Module 4&5 ATI Questions (Respiratory, GI, and Cardiovascular Systems)

the client drinks two cups of coffee each morning

Which of the following information indicates that a client who is taking theophylline needs further instruction? (the client drives a school bus every day, the client drinks 8 oz. wine with dinner, the client exercises 1 hour each day, the client drinks two cups of coffee each morning)

NSAIDs

A nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmias. The nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propranolol? (antihistamines, potassium supplements, NSAIDs, vitamin C)

reduces inflammation

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? (increases leukocyte activity, blocks muscarinic receptors, causes bronchodilation, reduces inflammation)

allow at least 2 weeks for the full therapeutic effect

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? (start at a low dose and gradually increase it, take the drug as needed for nasal congestion, allow at least 2 weeks for the full therapeutic effect, use the drug prior to exercise)

dizziness

You are about to administer ondansetron to a client to prevent anesthesia-induced asthma and vomiting. You prepare to monitor the client for which adverse effect of this drug? (bronchospasm, dizziness, hypertension, anxiety)

cough, blurred vision, dizziness, fever

You are caring for a client who is taking oral amiodarone to treat atrial fibrillation. Recognizing the adverse effects of amiodarone, you advise the client to watch for and report which of the following? Select all that apply. (cough, blurred vision, dizziness, sore throat, fever)

swallow the capsules whole

A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse provide? (take the drug with food, swallow the capsules whole, dissolve the tablets in water, take the drug at bedtime)

urinary retention, dry mouth

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? Select all that apply. (muscle tremors, urinary retention, dry mouth, insomnia, tachycardia)

wait 5 min between using the drug and another inhaled drug

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? (do not drink anything for 30 min after using the drug, wait 5 min between using the drug and another inhaled drug, this drug is used to thin respiratory secretions, check pulse rate after inhaling the drug)

take the drug once a day in the evening

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? (use a spacer to improve inhalation, take the drug at the onset of bronchospasm, rinse mouth to prevent an oral fungal infection, take the drug once a day in the evening)

restlessness, insomnia, muscle pain

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? Select all that apply. (restlessness, bradycardia, insomnia, muscle pain, anxiety)

reduces surface tension

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? (suppresses the cough stimulus, reduces surface tension, reduces inflammation, dries mucous membranes)

prevent histamine from binding to receptors

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? (decrease viscosity of nasal secretions, block H2 receptors, prevent histamine from binding to receptors, reduce nasal congestion)

decreases inflammation

A nurse is teaching a client about the use of bechlomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? (thins mucus, relaxes bronchial smooth muscle, decreases inflammation, increases the cough threshold)

have laboratory tests performed at regular intervals (can cause liver injury)

A nurse is teaching a client who has a prescription for zileuton (leukotriene modifier). Which of the following instructions should the nurse include? (check apical pulse before taking the drug, take the drug only as needed before exercising, rinse mouth after using the drug, have laboratory tests performed at regular intervals)

avoid taking non steroidal anti-inflammatory drugs

A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which o the following instructions should the nurse include? (avoid taking non steroidal anti-inflammatory drugs, rinse your mouth after taking the medication to prevent a yeast infection, stop taking the medication if you become nauseous, change position slowly when standing up)

prevents straining

A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium has which of the following therapeutic effects? (reduces inflammation, reduces gastric acid, prevents diarrhea, prevents straining)

potentiation of depression of CNS actions

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? (reduced antitussive effect of dextromethorphan, potentiation of depression of CNS actions, increased renal reabsorption of the dextromethorphan, delayed analgesic effect of the opioid)

digoxin toxicity

A primary care provider then prescribes quinidine gluconate as an oral dysrhythmic agent. A health care professional should question the use of quinidine for a client taking digoxin (cardiac glycoside), due to a possible drug interaction that can result in which adverse effect? (liver toxicity, quinidine toxicity, digoxin toxicity, cardiotoxicity)

decreases

Digoxin (cardiac glycoside) (increases/decreases) heart rate

exerts positive inotropic action, decreases sympathetic tone, increases myocardial contractility

Digoxin (cardiac glycoside) is effective in treating heart failure due to which pharmacological actions? Select all that apply. (exerts positive inotropic action, decreases cardiac output, decreases sympathetic tone, increases vascular constriction, increases myocardial contractility)

to increase the amount of drug delivered to the lungs

For which of the following reasons should a client attach a spacer to a metered-dose inhaler? (to increase the amount of drug delivered to the lungs, to increase the amount of drug delivered to the oropharynx, to increase the amount of drug delivered on exhalation, to increase the speed of the drug delivery into the mouth)

over-the-counter cold products can also contain guaifenesin

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? (over-the-counter cold products can also contain guaifenesin, blood glucose levels are increased, rebound congestion is likely, drug tolerance is likely)

increase gastric pH and neutralize stomach acid

How do antacids (aluminum/magnesium hydroxide) protect against and help treat symptoms of ulcers? (2)

inhibit the gastric pump

How do proton pump inhibitors (omeprazole) protect against and help treat symptoms of ulcers?

CNS depression (drowsiness and confusion)

Knowing the adverse effects of cimetidine (histamine H2-receptor antagonist), the primary care provider's assistant should instruct a client to watch for and report which of the following? (hyperactivity, CNS depression, hypertension, bone pain)

digoxin toxicity

Recognizing the potential for a drug interaction between the loop diuretic, furosemide, and the cardiac glycoside, digoxin, the primary care provider plans to monitor this client for which adverse effect? (hyperkalemia, ototoxicity, digoxin toxicity, hypoglycemia)

check labels for sodium and phosphate content, increase fluid and fiber intake, monitor for signs of constipation

The health care professional is providing instructions to the client on taking aluminum hydroxide. Which information should be included? Select all that apply. (check labels for sodium and phosphate content, decrease activity and exercise, increase fluid and fiber intake, report whitish color stools, monitor for signs of constipation)

hyperglycemia, infection, gastric bleeding

The provider prescribes a stat parental dose of a glucocorticoids. Recognizing the adverse effects of glucocorticoids, you should monitor the client for which of the following? Select all that apply. (hyperglycemia, thrombophlebitis, dysrhythmias, infection, gastric bleeding)

albuterol

Which of the following drugs is appropriate for shortness of breath and acute exacerbations of asthma? (formoterol, theophylline, albuterol, salmeterol)

cimetidine (histamine H2-receptor antagonist), 1 hour

antacids can decrease the absorption of ___, therefore a client should wait how long between the two?

propranolol

beta adrenergic blocker that controls atrial and ventricular tachycardia

verapamil

calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

amiodarone

potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia

fatty foods

A client is about to start taking aliskiren (direct renin inhibitor) to treat hypertension. Which of the following should you tell the client to avoid to ensure the optimal absorption of this drug? (soy sauce, green, leafy vegetables, fatty foods, foods high in carbohydrates)

chew the tablets thoroughly, drink a glass of water after taking it, increase fluid and fiber intake

A client is about to start taking aluminum hydroxide tablets to reduce gastric acid. Which instructions should you include when talking with the client about taking this drug? Select all that apply. (take the drug with a large meal, chew the tablets thoroughly, drink a glass of water after taking it, increase fluid and fiber intake, take it once daily)

hyponatremia, hypokalemia, dehydration

A client is about to start taking hydrochlorothiazide, a thiazide diuretic, for hypertension. To assess for adverse effects of this drug, you monitor for which during drug therapy? Select all that apply. (ototoxicity, hyponatremia, hypokalemia, dehydration, hypoglycemia)

consume adequate amounts of fluids

A client is about to start taking omeprazole to treat a duodenal ulcer. Which of the following instructions should you include when talking with the client about taking this drug? (take it with food, avoid using aluminum-based antacids, consume adequate amounts of fluids, do not drink grapefruit juice)

coronary artery disease

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? (peptic ulcer disease, a seizure disorder, anemia, coronary artery disease)

ibuprofen

A primary care provider prescribes captopril (ACE inhibitor) to treat the client's hypertension and also help alleviate his heart failure. It is essential for a health care provider to make sure a client understands that he should not take which over-the-counter drugs while taking captopril? (ibuprofen, acetaminophen, calcium carbonate, diphenhydramine)

drug abuse

Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? (respiratory depression, drug abuse, drug tolerance, rebound congestion)

creates a protective barrier

The health care professional instructs a client about the therapeutic actions of sucralfate. She explains that this drug promotes ulcer healing by which action? (creates a protective barrier, increases gastric pH, inhibits the proton pump, neutralizes gastric acid)

use it periodically to prevent exercise-induced asthma

Which of the following information should you include when teaching a client about the use of an albuterol inhaler for asthma management? (use it every 12 hours, use it periodically to prevent exercise-induced asthma, store the drug canister in the refrigerator, watch for an oral yeast infection)

increase fluid and fiber intake

Which of the following instructions should the health care professional give a client about taking sucralfate to treat an acute duodenal ulcer? (take it with a prescribed antacid, reduce sodium intake, take it with food, increase fluid and fiber intake)

drug abuse

You should monitor a client taking dextromethorphan because of the potential for which of the following? (tachycardia, fluid retention, blurred vision, drug abuse)

hypokalemia

A client is taking furosemide (loop diuretic) and spironolactone (potassium sparing diuretic). You explain to the client that using these drugs together may reduce the risk of which adverse effect? (hypokalemia, hyponatremia, hyperglycemia, hypochloremia)

wait at least 1 minute before inhaling the second puff

A client will be taking albuterol via a metered-dose inhaler (MDI) with a glucocorticoid. When instructing the client about using the MDI, you should include which of the following information? (take a short, quick breath before using the inhaler, wait at least 1 minute before inhaling the second puff, hold down the canister of the inhaler while inhaling rapidly, block one nasal passage while inhaling)

hyperuricemia

A nurse is administering hydrochlorothiazide (thiazide diuretic) to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? (hyperuricemia, hypernatremia, hyperkalemia, hypoglycemia)

hypokalemia

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? (hypokalemia, hypoglycemia, hypouricemia, hyponatremia)

dizziness

A nurse is assessing a client who was administered ondansetron IV 1 hr ago. Which of the following findings should the nurse recognize as an adverse effect of this drug? (dizziness, bradycardia, tardive dyskinesia, dyspepsia)

hypotension

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? (tachycardia, dehydration, diarrhea, hypotension)

second-degree AV block

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? (migraine headaches, pancreatitis, second-degree AV block, angina pectoris)

aluminum hydroxide

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client's phosphorous levels when administering which of the following drugs? (omeprazole, aluminum hydroxide, sucralfate, ranitidine)

rash, distorted taste, swelling of the tongue, dry cough

A nurse is caring for a client who is about to begin captropril (ACE inhibitor) therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? Select all that apply. (rash, distorted taste, swelling of the tongue, photosensitivity, dry cough)

raisins

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? (raisins, cabbage, cheese, eggs)

grapefruit juice (can cause toxicity)

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug? (grapefruit juice, milk, foods high in vitamin K, NSAIDs)

respirations

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? (blood pressure, apical heart rate, respirations, level of consciousness)

antigen-binding fragments

A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication? (acetylcysteine, flumazenil, antigen-binding fragments, deferoxamine)

sucralfate interferes with the absorption of phenytoin

A nurse is caring for a client who is taking phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least 2 hr apart for which of the following reasons? (phenytoin increases the metabolism of sucralfate, phenytoin reduces the effectiveness of sucralfate, sucralfate increases the risk for phenytoin toxicity, sucralfate interferes with the absorption of phenytoin)

potassium 5.2 mEq/L

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention? (sodium 140 mEq/L, potassium 5.2 mEq/L, chloride 100 mEq/L, magnesium 1.9 mEq/L)

lethargy (CNS depression effects)

A nurse is caring for an older adult client who has renal impairment and a new prescription for cimetidine (histamine H2-receptor antagonist). The nurse should instruct the client to report which of the following manifestations? (lethargy, cellulitis, dry mouth, myalgia)

seizures

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? (seizures, constipation, normal sinus rhythm, somnolence)

infuse the drug 30 min prior to chemotherapy, infuse the drug slowly over 15 min, repeat the dose 4 hr after chemotherapy

A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. Which of the following actions should the nurse plan to take? Select all that apply. (infuse the drug 30 min prior to chemotherapy, administer the drug when the client reports nausea, infuse the drug slowly over 15 min, administer the drug immediately following chemotherapy, repeat the dose 4 hr after chemotherapy)

take the drug 30 to 60 min before activities that trigger nausea, avoid activities that require alertness, increase fluid and fiber intake

A nurse is providing teaching to a client who has a new prescription for dimenhydrinate to prevent motion sickness. Which of the following should the nurse include? Select all that apply. (sit upright for 30 min after taking the drug, avoid antacids, take the drug 30 to 60 min before activities that trigger nausea, avoid activities that require alertness, increase fluid and fiber intake)

facial edema

A nurse is providing teaching to a client who has a new prescription for losartan (angiotensin II receptor blocker) to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? (facial edema, sleepiness, peripheral edema, constipation)

take the drug with at least 8 oz of fluid, increase fluid and fiber intake

A nurse is providing teaching to a client who is about to start taking senna to treat constipation. Which of the following instructions should the nurse include? Select all that apply. (expect results in 6 to 12 hr, urinate every 4 hr., take the drug with at least 8 oz of fluid, avoid activities that require alertness, increase fluid and fiber intake)

palpitations

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? (fever, bruising, polyuria, palpitations)

albuterol will increase the absorption of fluticasone

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? (albuterol will increase the absorption of fluticasone, albuterol will decrease inflammation, albuterol will reduce nasal secretions, fluticasone will reduce the adverse effects of albuterol)

increase weight-bearing activity

A nurse is teaching a client who is beginning fluticasone proprionate/salmeterol therapy. Which of the following instructions should the nurse include? (take the drug as needed for acute asthma, follow a low-sodium diet, use an alternate-day dosing schedule, increase weight-bearing activity)

drowsiness

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? (muscle tremors, drowsiness, excitation, insomnia)

procainamide

A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use? (quinidine, procainamide, nitroglycerin, verapamil)

peanut allergy, glaucoma

You are obtaining a health history from a client who is to start a new ipratropium inhaler. Which of the following information from the client's history alerts you to take further action? Select all that apply. (seizure disorder, peanut allergy, depression treated with an MAOI, hypothyroidism treated with synthetic thyroid hormone, glaucoma)

fetal injury

You are talking with a client who is taking losartan (angiotensin II receptor blocker) for hypertension. She asks you about stopping contraception and starting a family. You inform the client that losartan is unsafe to take during pregnancy due to which risk? (macrosomia, fetal injury, gestational diabetes, thromboembolic disease)

antacids

You should not take ___ within 30-60 minutes of taking sucralfate

emphysema

You should recognize that which of the following is a contraindication for taking codeine? (emphysema, cataracts, hyperthyroidism, nonproductive cough)

the drug does not promote diuresis for clients who have renal insufficiency

A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug? (the drug can cause hypoglycemia in clients who have a low urine output, the drug does not reduce blood pressure for clients who have a low urine output, the drug can increase the risk of pulmonary edema for clients who have renal insufficiency, the drug does not promote diuresis for clients who have renal insufficiency)

hyperkalemia, throat swelling, cough

A nurse is caring for a client who has a new prescription for aliskiren (direct renin inhibitor) to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? Select all that apply. (hyperkalemia, throat swelling, constipation, cough, joint pain)

antacids

A nurse is caring for a client who has a new prescription for cimetidine (histamine H2-receptor antagonist) to treat GERD. The nurse should instruct the client to wait at least 1 hr between taking cimetidine and which of the following over-the-counter drugs? (ginko biloba, antidiarrheals, St. John's wort, antacids)

do not use salt substitutes to season your food

While talking with a client who is taking captopril (ACE inhibitor) to treat hypertension, which instructions do you include to help her manage the drug's adverse effects? (check your heart rate prior to taking the drug, wear sunscreen and protective clothing while outdoors, do not use salt substitutes to season your food, take the drug with a meal)

15 minutes before exercising

You are instructing a client about using cromolyn via inhalation to treat exercise-induced bronchospasm. You advise the client to take the drug (15 minutes before exercising, if needed to stop bronchospasm, after strenuous activity, once in the evening at bedtime)

administer the drug prophylactically during allergy seasons

You are instructing a client who has a new prescription for cetirizine. Which of the following information should you be sure to include? (restrict fluids to minimize the drug's adverse effects, take the drug in the morning to reduce adverse effects, take the drug on an empty stomach to increase absorption, administer the drug prophylactically during allergy seasons)

white coating in the mouth

You should advise a client who is taking beclomethasone to watch for which of the following possible indications of an adverse effect of this drug? (white coating in the mouth, abdominal pain, muscle twitching, palpitations)

limit the drug's use to 3 to 5 days

You should instruct a client using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion? (limit the drug's use to 3 to 5 days, add an intranasal glucocorticoid, taper the dose before discontinuation, restrict the drug's use to one nostril at a time)

abdominal pain

You should instruct a client who is taking zileuton (leukotriene modifier) to report which of the following possible indicates of a serious adverse effect of this drug? (abdominal pain, dysphagia, blurred vision, bradycardia)

black, tarry stools, sore throat, muscle weakness

A client is being discharged for home and will continue to take prednisone orally at home, as prescribed, and that she should watch for and report which of the following to her usual provider? Select all that apply. (persistent cough, black tarry, stools, sore throat, muscle weakness, urinary retention)

ibuprofen (can increase risk of gastrointestinal ulceration)

A client is prescribed prednisone by mouth. You review her history and the drugs she has been taking. Which of the following drugs might interact adversely with prednisone? (ibuprofen, levothyroxine, atorvastatin, spironolactone)

relieve constipation, reduce diarrhea

A client is starting therapeutic with methylcellulose, a bulk-forming agent. You explain to the client that this agent will have which of the following therapeutic effects? (relieve constipation, increase gastric pH, reduce diarrhea, decrease gastric acid secretion, alleviate nausea)