N2 ATI Pharm Questions

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effects? (Select all that apply) A. Bradycardia B. Anxiety C. Increased blood pressure D. Tremors E. Drowsiness at night

B. Anxiety C. Increased blood pressure D. Tremors

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. Cardiac Dysrhythmias

A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8. Which of the following routes of administration will deliver the medication with the shortest time of onset? A. Oral B. Intravenous C. Intramuscular D. SubQ

B. Intravenous No barriers to absorption and is deposited directly into the circulatory system

Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication? A. A patient with a fever of 103.4 F B. A patient admitted with deep vein thrombosis C. A patient admitted with severe hepatitis D. A patient who had abdominal surgery 1 week earlier

C. A patient admitted with severe hepatitis

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the follow prescriptions should the nurse clarify with the provider? A. Metoprolol B. Ondansetron C. Lorazepam D. Naloxone

C. Lorazepam Lorazepam can cause CNS depression, which can result in increased respiratory depression and sedation when administered with an opioid.

A nurse is caring for a client who was brought to the emergency department by friends after a reported heroin overdosed. Which of the following findings should the nurse expect to assess? A. Temperature 39.2 C (102.6 F) B. Respiratory rate 30/min. C. Pinpoint pupils D. Severe abdominal cramping

C. Pinpoint pupils Pinpoint pupils are an expected finding in opioid toxicity. Increased pupil size is seen in opioid withdrawal

For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication is which of these? A. As needed B. Around the clock C. On schedule during waking hours only D. Around the clock, with additional doses as needed for breakthrough pain

D. Around the clock, with additional doses as needed for breakthrough pain

A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as a rationale for increasing the client's daily intake of fiber? A. Fiber binds with the medication to relieve pain B. Dietary fiber prevents nausea caused by opioids C. Fiber promotes the absorption of opioids D. Dietary fiber helps prevent constipation

D. Dietary fiber helps prevent constipation The nurse should inform the client that constipation is an adverse effect of opioids

A nurse is caring for a client who takes scheduled morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following medications to treat breakthrough pain? A/ Meperidine B. Buprenorphine C. Methadone D. Fentanyl

D. Fentanyl The nurse should expect a prescription for fentanyl transmucosal (nasal spray) to treat breakthrough pain. Fentanyl is an opioid agonist with a rapid onset and a duration of 2 to 4 hours. Fentanyl should not interfere with the client's long-term opioid medication but should relieve breakthrough pain.

The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg Q3hrs as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?

0.75 mL

A nurse is teaching a client about a new prescription for extended-release oxycodone for pain management. Which of the following statements should the nurse include in the teaching? A. "Swallow this medication whole" B. "Take this medication before meals and at bedtime" C. "Constipation decreases with continued use" D. "Avoid taking other supplemental analgesics with this medication"

A. "Swallow this medication whole" The nurse should tell the client that extended-release oxycodone is a long-acting opioid medication and should not be cut in half or crushed to prevent immediate absorption of the entire does. This medication should be swallowed whole and is administered every 12 hours

A charge nurse is teaching a newly licensed nurse about the purpose of a client being prescribed a transdermal fentanyl patch. Which of the following clients should the charge nurse include in the teaching as a client who required this medication? A. A client who is opioid-tolerant B. A client who has difficulty swallowing C. A client who has severe intermittent pain D. A client who is postoperative following abdominal surgery

A. A client who is opioid-tolerant

D. Slow the rate of the infusion The nurse should decrease the infusion rate to reduce the amount of morphine the client receives and limit the risk of respiratory depression

A. Administer the medication over 4 to 5 minutes 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

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features? A. More constant drug levels for analgesia B. Less constipation and minimal dry mouth C. Less drowsiness than with oral opioids D. Lower dependency potential and no major adverse effects

A. More constant drug levels for analgesia

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Report of pain B. Respiratory rate 8/min C. Report of numbness D. Report of abdominal cramping and diarrhea

A. Report of pain The nurse should identify that naloxone is used to reverse the effects of an opioid overdose administered for pain, sedation euphoria, and respiratory depression. Excess doses of naloxone can cause the return of pain but can improve the client's respiratory rate

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should inform the client that 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. Status Epilepticus

A nurse is providing teaching to a client who has a new prescription for a fentanyl transdermal patch. Which of the following statements by the client indicates an understanding of the teaching? A. "The patch will not cause constipation like other pain medications do" B. "I will have to stop drinking grapefruit juice while using the patch" C. "I will place a heating pad over the patch to boost its effectiveness D. "The patch will give me relief from my pain faster than pills can"

B. "I will have to stop drinking grapefruit juice while using the patch" Grapefruit juice can increase the absorption of the medication, raising the amount of fentanyl in the client's blood. This effect can place the client at risk for CNS and respiratory depression

A nurse is providing teaching about benzodiazepines to a client who is discontinuing long-term alprazolam use. Which of the following pieces of information should the nurse include in teaching? A "You might experience somnolence." B. "Plan to taper the dose slowly over several months." C. "Call the provider if you have muscle weakness." D. "Confusion is common during this process."

B. "Plan to taper the dose slowly over several months." The nurse should instruct the client to plan to taper the alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal

A nurse is 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. "You should increase your fluid intake" An adverse effect of morphine is constipation

Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply) A. Diarrhea B. Constipation C. Pruritus D. Urinary frequency E. Nausea

B. Constipation C. Pruritus E. Nausea

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3 times per day, to the client for restlessness and anxiety of the past few days. For which of the following adverse effects should the nurse asses the client? A. Low-grade fever B. Sedation C. Diuresis D. Tonic-clonic seizures

B. Sedation Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients are especially at risk for central nervous system depression, even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? (Select all that apply) A. Renal insufficiency B. Severe asthma C. Sleep apnea D. Severe head injury E. Liver disease

B. Severe asthma C. Sleep apnea D. Severe head injury

A nurse is caring for a client who is experiencing acute pain and is receiving morphine. Which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? A. The client reports an inability to void B. The client's respiratory rate is 10/min C. The client has hypoactive bowel sounds D. The client has vomiting once in the last 4 hours

B. The client's respiratory rate is 10/min Morphine causes respiratory depression. If the RR is less than 12/min, the nurse should withhold the next does of morphine and notify the provider

The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply) A. "Be sure to have your child blow his nose before administering the nasal spray" B. "This medication is used only when symptoms of ADHD are severe" C. "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep" D. "Be sure to contact the physician right away if you notice expression of suicidal thoughts" E. "We will need to check your child's height and weight periodically to monitor physical growth" F. "If adverse effects become severe, stop the medication for 3 to 4 days"

C. "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep" D. "Be sure to contact the physician right away if you notice expression of suicidal thoughts" E. "We will need to check your child's height and weight periodically to monitor physical growth"

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mmHg. After stopping the opioid infusion, what should the nurse do next? A. Notify the charge nurse B. Draw arterial blood gases C. Administer an opiate antagonist per standing orders D. Perform a thorough assessment, including mental status examination

C. Administer an opiate antagonist per standing orders

A nurse is caring for a client who is due to receive general anesthesia. The client asks the nurse, "What is the difference between an analgesic and anesthesia?" Which of the following statements should the nurse make? A. "Analgesics can cause a lack of sensation" B. "Anesthesia is specifically for eliminating pain perception" C. "Analgesics treat pain without causing sedation" D. "Anesthesia can cause loss of consiousness"

D. "Anesthesia can cause loss of consciousness"

A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to adminsiter? A. Ibuprofen B. Naproxen C. Aspirin D. Acetaminophen

D. Acetaminophen Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of GI bleeding Ibuprofen, Naproxen, and Aspirin are all NSAIDs that increase the risk of GI bleeding

A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A. Flush the IV line with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of the infusion

D. Slow the rate of the infusion The nurse should decrease the infusion rate to reduce the amount of morphine the client receives and limit the risk of respiratory depression