N262 Pharm 1 Final
A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? A. Mucolytic B. Centrally acting antitussive C. Expectorant D. Peripherally acting antitussive E. Antihistamine
A. Mucolytic
A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system? A. cardiovascular B. neurological C. gastrointestinal D. renal
A. cardiovascular
The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? A. Supine B. Semi-Fowler's C. High Fowler's D. Side-lying
C. High Fowler's
A nursing instructor is preparing a teaching plan for a nursing class on opioid analgesics. Which body system would the nursing instructor describe as not adapting to and compensating for the secondary effects of this class of drugs? GI system respiratory system cardiovascular system nervous system
GI system
Which of the following antitubercular drugs are used during the continuation treatment phase of tuberculosis? Select all that apply: a. Isoniazid b. Rifampin c. Ciprofloxacin d. Pyrazinamide e. Ethambutol
a, b
Which of the following can occur if the nurse administers naloxone (Narcan) as a rapid IV bolus? Select all that apply: a. Withdrawal b. Intense pain c. Vomiting d. Hypotension e. Respiratory depression
a, b, c
What effects are exerted by aspirin? (Select all that apply.) a. Analgesic b. Antipyretic c. Anti-inflammatory d. Anti-infective e. Antiviral
a, b, c.
A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply. a. Gastric emptying b. Administration of an anticoagulant c. Administration of activated charcoal d. Life support, if indicated
a, c, d
A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer? a. Oral rehydration solutions b. Diphenoxylate (Lomotil) c. Octreotide (Sandostatin) d. Psyllium (Metamucil)
a. Oral rehydration solutions
The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action? a. Slows peristalsis by acting on the smooth muscles of the intestine b. Anti-inflammatory effects allowing absorption of fluids c. Antimicrobial effects d. Decreases GI secretions
a. Slows peristalsis by acting on the smooth muscles of the intestine
A health care provider orders diphenoxylate to treat a client who has severe hepatorenal disease. The nurse calls the provider to question this order because it may precipitate: a. hepatic coma. b. hyperkalemia. c. hypercalcemia. d. hyperglycemia.
a. hepatic coma.
A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed? a. loperamide b. diphenoxylate c. sodium bicarbonate d. omeprazole
a. loperamide
A client needing to evacuate the colon for endoscopy would likely be prescribed which medication? a. polyethylene glycol electrolyte solution b. methylcellulose c. psyllium d. mineral oil
a. polyethylene glycol electrolyte solution
A male client who has been on a drug regimen for tuberculosis (TB) for the last 2 months says he has lost his appetite and 10 pounds. What should the nurse suggest to the health care provider for this client to help in the area of nutrition? a. pyridoxine b. pyridium c. pyrazinamide d. rifampin
a. pyridoxine
The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.) A. Vomiting b. Drowsiness c. Decrease heart rate d. Dizziness e. Bowel obstruction
b, d
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? a. Acetaminophen b. Acetylsalicylic acid c. Ibuprofen d. Ascorbic acid
b. Acetylsalicylic acid
A client has been prescribed metronidazole for treatment of Giardia. What instruction is most important for the nurse to give to this client? a. Do not smoke while taking this medication. b. Do not drink alcohol while taking this medication. c. Regularly use sunscreen products while taking this medication. d. Do not eat dairy foods while taking this medication.
b. Do not drink alcohol while taking this medication.
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following? a. To treat osteoarthritis b. To inhibit platelet aggregation c. To decrease pain d. To decrease temperature
b. To inhibit platelet aggregation
An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that: a. the tablet would have no effect if crushed and ingested. b. there is risk of an extremely high dose available all at once if the tablet is crushed. c. crushing the tablet increases the drug's efficacy. d. crushing the tablet is a safe option.
b. there is risk of an extremely high dose available all at once if the tablet is crushed.
The nurse is providing education to a client who has been prescribed naltrexone. What effect should the nurse teach the client to expect if an opioid is taken? a. A decline in neurological function b. Visual hallucinations c. The absence of usual physiological effects d. A sudden onset of nausea and vomiting
c. The absence of usual physiological effects
When assessing a client who is to receive celecoxib, a history of which disease process or condition would be most important to assess? a. peptic ulcer b. diabetes c. cardiac disease d. respiratory disorder
c. cardiac disease
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy? a. Blood sugar b. Respiratory rate c. Body temperature d. Better mobility
d. Better mobility
A caregiver asks the nurse what the caregiver can give a 9-year-old child for a headache. What is the nurse's best response? "Acetaminophen is appropriate." "Acetaminophen-aspirin-caffeine works best." "Ketorolac can be prescribed." "The prescriber can order them a triptan."
"Acetaminophen is appropriate."
Your client receives IV vancomycin every 12 hours. You know that this infusion should run over: 3 to 4 hours. 2 to 4 hours. 30 minutes. 1 to 2 hours.
1 to 2 hours.
The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long? 2 days 1 day 12 hours 7 days
2 days
Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake? 2 to 3 days 1 to 2 days 3 to 4 days 1 week
2 to 3 days
A patient is taking acetylsalicylic acid (aspirin) to prevent platelet aggregation. Which dose of aspirin will irreversibly acetylate circulating platelets within a few minutes, with effects lasting for the lifespan of the platelets? 81 mg 180 mg 325 mg 650 mg
325 mg
Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose? 81-325 mg 180-240 mg 360-460 mg 600-650 mg
81-325 mg
A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? A. Dextromethorphan works in the medulla to suppress the cough reflex. B. Dextromethorphan works on the receptors in the throat to prevent a cough. C. Dextromethorphan works by inhibiting allergen response. D. Dextromethorphan works by relaxing the smooth muscles in the bronchioles.
A. Dextromethorphan works in the medulla to suppress the cough reflex.
The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration? Pain Electrolytes Allergy to aspirin Allergy to opioids
Allergy to aspirin
What home remedies are effective for mouth dryness and cough? (Select all that apply.) A. Administration of over-the-counter antihistamine B. Adequate fluid intake C. Humidification of the environment D. Sucking on hard candy or throat lozenges E. Swishing the mouth with astringent mouthwash.
B, C, D
Which agent acts directly on the medullary cough center? A. Benzonatate B. Codeine C. Ephedrine D. tetrahydrozoline
B. Codeine
A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? A. Codeine B. Guaifenesin C. Dextromethorphan D. Aspirin
B. Guaifenesin
A new mother required an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will be the most effective drug for the nurse to administer? Bisacodyl Castor oil Magnesium sulfate Docusate
Docusate
You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect? Hypomagnesemia Hypernatremia Hypochloremia Hyperphosphatemia
Hypernatremia
The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug? Ataxia Blurred vision Hypotension arrhythmias
Hypotension
The nurse should monitor the client for which common side effects of erythromycin therapy? Headache and fever Urticaria and ophthalmic drainage Nausea, vomiting, and diarrhea Shortness of breath and sore throat
Nausea, vomiting, and diarrhea
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection? Nausea Nephrotoxicity Increased bleeding Respiratory difficulty
Nephrotoxicity
A nurse is preparing a community teaching program about tuberculosis. When describing the individuals who are susceptible, who would the nurse include? Select all that apply. a. individuals living in crowded conditions b. individuals with human immunodeficiency virus (HIV) c. individuals less than 6 years of age d. individuals more than 30 years of age e. individuals with asthma
a, b
A client is treated for HIV with NNRTIs. The client develops tuberculosis, and the health care provider includes rifampin in the treatment regimen. Why would this be cause for concern? a. Rifampin decreases blood levels of anti-HIV drugs. b. Rifampin increases adverse side effects of anti-HIV drugs. c. Rifampin causes exacerbation of HIV infections. d. Rifampin causes critical anemias in clients with HIV.
a. Rifampin decreases blood levels of anti-HIV drugs.
Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client: a. that the therapy can cause decreased sexual urge or libido. b. that there may be an elevation in his blood pressure. c. he should wear glasses during the therapy. d. to continue rifampin therapy at least for a year.
c. he should wear glasses during the therapy.
For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply. a. A client with a partial small bowel obstruction b. A client being assessed for appendicitis c. A pregnant client who is in early labor d. A client who is recovering from a myocardial infarction e. A client who has completed anthelmintic therapy
d, e
Acetaminophen overdose has the potential to cause fatal: kidney damage. pancreas damage. lung damage. liver damage.
liver damage.
A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what? pupil constriction. diarrhea. tachypnea. hypertension.
pupil constriction.
A nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved? stomach lungs liver peripheral nerves
stomach
A client is taking pseudoephedrine to reduce nasal congestion. The nurse should caution the client against use of this decongestant if the client is currently taking what other type of drug? A. Anti-infective agents B. Anti-inflammatory agents C. Proton pump inhibitors (PPIs) D. thyroid preparations
D. thyroid preparations
The nurse is caring for a client newly admitted for chronic opioid abuse. What medication does the nurse expect to be prescribed to the client? Disulfiram Flumazenil Methadone Naloxone
Methadone
The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours? a. 2 to 3 L of clear liquids b. 1 to 2 L of clear liquids c. 0.5 to 1 L of clear liquids d. 3 to 4 L of clear liquids
a. 2 to 3 L of clear liquids
A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend: a. Psyllium (Metamucil). b. Docusate (Colace). c. mineral oil. d. milk of magnesia.
a. Psyllium (Metamucil).
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? a. The fluoroquinolone does not have adverse effects. b. The fluoroquinolone can be given orally. c. The fluoroquinolone has a nearly immediate peak. d. The fluoroquinolone has a broader spectrum.
b. The fluoroquinolone can be given orally.
A client is in the hospital recovering from surgery and is using a client-controlled anesthisia (PCA) pump. The client's adult child tells the nurse they are concerned about the possibility of morphine overdose because their parent keeps pressing the button on the PCA. In addition to reassessing the client's pain, what is the nurse's best response? a. "I'll teach you some techniques to take their focus off the pain so they don't press the button so often." b. "If they follow the directions given, that will not happen." c. "I'll come and teach them again how to use the PCA safely and effectively." d. "The device has maximum limits programmed, so your parent cannot get more than a specific amount."
d. "The device has maximum limits programmed, so your parent cannot get more than a specific amount."
A female client asks why she must consult with the health care provider when she uses cold products for her children. What is the nurse's best response? a. "Your health insurance requires that you notify the health care provider whenever you administer over-the-counter medications to your children." b. "Notification is just a precaution to protect you and your children." c. "You really aren't required to do so, it is just a precaution." d. "There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies."
d. "There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies."
The healthcare provider prescribes codeine 20 mg PO q4h as an adjunctive therapy to a client's NSAID. What is the nurse's best action? a. Contact the care provider to question the dose. b. Contact the care provider to question the frequency of administration. c. Contact the care provider to question concurrent use of an NSAID and codeine. d. Administer the medication as prescribed and monitor the client's pain.
d. Administer the medication as prescribed and monitor the client's pain.
Constipation is a frequent problem. The nurse knows that which of these statements regarding constipation is correct? a. Opioid drugs relieve constipation. b. Constipation is defined as the absence of daily bowel movements. c. Dietary fiber causes constipation. d. Constipation is characterized by hard, dry stools.
d. Constipation is characterized by hard, dry stools.
A 12-year-old cancer client is receiving morphine 5-10 mg PO q6 hours. The 12-year-old reports being in pain. The nurse checks the medication record and finds that it has been 5 1/2 hours since the client last received pain medicine. What would the nurse do? a. Notify the health care provider that the dosage is not strong enough. b. Tell the client to wait another 30 minutes before receiving pain medication. c. Ask the parents whether they think the client really needs the pain medicine at this time. d. Give the client 5 mg of morphine PO.
d. Give the client 5 mg of morphine PO.
The nurse should question an order for bismuth salts for a client with what condition? a. Rheumatoid arthritis b. Allergy to aspirin c. Hypertension d. Viral gastroenteritis
b. Allergy to aspirin
Which of the following is a serious risk involved in the use of NSAIDs? a. Increased granulocyte count b. Cardiovascular thrombosis c. Increased WBC count d. Sickle cell anemia
b. Cardiovascular thrombosis
What is first-line therapy for infants and children 1 to 4 years of age with diarrhea? a. Bismuth salts (Pepto-Bismol) b. Electrolyte replacement c. Paregoric d. Difenoxin (Motofen)
b. Electrolyte replacement
A woman who has given birth to a baby girl by cesarean delivery is experiencing abdominal pain. The client receive a bolus dose of morphine intravenously. The nurse would recommend that the mother refrain from breast-feeding the baby for how long? 1 to 2 hours 2 to 4 hours 4 to 6 hours 6 to 8 hours
4 to 6 hours
The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine A. an antihistamine, a stimulant, and a decongestant. B. a stimulant, a decongestant, and an antitussive. C. a decongestant, an analgesic, and an antihistamine. D. an analgesic, an antitussive, and an antiviral.
C. a decongestant, an analgesic, and an antihistamine.
A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to: A. continue taking the drug because the sensations will resolve with time. B. decrease the dosage by one half. C. stop taking the medication and come to the clinic as ordered by the health care provider. D. lie down after each dose.
C. stop taking medication and come to clinic as covered by provider
What is a contraindication to use of a fluoroquinolone? Weight Lactation Gender Height
Lactation
The nurse is caring for a client who has had impacted stools twice in the past month. What is the most appropriate laxative for this client? Magnesium hydroxide Mineral oil Docusate Psyllium
Mineral oil
A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply. a. "Antihistamines are not recommended because they tend to worsen your cough." b. "Antihistamines are used for allergy-related coughs." c. "Antihistamines are effective but only if you also increase your fluid intake." d. "Antihistamines are not recommended in your situation but an antibiotic may be useful." e. "Antihistamines are recommended for your type of cough, but you must monitor for adverse effects."
a, b
A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply. a. consuming a high-fiber diet b. engaging in frequent physical exercise c. drinking 6 to 10 glasses of fluid each day d. introducing organic foods into the daily diet e. reserving at least 8 hours nightly to assure adequate sleep
a, b, c
The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply. a. tachycardia b. hypertension c. vomiting d. bradypnea e. sedation
a, b, c
The nurse is reviewing the discharge instructions with the client going home on an opioid analgesic for pain management. What would the nurse include in the instructions? Select all that apply. a. Take a laxative/stool softener. b. Keep the room well lit during the day. c. Rise slowly from a sitting or lying position. d. Keep a record of bowel movements. e. Limit fluid intake.
a, b, c, d
Which should be included when assessing pain? (Select all that apply.) a. Location of the pain b. Intensity of pain c. What factors cause the pain to improve or worsen d. What medications client usually takes to relieve the pain
a, b, c, d
Linezolid can be used to treat which of the following infections? Select all that apply. a. Community-acquired pneumonia (CAP) b. Vancomycin-resistant Enterococcus faecium (VREF) c. Methicillin-resistant Staphylococcus aureus (MRSA) d. Acute otitis media e. Nosocomial pneumonia
a, b, c, e
What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) a. Anti-inflammatory b. Analgesic c. Antipruritic d. Antipyretic e. Antibacterial
a, b, d
What drugs are examples of second-line opioid agonists/antagonists prescribed for the treatment of moderate-to-severe pain? Select all that apply. a. butorphanol b. nalbuphine c. methadone d. naltrexone e. pentazocine
a, b, e
A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure? (Select all that apply.) a. inadequate initial drug treatment b. lack of vegetables in person's diet c. noncompliance with the therapeutic regimen d. type of facility where the client resides e. lack of access to vitamins
a, c
A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply. a. Take the drug with food or milk to improve absorption. b. Dissolve the drug in 90 to 120 mL of water. c. Continue therapy for at least 1 week. d. Notify the PHCP in case of fever, chills, or cough. e. Avoid excessive intake of citrus products or milk products.
a, c, d
Lactulose (Chronulac, Cephulac) is prescribed for a client. The nurse knows that which of these statements regarding lactulose are correct? Select all that apply. a. Lactulose is used to manage hepatic encephalopathy. b. Lactulose increases accumulation of ammonia in the intestine. c. Lactulose can cause electrolyte imbalance. d. Lactulose should produce two or three soft stools every day. e. Lactulose produces defecation within 6 hours.
a, c, d
Repeated lab work shows positive cultures for a client prescribed drug therapy for tuberculosis (TB) over 4 weeks ago. What are the likely reasons for this failure to achieve treatment goals? Select all that apply. a. client has been nonadherent with medication therapy b. prescribed intermittent medication administration c. a delay in the initial diagnosis of the client d. infecting strain of TB is drug resistant e. administration of defective medication
a, c, d
While caring for a client who is prescribed an opioid antagonist for treatment of respiratory depression caused by opioid therapy, the nurse would assess the client for which adverse reaction? Select all that apply. a. tachycardia b. fever c. tremors d. nausea e. diarrhea
a, c, d
A nurse should recognize which situations necessitate the need for an opioid antagonist. Which situations necessitate the need for an opioid antagonist? (Select all that apply.) a. Postoperative acute respiratory depression b. Reversal of phenytoin toxicity c. Reversal of opioid induced hypotension d. Suspected acute benzodiazepine overdosage e. Suspected acute opioid overdosage
a, c, e
An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction? Select all that apply. a. rectal suppository b. psyllium c. surgery d. enema e. magnesium citrate
a, d
Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis? Select all that apply: a. Sennosides (Senokot) b. Methylcellulose (Citrucel) c. Glycerin (Fleet Babylax) d. Bisacodyl (Dulcolax) e. Lactulose (Chronulac)
a, d
The nurse collects the past medical history of a client new to the clinic. The client reports an allergy to penicillin. What questions about the allergy should the nurse ask the client? Select all that apply. a. "What signs and symptoms were displayed with the reaction?" b. "Were you offered alternative medications?" c. "Do others in your family have similar allergies?" d. "How many doses were administered before the reaction occurred?" e. "Had the medication ever been prescribed before the time when the reaction occurred?"
a, d, e
The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent doesn't know why the teeth are discolored and reports that the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask? a. "Have they ever received tetracycline?" b. "Have they ever received gentamicin?" c. "Have they ever received ampicillin?" d. "Have they ever received cephalexin?"
a. "Have they ever received tetracycline?"
A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium? a. "This medication will only soften your stools over the next couple of days." b. "You'll usually have a bowel movement within 2 to 3 hours of taking this." c. "This medication will cause your bowels to contract more strongly than they normally do." d. "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days."
a. "This medication will only soften your stools over the next couple of days."
A client received erythromycin before dental surgery. The client has a past history of a cardiac surgery. The rest of the client's history is unremarkable. What does the nurse teach the client about this medication? a. "You are receiving this medication to prevent infection that may affect your heart." b. "You need this medication to decrease the extraction pain of surgery." c. "You cannot receive other antibiotics because of your cardiac history." d. "This medication will help them remove your tooth easier."
a. "You are receiving this medication to prevent infection that may affect your heart."
The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine? a. A 78-year-old with osteoarthritis b. A 45-year-old, 1-day postoperative mastectomy c. An 8-year-old with a fractured femur d. A 17-year-old, 1-day postoperative appendectomy
a. A 78-year-old with osteoarthritis
A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching? a. Drink at least 8 ounces of fluid with the medication. b. Mix the medication with your food at your evening meal. c. Add all of the medications to the mucilloid. d. Discontinue the mucilloid if no bowel movement occurs in 24 hours.
a. Drink at least 8 ounces of fluid with the medication.
A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug? a. Duration of action will be prolonged. b. Onset of desired effect will be shortened. c. The peak drug effect will occur earlier. d. Desired effect will be lessened.
a. Duration of action will be prolonged.
When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause? a. E. coli b. Pseudomonas c. C. difficile d. Staphylococcus aureus
a. E. coli
Determining the cause of diarrhea in a patient is important. It enables choosing the correct treatment. The nurse recognizes that a stool specimen is sometimes necessary to determine correct therapy. The nurse recognizes that a green, liquid stool may be from which of the following? a. Escherichia coli b. Cholecystitis c. Shigella d. Inflammatory bowel disease
a. Escherichia coli
Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist? a. Increase in the client's pain rating b. Decrease in the client's pain rating c. No change in the client's pain rating d. None of these options
a. Increase in the client's pain rating
A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants? a. Increase the fluid in the intestinal contents b. Directly stimulate the nerve plexus in the intestinal wall c. Allow formation of a slippery coat on the intestinal contents d. Selectively antagonize opioid binding
a. Increase the fluid in the intestinal contents
A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis? a. Increased risk of GI bleeding b. Increased risk of CNS disorders c. Increased risk of hearing impairment d. Increased risk of blindness
a. Increased risk of GI bleeding
The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means? a. It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. b. It is a drug that has a special caution because use of this drug is more likely to have adverse effects. c. It is a drug that no longer has a patent and can be sold by its generic name. d. It is a drug that reduces the likelihood of drug abuse and dependence.
a. It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance
What nursing intervention would not be effective in assisting the client in stopping his or her migraine headache? a. Keeping the room well lit b. Having the client lie quietly c. Administering a triptan d. Administering a nonsteroidal anti-inflammatory drug
a. Keeping the room well lit
The client returns to the unit following surgery. The client reports being in pain. After checking the medication administration record in the client's chart, the nurse sees that the client has not received the morphine the health care provider has ordered for over an hour. As the order reads q 1-2 hours, the nurse administers the low dose of the morphine. The PACU nurse calls to tell the floor nurse that the nurse forgot to chart the last dose of morphine the client had received just before the client was transferred to the floor. What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids? a. Naloxone hydrochloride (Narcan) tartrate b. Butorphanol c. Buprenorphine (Buprenex) d. Nalbuphine hydrochloride (Nubain)
a. Naloxone hydrochloride (Narcan) tartrate
A client is receiving acetaminophen for fever. The client also has inflammation in the knees and elbows with pain. Why will acetaminophen assist in reducing fever but not in decreasing the inflammatory process? a. Prostaglandin inhibition is limited to the central nervous system. b. Acetaminophen inhibits cyclooxygenase (COX-1 and COX-2) only. c. Acetaminophen has an antiplatelet effect to decrease edema. d. Prostaglandins decrease the gastric acid secretion.
a. Prostaglandin inhibition is limited to the central nervous system.
The nurse is giving instructions to a client who will be having a colonoscopy in the morning. The client will be taking polyethylene glycol-electrolyte solution for bowel cleaning. What information will help increase the palatability of this medication? a. Refrigerate the solution until it is cold. b. Add ice cubes to each glass of liquid. c. Allow the liquid to warm up before drinking it. d. Warm the liquid in the microwave for 25 seconds before using it.
a. Refrigerate the solution until it is cold.
A client has been prescribed a fentanyl patch for chronic pain. What client teaching should the nurse provide to the client and family upon discharge? a. Remove the patch every 3 days. b. Apply it to the chest only. c. Apply it for breakthrough pain. d. Remove it daily and clean skin.
a. Remove the patch every 3 days.
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? a. Serum alanine transaminase, aspartate transaminase, and bilirubin b. Red blood count, white blood count, and differential c. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels d. Fasting blood sugar and 2-hour postprandial blood sugar
a. Serum alanine transaminase, aspartate transaminase, and bilirubin
A 2-year-old child from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the family's arrival in the United States 3 weeks ago. History reveals nothing remarkable, but the mother comments on her child's love of (and continual consumption of) ice cream, something not available in their native country. This history supports what possible cause of the child's diarrhea? a. lactase deficiency b. Clostridium difficile c. irritable bowel syndrome d. inflammatory bowel disorder
a. lactase deficiency
A 75-year-old client is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the client is being treated for rheumatoid arthritis and hypertension. The client is in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the client's: home environment. diet. activity level. medication history.
activity level.
To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.) a. Keep the lights in the client's room turned down. b. Assist client from their bed to the toilet. c. Assist client with rising from a lying position. d. Assist client with hall-walking activities. e. Advise the client to stay in bed all night.
b, c, d
A nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if what occurs? Select all that apply: a. Constipation b. Blood is noted in the stool c. Diarrhea worsens d. Client reports severe abdominal pain e. Diarrhea is not relieved
b, c, d, e
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply. a. Draw the trough level 30 to 60 minutes after drug is administered, and report level above 10 to 12 mcg/mL. b. Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. c. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. d. Obtain peak level before administering next dose of drug, and report level above 2 mcg/mL. e. Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated.
b, c, e
The nurse prepares to administer acetylcysteine by nebulization to an adult client diagnosed with chronic bronchitis. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. a. Instruct client that the drug irritates gastric vagal receptors to stimulate respiratory tract fluid. b. Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. c. Provide drug after meals and before bedtime to remove mucous, which causes difficulties in breathing. d. Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. e. Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber.
b, d, e
A nurse is assessing a female client who has been taking NSAIDs. What statement by the client indicates a good understanding of the use of NSAID therapy? a. "I drink a glass of wine every night." b. "I asked my provider to check for blood in my stool on a regular basis." c. "I don't like to swallow tablets so I crush them." d. "I take as little water as possible when I take my medication."
b. "I asked my provider to check for blood in my stool on a regular basis."
A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug? a. "Take a dose of sumatriptan each morning when you suspect there's a chance of having a migraine." b. "Take this drug as soon as you feel the first signs of a migraine." c. "Lie down when you feel a migraine coming on and take some sumatriptan around 30 minutes later." d. "Take a dose of sumatriptan after you feel that you're unable to endure the pain of your migraine."
b. "Take this drug as soon as you feel the first signs of a migraine."
The nurse has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next? a. No further action is required because the naloxone has already been administered. b. Call the provider as another dose of opioid antagonist may be necessary. c. Administer a second dose and then notify the provider to obtain an order. d. Continue to monitor the client's vital signs and oxygen saturation levels.
b. Call the provider as another dose of opioid antagonist may be necessary.
Which medication will be administered for the treatment of salicylate overdose? a. Intravenous meperidine b. Intravenous sodium bicarbonate c. Intravenous furosemide d. Inhaled acetylcysteine
b. Intravenous sodium bicarbonate
The nurse should know that lactulose achieves a therapeutic effect by which means? a. Decreasing the viscosity of intestinal contents in the duodenum b. Pulling water into the intestinal lumen by osmotic pressure c. Irritating the intestinal mucous membrane d. Relaxing the muscle tone of the ileocecal valve and anal sphincter
b. Pulling water into the intestinal lumen by osmotic pressure
The client has been taking acetaminophen daily for two years. The health care provider has now prescribed ketoprofen in addition to the acetaminophen. The nurse plans to educate the client on NSAIDs and acetaminophen and that their interaction can cause what condition? a. Respiratory impairment b. Renal impairment c. Hematologic disorders d. Immunologic disorders
b. Renal impairment
A family member asks the nurse why a second dose of an opioid antagonist is needed. Which response by the nurse is correct? a. The opioid antagonist is not a very high dose, so more than one dose is needed to have an effect. b. The opioid medication that was given may last longer than the opioid antagonist medication. c. Depending on the client's metabolism, multiple doses may be required to have an effect. d. When a client is on multiple medications, more opioid antagonist is needed to be effective.
b. The opioid medication that was given may last longer than the opioid antagonist medication.
The parent of a toddler asks about giving an over-the-counter (OTC) cough and cold product containing pseudoephedrine to the child. What information regarding safety and efficacy should the nurse offer? a. Cough and cold remedies are generally safe and effective for children over the age of 2. b. There are concerns among health professionals about how safe and effective these medications are. c, Media reports about the risks of cough and cold medications in children have greatly exaggerated the risks. d. Risk can be minimized by using age-specific preparations of cough and cold remedies.
b. There are concerns among health professionals about how safe and effective these medications are.
Clients diagnosed with chronic pain should be given what information regarding opioids' effectiveness? a. They should be given as soon as the client feels uncomfortable. b. They should be given on a regular schedule, around the clock. c. They should be given IM as the preferred route of administration. d. They should be given topically only as a last resort.
b. They should be given on a regular schedule, around the clock.
A postsurgical client has been prescribed morphine to address the pain that is anticipated over the next 24 to 48 hours. What is the most effective strategy to manage a client's postsurgical pain for the initial 24 to 48 hours? a. administering the maximum safe dose of morphine for 12 to 24 hours and then transitioning to nonsteroidal anti-inflammatory drugs (NSAIDs) b. administering morphine on a scheduled basis and supplementing it with additional morphine when the pain worsens c. administering morphine every 4 hours, with gradually decreasing doses over the next several days d. encouraging the client to endure the pain as much as possible before administering morphine
b. administering morphine on a scheduled basis and supplementing it with additional morphine when the pain worsens
Tuberculosis caused by drug-resistant organisms should be considered in which clients? Select all that apply: a. Clients who are HIV positive b. Clients who have no response to therapy c. Clients who have been treated in the past d. Clients who have asthma e. Clients who smoke
b. c
Which medication is prescribed parenterally for severe pain? a. naproxen b. ketorolac c. acetaminophen d. acetylsalicylic acid
b. ketorolac
The nurse is providing client teaching about a prescribed opioid analgesic. When monitoring the client for potential adverse effects, what assessment should the nurse prioritize? coordination visual acuity blood pressure heart rhythm
blood pressure
A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this client's statements? a. "Because we become more prone to constipation as we age, you'll likely need to increase the number of stool softeners you take." b. "I'll refer you to a specialist because it could be that you have a disease affecting your bowels or stomach." c. "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." d. "Try using a different over-the-counter laxative and see that if you resolves your problem."
c. "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."
A client is concerned because his drug regimen for drug-resistant TB is different from that of his friends. Which explanation by the nurse is accurate? a. "Treatment varies based on the length of time you are ill." b. "Treatment is based on the amount of sputum production." c. "Treatment is based on drug susceptibility reports." d. "There is a standardized treatment regimen."
c. "Treatment is based on drug susceptibility reports."
A client is taking a nonsteroidal anti-inflammatory agent. Which instruction should the client be given in regard to administration? a. Administer the medication with orange juice. b. Crush enteric-coated tablets for impaired swallowing. c. Administer the medication with food. d. Administer the medication every other day.
c. Administer the medication with food.
A nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate? a. Provide aggressive bowel program. b. Administer the drug through the IV route. c. Consult with the prescriber about lowering the dosage of the drug. d. Administer an antacid with the drug.
c. Consult with the prescriber about lowering the dosage of the drug.
The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug? a. Bradycardia b. Polyuria c. Dizziness d. Paleness of the face
c. Dizziness
Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction? a. Take the first dose together with diphenhydramine to reduce the chance of an allergic reaction. b. Take the drug immediately before a meal, unless the meal will contain large amounts of fat. c. Drink a full glass of water when taking a dose of the drug. d. Taper off the drug rather than abruptly stopping it.
c. Drink a full glass of water when taking a dose of the drug.
A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment? a. INH, streptomycin, and rifampin b. INH, streptomycin, pyrazinamide c. INH, rifampin, pyrazinamide, ethambutol d. INH, rifampin, streptomycin, ethambutol
c. INH, rifampin, pyrazinamide, ethambutol
How do opioid analgesics relieve moderate-to-severe pain? a. inhibiting the transmission of pain signals from the hypothalamus to the spinal cord b. preventing the opioid from binding with a receptor site c. inhibiting the transmission of pain signals from peripheral tissues to the brain d. increasing the production of endorphins in the brain
c. inhibiting the transmission of pain signals from peripheral tissues to the brain
A postsurgical client has been provided with a morphine patient-controlled analgesic (PCA) but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond to this client's concerns? a. "You don't need to worry. It's actually not true that you can get addicted to the medications we use in a hospital setting." b. "If you do become addicted, we'll make sure to provide you with the support and resources necessary to help you with your recovery." c. "It's important that you accept that your current need to control your pain is more important than fears of becoming addicted." d. "It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."
d. "It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."
A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit? a. Maintain the head of the client's bed at ≥ 45°. b. Encourage fluid intake. c. Create a restful, dark, quiet environment. d. Put side rails up and place bed in low position.
d. Put side rails up and place bed in low position.
When teaching a client about the action of an opioid antagonist, what should the nurse include in the education? a. A medication called an opioid antagonist is given to enhance the effect of the opioid. b. An antagonist increases the rate of respirations to counter the effects of the opioid medication. c. An opioid antagonist acts on the central nervous system to elevate the level of consciousness. d. This medication competes with the opioid pain medication, binding to the cell receptors instead.
d. This medication competes with the opioid pain medication, binding to the cell receptors instead.
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins: a. are ineffective in clients who are allergic to penicillins. b. can cause kidney damage in clients who are allergic to penicillins. c. are derived from penicillin. d. can cause allergic reactions in clients who are allergic to penicillins.
d. can cause allergic reactions in clients who are allergic to penicillins.
A 23-year-old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. During the assessment, she informs the nurse that she has been experiencing these symptoms for the last three months on a weekly basis. These symptoms are those of: a. fever. b. inflammation. c. headache. d. migraine headache.
d. migraine headache.
