication
A The nurse should review the client's medical record for a history of glaucoma prior to administration. Diphenhydramine is contraindicated for clients who have narrow-angle glaucoma. Incorrect Answers: B. The nurse should administer diphenhydramine with food or milk to decrease gastrointestinal adverse effects. C. The nurse should plan to inform the client to increase fluid intake. This medication has an atropine-like drying effect and thickens bronchial secretions. D. The nurse should remind the client that anorexia, nausea, and vomiting are gastrointestinal adverse effects of the medication.
A nurse is reinforcing teaching with a client who has anxiety and a new prescription for diazepam. Which of the following statements should the nurse make? A. "Feelings of sedation should resolve in about 1 week." B. "There is no risk of physical dependence with this medication." C. "You can increase the dose when you feel especially anxious." D. "It will take several months for you to feel the maximum benefit of the medication."
A Adverse effects of diazepam and other benzodiazepines are sedation and psychomotor slowing. The nurse should inform the client that these effects should subside in 7 to 10 days. Incorrect Answers: B. The nurse should inform the client that the long-term use of diazepam and other benzodiazepines is a risk for physical dependence. C. The nurse should inform the client not to increase the dose or take more medication than prescribed without the approval of the provider. D. The nurse should inform the client that the onset of diazepam and other benzodiazepines is immediate.
A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimer's disease. The client's partner ask the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse provide? A. "Ginkgo biloba will probably interfere with the effectiveness of his other medications." B. "You should ask his provider if ginkgo biloba is safe." C. "Ginkgo biloba is most effective in the later stages of Alzheimer's disease." D. "People who have Alzheimer's disease should adhere to the medication regimen their provider prescribes."
A. Some experts believe that ginkgo biloba can delay the mental deterioration of Alzheimer's disease if taken in the early stages. Research, however, has not demonstrated this; more importantly, ginkgo biloba increases the client's risk for bleeding when taken with warfarin. Incorrect Answers: B. This is a nontherapeutic response because it refers the client's partner to another professional without responding to the question. C. Research has not demonstrated significant evidence that ginkgo biloba is effective in delaying the mental deterioration of Alzheimer's disease. D. This is a nontherapeutic response, as it dismisses the partner's concerns and does not answer his question.
A nurse is collecting data from a client who has heart failure and is taking daily furosemide. The client's apical pulse is weak and irregular. This client has manifestations of which of the following electrolyte imbalances? A. Hypokalemia B. Hypophosphatemia C. Hypercalcemia D. Hypermagnesemia
A. The nurse should identify that furosemide can cause a loss of potassium, sodium, calcium, and magnesium. Manifestations of hypokalemia can include shallow respirations, muscle weakness, lethargy, and ectopic heartbeats. Incorrect Answers: B. The nurse should identify that manifestations of hypophosphatemia can include muscle weakness and bradycardia. C. The nurse should identify that manifestations of hypercalcemia can include tachycardia, hypertension, and muscle weakness. D. The nurse should identify that manifestations of hypermagnesemia can include bradycardia, hypotension, and decreased deep tendon reflexes.
A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? A. Acetylsalicylic Acid EC 325 mg per NG tube daily B. Atorvastatin 40 mg per NG tube daily C. Propranolol 20 mg per NG tube daily D. Sucralfate 2 g oral suspension per NG tube BID
A. Acetylsalicylic acid EC mg per NG tube daily This is an enteric-coated tablet and it should not be crushed the rest are fine to give
A nurse is caring for a client who is receiving treatment for alcohol detoxification. Which of the following medications should the nurse expect to administer during this phase of the client's care? A. BUprenorphine B. Diazepam c. Varenicline D. Rimonabant
B The nurse should expect to administer diazepam to a client during alcohol detoxification. Anti-anxiety agents such as chlordiazepoxide and diazepam are long-acting CNS depressants that are used to minimize the manifestations of alcohol withdrawal. Incorrect Answers: A. The nurse should expect to administer buprenorphine to a client during opiate detoxification. C. The nurse should expect to administer varenicline to a client who has nicotine use disorder. D. The nurse should expect to administer rimonabant to a client who has nicotine use disorder.
A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication? A Hypertension B. Cardiac dysrhythmias C. Gastric discomfort D. Tachycardia
B The nurse should identify cardiac dysrhythmias as an adverse effect of phenytoin IV. As a result of this potential complication, cardiac monitoring is required. Incorrect Answers: A. Hypertension is not an adverse effect of administration of phenytoin IV. Hypotension might result if the medication is administered too quickly. C. Gastric discomfort is an adverse effect of oral phenytoin that can be reduced by administering the medication with or immediately after a meal. D. Tachycardia is not an adverse effect of phenytoin IV. Due to the risk of bradycardia, phenytoin IV administration should not exceed 50 mg/min.
A nurse is reinforcing teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? A "You might notice that you see better in dim areas." B. "You should increase your fluid intake." C. "You should expect to have excessive urination." D. "You might experience difficulty sleeping."
B The nurse should inform the client that an adverse effect of morphine is constipation. Therefore, the nurse should encourage the client to increase oral fluids to promote motility of the bowel. Incorrect Answers: A. The nurse should inform the client that morphine can cause pupillary constriction, making it difficult to see in a dark or dim room. The client's room should be kept well-lit to provide optimal visibility. C. The nurse should inform the client that an adverse effect of morphine is urinary retention. Therefore, the nurse should encourage the client to void at least once every 4 hours. D. The nurse should inform the client that sedation and drowsiness are adverse effects of morphine. Therefore, the nurse should encourage the client to stand up slowly when getting ouf of bed
A nurse is caring for a client who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately? A. Nausea B. Bloody stools C. Drowsiness D. Headache
B. When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is bloody stool. Adverse effects of treatment with famotidine might include blood dyscrasias such as thrombocytopenia, which can lead to bleeding. This findings should be reported to the provider immediately. The rest are expected findings for a client taking Famotidine.
A nurse is reinforcing teaching with an older adult client who is scheduled to start taking warfarin. Which of the following statements indicates the client understands the teaching? A. "IfI miss a dose, I will double it the next day." B. "I can continue to eat green salads." C. "I will need to have laboratory blood testing every 6 months to monitor the effects of the warfarin." D. "I should expect my urine to be pink-tinged while I am taking this medication."
B. The client should have a diet that is consistent in foods containing vitamin K, (e.g. green, leafy vegetables). Sudden increases or decreases in consumption will alter the coagulation effects of warfarin. The nurse should report any alterations in the client's consumption of foods containing vitamin K. A. If the client misses a dose, the client should take a dose as soon as possible on the day it is due. It is not safe to double the dose the following day, as this will alter the coagulability of the blood beyond the prescribed parameters. C. The nurse should instruct the client that close monitoring of the effects of warfarin is important, and the client should keep to the schedule for laboratory blood testing that the provider establishes. PT/IN levels are drawn daily for the first 5 days of therapy, twice weekly for the next 1 to 2 weeks, once a week for the next 1 to 2 months, and every 2 to 4 weeks thereafter. D. The client should report any pink- or red-tinged urine or any noted blood in the stool to the provider right away. This might be an indication that the provider needs to adjust the medication dosage.
A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective.Which of the following factors should the nurse identify as a possible explanation for this change? a. Potential interaction b. Detrimental inhibitory interaction c. Increased adverse reaction d. Toxicity-reducing inhibitory interaction
B. Detrimental inhibitory interaction When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effect.
A nurse is caring for a client who has acute glomerulonephritis and a prescription for furosemide. The nurse should monitor the client for which of the following therapeutic effects of this medication? A. Hypotension B. Diuresis C. Increased blood glucose level D. Weight gain
B. Diuresis The nurse should identify that furosemide is a high-ceiling loop diuretic indicated for the treatment of clients who have severe renal impairment such as acute glomerulonephritis. Furosemide blocks the reabsorption of sodium and chloride, thereby preventing the reabsorption of water. Diuresis is a therapeutic response to the administration of furosemide. Incorrect Answers: A. Hypotension is an adverse effect of furosemide. The nurse should identify that furosemide can contribute to a decrease in blood pressure through a loss of fluid volume and the relaxation of venous smooth muscles. The nurse should monitor the client's blood pressure while the client is receiving furosemide. C. An increased blood glucose level is an adverse effect of furosemide in clients who have diabetes mellitus. The nurse should monitor the client's glucose level closely while the client is receiving furosemide. D. Weight loss is a therapeutic response in a client who has acute glomerulonephritis and is receiving fyrosemide. Furosemide prevents the reabsorption of water and blocks the absorption of sodium and chloride, which decreases fluid retention.
A nurse is contributing to the plan of care for a client who is receiving phenytoin to treat seizures. Which of the following recommendations should the nurse make to counteract potential adverse effects of the medication? A. Administer an antidiarrheal agent to the client as needed B. Encourage the client to increase dietary intake of foods high in potassium C. Reinforce teaching with the client about how to perform gum massage D. Offer hard candy for the client to suck
C Phenytoin can cause gingival hyperplasia (overgrowth of gum tissue). The nurse should instruct the client about proper brushing and flossing techniques as well as gum massage to decrease the risk of damage and discomfort. Incorrect Answers: A. Phenytoin can cause constipation, not diarrhea. Therefore, the nurse does not need to administer an antidiarrheal agent. B. Phenytoin does not adversely affect the client's potassium level. Therefore, the nurse should not encourage the client to increase dietary intake of foods high in potassium. D. Phenytoin does not cause the adverse effect of xerostomia (dry mouth). Therefore. the nurse does not need to offer hard candy for the client to suck
Anurse is caring for a client who is experiencing severe cancer pain. which of the following medications should the nurse expect the provider to prescribe? A. Buprenorphine B. Tramadol C. Hydromorphone D. Oxycodone
C The nurse should expect the provider to prescribe hydromorphone, an opioid agonist. Hydromorphone is used for the treatment of moderate to severe pain management in clients who have cancer. Incorrect Answers: A. Buprenorphine is an opioid agonist-antagonist that should not be used for cancer pain because it is less effective for cancer pain than pure opioid agonists. The medication can cause distressing adverse effects such as nightmares, hallucinations, and dysphoria. If administered to an opioid agonist-dependent client, the medication might not provide analgesia and can precipitate withdrawal. For severe cancer pain, the nurse should expect the provider to prescribe hydromorphone. B. Tramadol is a non-opioid centrally acting analgesic that is used for the treatment of mild to moderate pain. For severe cancer pain, the nurse should expect the provider to prescribe hydromorphone. D. Oxycodone is an opioid agonist that is used for the treatment of mild to moderate pain. For severe cancer pain, the nurse should expect the provider to prescribe hydromorphone.
A nurse is reinforcing teaching with a client who has generalized anxiety disorder and a new prescription for lorazepam. Which of the following statements should the nurse include? A. "Taking an antacid with the medication will decrease stomach upset." B. "Expect the medication to cause insomnia for the first 1 to 2 weeks." C. "Drinking caffeinated beverages will decrease the effectiveness of the medication." D. "Increase the dosage if the effectiveness of the medication decreases."
C The nurse should inform the client that consuming caffeine while taking benzodiazepines such as lorazepam will result in decreased effectiveness of the medication. Caffeine is a stimulant, and lorazepam is a CNS depressant; therefore, the substances will counteract each other. The client should avoid consumption of caffeine while taking this medication. Incorrect Answers: A. Antacids interact with benzodiazepines such as lorazepam by delaying absorption. B. Benzodiazepines such as lorazepam are CNS depressants and are expected to cause drowsiness D. The client should notify the provider if the medication's effectiveness decreases. The client should&t increase the dosage without a prescription.
A nurse is reinforcing teaching with a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A. "You can take ibuprofen for headaches while taking this medication." B. "You may experience increased swelling in your lower extremities while taking this medication." C. "You should eat foods that are high in potassium while taking this medication." D. "You should take this medication at bedtime."
C The nurse should instruct this client who has a prescription for furosemide to consume foods that are high in potassium. Furosemide is a high-ceiling loop diuretic that depletes potassium, sodium, chloride, magnesium, and water. Incorrect Answers: A. The nurse should instruct the client that ibuprofen, which is an NSAID, can cause interaction with furosemide. NSAIDs can decrease the efficacy of this medication B. The nurse should instruct the client that furosemide is prescribed to secrete fluid from the body and should reduce the client's swelling and edema. D. The nurse should instruct the client to avoid taking furosemide at bedtime to prevent the disruption of the client's sleep, as this medication increases the need to urinate.
A nurse is collecting data on a client who is postoperative and received a dose of morphine 15 minutes ago. The client now has a respiratory rate of 8/min and is unresponsive. Which of the following medications should the nurse prepare to administer? A. Naproxen B. Nifedipine C. Naloxone D. Nebivolol
C The nurse should prepare to administer naloxone, an opioid antagonist. Naloxone will reverse the over-sedation and respiratory depression the client is experiencing. However, with too large a dose the analgesia of the morphine will also be reversed, causing the client to experience postoperative pain again. Incorrect Answers: A. Naproxen is a NSAID used for mild to moderate pain. It will not reverse over-sedation and respiratory depression associated with opioid use. B. Nifedipine is a calcium channel blocker used for the management of hypertension and angina. It will not reverse over-sedation and respiratory depression associated with opioid use. D. Nebivolol is a beta blocker used for the management of hypertension. It will not reverse over-sedation and respiratory depression associated with opioid use.
A nurse is reinforcing teaching with a client who has a prescription for famotidine to treat gastric ulcer. Which of the following statements should the nurse include in the teaching? A. "This medication is more effective when taken on an empty stomach." B. " You should take this medication with an antiacid for pain control." C. "This medication is less effective for people who smoke." D. "You should expect to experience dizziness when taking this medication."
C. The nurse should reinforce with the client that smoking interferes with the effectiveness of famotidine. If a client taking famotidine smokes, the nurse should encourage the client to quit smoking or, if unable to quit, to avoid smoking after the last dose of the day. a. The nurse should reinforce with the client that food does not affect absorption of famotidine. Therefore, the client can take famotidine without regard to food intake. b. The nurse should reinforce with the client to take antiacids at least 30-60 min after taking famotidine. d. The nurse should reinforce with the client that dizziness is an adverse effect of famotidine and to contact their provider if they experience this manifestation.
A nurse is collecting data from a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? a. suppression of dysrhythmias b. increase in atrioventricular (AV) conduction c. Visual disturbances d. Weight gain
C. N/V, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate the client is experiencing digoxin toxicity. a. this is an indication for administering digoxin b. digoxin slows AV conduction and prolongs the PR interval d. Weight gain is a manifestation of right-sided HF. not caused by digoxin
A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse identify as a contraindication to administering an opioid medication? A. Metoprolol B. Ondansetron C. Lorazepam D. Naloxone
C. Lorazepam The nurse should identify that lorazepam can cause central nervous system depression, which can result in increased respiratory depression and sedation when administered with an opioid. The nurse should clarify the prescription with the provider. Incorrect Answers: A. The nurse should identify that metoprolol is a beta-blocker used to treat hypertension. The nurse should monitor the client's blood pressure after administering metoprolol when an opioid medication is administered, but metoprolol is not contraindicated. B. The nurse should identify that ondansetron can relieve the adverse effects of nausea and,vomiting associated with the administration of an opioid. D. The nurse should identify that naloxone, which is an opioid antagonist, is used to reverse the adverse effects of opioid medication and opioid toxicity.
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs? A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache
C. tinnitus Loop diuretics, such as furosemide, can cause ototoxicity. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs. Incorrect Answers: A. Nasal congestion is not an adverse effect of furosemide. B. Furosemide does not cause movement disorders such as tremors. D. Headaches are not an adverse effect of furosemide. Headaches can occur in a client who has fluid overload, which furosemide might be prescribed to treat.
A nurse is reviewing the medical record of an older adult client. For which of the following medications should the nurse request a hearing assessment for the client? A. Omeprazole B. Ferrous sulfate C. Digoxin D. Furosemide
D Furosemide can cause ototoxicity, especially in older adult clients, due to a decrease in medication metabolism in the kidneys. The nurse should monitor clients taking ototoxic medications such as furosemide and teach the client the signs of ototoxicity such as tinnitus and difficulty hearing. Incorrect Answers: A. The nurse should monitor the client who is taking omeprazole for bone loss. B. The nurse should monitor the client who is taking ferrous sulfate for gastrointestinal effects, such as bloating or changes in elimination. C. The nurse should monitor the client who is taking digoxin for manifestations of hypokalemia, Such as muscle weakness.
A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? A. Dextromethorphan B. Montelukast C. Ciprofloxacin D. Propranolol
D The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol. a. Dextromethorphan is an OTC cough suppressant b. Montelukast is a leukotriene receptor blocker that is used as a prophylaxis for the maintenance of asthma c. Ciprofloxacin is an antibiotic that is used to treat bacterial infections.
A nurse is reviewing the morning laboratory results of an infant who is receiving digoxin and furosemide for the treatment of heart failure. Which of the following findings should the nurse report to the provider? A Sodium 140 mEg/L B. Calcium 10.2 mg/dL. C. Chloride 100 mEg/L D. Potassium 3.2 mEg/L
D The nurse should identify that a potassium level of 3.2 mE/L is below the expected reference range of 4,1 to 5.3 mE/L for an infant. Therefore, the nurse should report this finding to the provider. Incorrect Answers: A. The nurse should identify that a sodium level of 140 mEg/L is within the expected reference range of 134 to 150 mE/L for an infant. B. The nurse should identify that a calcium level of 10.2 mg/dL is within the expected reference range of 8.8 to 10.8 mg/dL for an infant. C. The nurse should identify that a chloride level of 100 mEg/L is within the expected reference range of 90 to 110 mEq/L fer an infant.
A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleepy during the day." Which of the following responses should the nurse make? A. "You will find that all antihistamines cause sedation." B. "You should avoid taking the antihistamine with food." C. "The effects of sedation will occur with each dose.! D. "You should try antihistamines with non-sedative effects."
D The nurse should tell the client to try second-generation antihistamines that have no sedative effect, as these are large molecules with low lipid solubility that cannot cross the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation. Incorrect Answers: A. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation B. The nurse should tell the client to take diphenhydramine with food to decrease gastrointestinal irritation that can cause nausea and vomiting. C. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation. However, sedative effects subside after a few days of taking the antihistamine.
A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse reinforce with the client about the treatment plan? A. "Your partner needs to be cultured and treated with metronidazole only if his cultures are positive." B. "Only you will need to take the metronidazole, but you should not have intercourse until your culture is negative." C. "If both you and your partner are treated simultaneously, you may continue to engage in sexual intercourse." D. "You and your partner need to take the medication and use a condom during intercourse until cultures al negative."
D Trichomonas vaginalis is the organism that causes the sexually transmitted infection trichomoniasis. Both men and women can be infected with trichomoniasis. Clinical findings in women include yellowish to greenish, frothy, mucopurulent, copious discharge with an unpleasant odor, as well as itching, burning, or redness of the vulva and vagina. Trichomoniasis can be treated easily with metronidazole. However, for the treatment to work, both sexual partners must receive treatment to prevent reinfection. The nurse should also instruct the client to use condoms during sexual intercourse while being treated. Incorrect Answers: A. Treatment of the male partner is done without a culture if his female partner has trichomoniasis. B. Both men and women can be infected with trichomoniasis. Unless both partners are treated, the male will likely reinfect the female. C. Trichomoniasis can be easily treated and cured with metronidazole. However, for the treatment to work, the client should avoid sexual intercourse while being treated or use a condom.
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? А. HE 45% B. Hgb 15 g/aL C. PTT 35 seconds D. INR 3.0
D Warfarin is an anticoagulant that prevents thrombus formation in susceptible clients. The INR measures its effectiveness. For most clients taking warfarin, an INR of 3.0 indicates effective therapy. Incorrect Answers: A. Hct measures the percentage of RBCs in the blood, not the effectiveness of warfarin therapy. B. Hgb measures the oxygen-carrying pigment in RBCs, not the effectiveness of warfarin therapy. C. The aPTT test monitors the effectiveness of the anticoagulant heparin, not warfarin.
A nurse is collecting data from a client who is receiving morphine via a patient-controlled analgesia (PCA) pump following a cesarean birth. Which of the following findings should the nurse report to the provider? A. Respiratory rate 14/min B. Temperature 37.8°C (100°F) C. Dizziness upon rising D. Urine output 20 mL/hr
D Opioid analgesics such as morphine can cause urinary retention. The client should have a urinary output of at least 30 mL/hr. The nurse should report this finding to the provider. Incorrect Answers: A. Opioid analgesics can cause respiratory depression. However, this respiratory rate is within the expected reference range. B. This temperature is within the expected reference range. C. Dizziness is a common adverse effect of receiving opioid analgesics. The nurse should instruct the client to sit on the side of the bed before getting up, assist the client with ambulation, and implement general safety measures. However, it is not necessary to report this finding to the provider.
A nurse is preparing to administer oral phenytoin to a client who has a seizure disorder. Before administering the medication, which of the following actions should the nurse take? A. Document the administration of the medication B. Count the available medication and sign for it C. Measure the client's respiratory rate D. Check the medication dose and the client's identification
D. The rights" of medication administration include verifying the right client and the right Incorrect Answers: A. The nurse should document the administration of the medication after administering it, not before. B. Phenytoin is not a controlled substance, so narcotic counts do not apply. C. Phenytoin does not affect respiratory status, so the nurse does not need to measure the client's respiratory rate immediately prior to administering this medication.
A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? A. Decreased blood glucose B. Increased potassium C. Increased prostaglandin synthesis D. Decreased inflammation
D. Decreased inflammation For a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes. Incorrect Answers: A. The nurse should identify that budesonide can increase blood glucose levels. Clients who have diabetes might need to adjust their dosage of hypoglycemic medication. The client's blood glucose should be monitored routinely while taking this medication. B. The nurse should identify that budesonide has mineralocorticoid activity, causing sodium, water retention, and potassium loss. Hypokalemia is a serious adverse effect that can cause life-threatening dysrhythmias. C. The nurse should identify that budesonide inhibits prostaglandin synthesis, which can augment the secretion of acid and pepsin. This can cause gastrointestinal ulceration and can place the client at risk for peptic ulcer disease.
A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of following medications should the nurse anticipate administering to this client to prevent deep vein thrombosis (DVT)? A Aspirin B. Warfarin C. Ticagrelor D. Enoxaparin
D. Enoxaparin The nurse should anticipate the administration of enoxaparin for a client who is 12 hours postoperative following surgery. Enoxaparin is low-molecular-weight (LMW) heparin that is used to prevent a DVT by inhibiting the effects of antithrombin and thrombin. Incorrect Answers: A. Aspirin is an antipyretic and a nonopioid analgesic that suppresses platelet aggregation, not anticoagulation. Aspirin can be used as a prophylactic therapy for ischemic stroke, transient ischemic attack, chronic stable angina, and coronary stenting. B. Warfarin is an anticoagulant that is indicated to prevent thrombosis. However, it has a delayed onset and is prescribed for long-term prophylaxis. C. Ticagnitor is an antiplatelet agent indicated to prevent thrombotic events in clients who have acute coronary syndrome by inhibiting platelet aggregation.
A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? a. BP 180/70 b. O2 sat 94% c. HR 51/min d. RR 21/min
c
A nurse is reinforcing discharge teaching with a client who has heart failure and a prescription for digoxin 0.125 mg PO daily and furosemide 20 mg PO daily. which of the following statements by the client indicates an understanding of the teaching? a. "Blurred vision is something I will expect to happen while taking digoxin." b. "I will measure my urine output each day and document it in. my diary." c. "I will skip a dose of my digoxin if my resting HR is below 72 bpm." d. "I will eat fruits and vegetables that have a high potassium content every day."
d Hypokalemia is an adverse effect of diuretic therapy. Because this client is taking digoxin, the client will need to maintain a potassium level between 3.5-5.0 mg/dL to avoid digoxin toxicity. a. this is a sign of digoxin toxicity. Call HCP immediately b. I&O is important in acute care facilities not at home. Client should record daily weight and report any weight gain or loss to the HCP c. hold <60 bpm and call HCP
A nurse is reviewing the laboratory reports for a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? a. PT 18 seconds b. Platelet count 160,000 c. Hct 43% d. INR 5.5
d. INR 5.5 A client who is taking warfarin for the treatment of atrial fibrillation is expected to have an INR of 2-3. A level of 5.5 is considered a critical value and places the client at risk for bleeding; therefore, the nurse should report this result to the provider immediately. a. expected for a client on warfarin b. c. within the normal range
Phenobarbital indications
seizures
