Medical-Surgical Drugs (EAQ)
A nurse reviews a list of medications that have been prescribed for a client. The nurse is aware that it is unsafe to administer which medication as an intravenous (IV) bolus?
Potassium Chloride
A client who is obtunded has a blood pressure of 80/35 mm Hg after a blood transfusion. In an effort to support renal perfusion, the nurse administers dopamine at 2 mcg/kg/min as prescribed. What is the most relevant outcome indicating effectiveness of the medication for this client?
An increase in urinary output
A client with rheumatoid arthritis has been given a prescription for acetylsalicylic acid. The client asks the nurse, "What kind of drug is acetylsalicylic acid?" The nurse recalls that this drug has which property?
Analgesic
A client is receiving morphine sulfate for severe metastatic bone pain. What will the nurse do to assess for complications from a common serious side effect of morphine?
Assess for altered breathing patterns
A nurse administers a parenteral preparation of potassium slowly and cautiously to avoid which complication?
Avoid cardiac arrest
A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond?
"Antiseizure drugs will probably be continued for life."
A client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important?
"Continue taking the medicine even after I feel better."
Immediately after a bilateral adrenalectomy a client is receiving corticosteroids that are to be continued after discharge from the hospital. Which statement by the client indicates to the nurse that additional education is needed?
"I am glad that I only have to take the medication once a day."
The client who takes furosemide and digoxin reports that everything looks yellow. How will the nurse respond?
"I will hold the medication until I consult with your healthcare provider."
During a teaching session about insulin injections, a client asks the nurse, "Why can't I take the insulin in pills instead of taking shots?" What is the nurse's best response?
"Insulin is destroyed by gastric juices, rendering it ineffective."
The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How will the nurse respond?
"It is not advisable because bleeding will increase."
The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond?
"This medication helps you lower the high ammonia level caused by your liver disease."
At 10 AM the nurse hangs a 1000-mL bag of D 5W with 20 mEq of potassium chloride to be administered at 80 mL/hr. At noon the healthcare provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion to use the circulatory access for the secondary infusion of the antibiotic?
1 hour
A nurse is administering serum albumin intravenously to a client with ascites. In response to this therapy, what does the nurse expect to decrease?
Abdominal girth
A client with type 1 diabetes mellitus has a finger stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime. A prescription for sliding-scale regular insulin exists. What should the nurse do?
Administer the insulin as prescribed
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?
Blocks the action of cholinesterase
What client response indicates to the nurse that a vasodilator medication is effective?
Blood pressure changes from 154/90 to 126/72 mm Hg
A nurse is providing discharge instructions about digoxin. Which response should a nurse include as a reason for a client to withhold the digoxin?
Blurred vision
A client is receiving doxorubicin as part of a chemotherapy protocol. The nurse should assess the client for which major life-threatening side effect of doxorubicin?
Cardiotoxicity
What should the nurse include in a teaching plan to help reduce the side effects associated with diltiazem?
Change slowly from sitting to standing.
A client residing in an assisted living facility is diagnosed with Parkinson disease, and the healthcare provider prescribes selegiline. What precaution will the nurse teach the client?
Change to a standing position slowly.
Following surgery, total parenteral nutrition is instituted via a central venous infusion. During the fourth hour of the infusion the client complains of nausea, fatigue, and a headache. The hourly urine output is twice the amount of the previous hour. After contacting the primary health care provider, what is the next action the nurse should take?
Check the serum glucose level.
A client is receiving patient-controlled analgesia (PCA) after surgery. What does the nurse identify as the primary benefit with this type of therapy?
Client is able to self-administer pain-relieving drugs as necessary
The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan?
Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.
A client is admitted to the intensive care unit with acute pulmonary edema. Which diuretic does the nurse anticipate will be prescribed?
Furosemide
A client with diabetes who is receiving long-term corticosteroid therapy is admitted to the hospital with leg ulcers. What increased risk does the nurse consider when assessing this client?
Inadequate wound healing
A client is receiving furosemide to relieve edema. The nurse should monitor the client for which response to the medication?
Hypokalemia
A client is admitted to the hospital for an adrenalectomy. The nurse is providing postoperative care before the client's replacement steroid therapy is regulated fully. The nurse should monitor the client for which complication?
Hypotension
What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema?
Decreased intracranial pressure
While awaiting surgery, a client with a long history of Crohn disease is receiving total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN helps to prepare for surgery by which process?
Decreasing fecal bulk
A client who is receiving multiple medications for a myocardial infarction complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of what drug?
Digoxin
A nurse is caring for a client who is receiving an intravenous (IV) infusion. What should the nurse do first if the IV infusion infiltrates?
Discontinue the infusion.
A client with arthritis is taking large doses of aspirin. What symptom does the nurse include when teaching the client about the clinical manifestations of aspirin toxicity?
Disturbances in hearing
A client with stage III Hodgkin disease is started on ABVD therapy, a multiple-drug regimen. The client asks why so many drugs need to be given all at once. Which is the best response by the nurse?
Each drug destroys the cancer cell at a different time in the cell cycle.
A client is undergoing diagnostic testing to determine if the client has myasthenia gravis. The nurse understands that the test that is most specific for determining the presence of this disease is what?
Edrophonium chloride test
A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low intermittent suction. The nurse recalls that the primary reason that an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium has been prescribed is to prevent which complication?
Electrolyte imbalance
A client is admitted for dehydration, and an intravenous (IV) infusion of normal saline is started at 125 mL/hour. One hour later, the client begins screaming, "I can't breathe!" How should the nurse respond?
Elevate the head of the client's bed and obtain vital signs.
What effect of povidone-iodine does a nurse consider when using it on the client's skin before obtaining a specimen for a blood culture?
Eliminates surface bacteria that may contaminate the culture
What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel?
Epistaxis
A client with Hodgkin disease is placed on an ABVD combination chemotherapy regimen. Because doxorubicin is part of this therapy, what education will the nurse provide about this drug?
Expect urine to turn red for a few days after taking this drug.
A client who is taking rifampin tells the nurse, "My urine looks orange." What action will the nurse take?
Explain this is expected.
A client with hyperthyroidism is to receive methimazole. What instructions does the nurse provide?
Initial improvement will take several weeks.
A client is receiving combination chemotherapy for treatment of metastatic carcinoma. For which systemic side effect should the nurse monitor the client?
Leukopenia
A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system?
Loop of Henle
A client is admitted to the hospital after general paresis develops as a complication of syphilis. Which therapy should the nurse anticipate will most likely be prescribed for this client?
Penicillin therapy
A client has an order for a sublingual nitroglycerin tablet. The nurse should teach the client to use what technique when self-administering this medication?
Place the pill under the tongue and let it dissolve.
Which relationship does the nurse consider reflective of the relationship of naloxone to morphine sulfate?
Protamine sulfate to heparin
Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given for what purpose?
Provide prophylaxis against postoperative thrombus formation
A client diagnosed with tuberculosis is taking isoniazid. To prevent a food and drug interaction, the nurse should advise the client to avoid which food item?
Red wine
The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. What does the nurse identify as the purpose of these drugs?
Reduce antibody production
A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. What reason should the nurse include in a response to this question?
Reduce inflammation
After a basal cell carcinoma is removed by fulguration, a client is given a topical steroid to apply to the surgical site. The nurse evaluates that the teaching regarding steroids and skin lesions is effective when the client identifies which action as the primary purpose of the medication?
Reduce inflammation at the surgical site
A nurse has administered sublingual nitroglycerin. Which parameter should the nurse use to determine the effectiveness of sublingual nitroglycerin?
Relief of anginal pain
A nurse is preparing to teach a client to apply a nitroglycerin patch as prophylaxis for angina. Which instruction should the nurse include in the teaching plan?
Remove a previous patch before applying the next one.
A client is admitted to the hospital for a subtotal thyroidectomy. When discussing postoperative drug therapy with the client, what will the nurse include in the teaching?
Report palpitations, nervousness, tremors, or loss of weight that may indicate an overdose of thyroid hormone.
What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy?
Rotate injection sites.
Tissue plasminogen activator (t-PA) is to be administered to a client in the emergency department. Which is the priority nursing assessment?
Signs of bleeding
The provider prescribes one unit of packed red blood cells to be administered to a client. To ensure the client's safety, which measure should the nurse take during administration of blood products?
Stay with client during first 15 minutes of infusion.
A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide?
Stimulates the pancreas to produce insulin
A client develops a maculopapular rash on the upper extremities and audible wheezing during the administration of intravenous vancomycin. To ensure the client's safety, which action would the nurse carry out first?
Stop infusion
A client with a hemoglobin level of 6.2 g/dL (62 mmol/L) is receiving packed red blood cells. Twenty minutes after the infusion starts, the client complains of chest pain, difficulty breathing, and feeling cold. What is the first action the nurse should take?
Stop the transfusion.
A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide?
To treat Helicobacter pylori infection
A nurse concludes that the simvastatin being administered to a client is effective. A decrease in what clinical finding supports this conclusion?
Triglycerides
