NUR 3420- Pharmacology Exam 5-ATI Questions
A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug? A) "Pre-medicate with acetaminophen" B) "Take the drug with food" C) "Increase your fluid intake" D) "Take the drug in the morning"
A) "Pre-medicate with acetaminophen" Rationale: Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these symptoms.
A nurse is providing teaching to a client who has a new prescription for fluoxetine, Which of the following instructions should the nurse include? A) "Weigh yourself twice a month" B) "If you have persistent headaches, let the provider know" C) "Reduce your daily sodium intake" D) "If your symptoms don't improve in 10 days, you will need a higher dosage"
B) "If you have persistent headaches, let the provider know" Rationale: The client should report persistent headache, anxiety, or insomnia to the provider as an adverse drug reaction.
A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client's phosphorus levels when administering which of the following drugs? A) Omeprazole B) Aluminum Hydroxide C) Sucralfate D) Famotidine
B) Aluminum Hydroxide Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophsphatemia because of the aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the clients phosphorus levels while administering this drug.
A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? A) "Avoid driving or activities requiring alertness" B) "If you miss a dose, double the next dose" C) " Rinsing the mouth with alcohol-based mouthwash can reduce dryness" D) "Having one glass of wine each night can improve medication effectiveness"
A) "Avoid driving or activities requiring alertness" Loperamide can cause drowsiness and dizziness. The clients should avoid driving or activities requiring alertness while taking the drug.
A nurse is teaching a client who has a new prescription for sulfasalazine. Which of the following statements should the nurse make? A) "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." B) "The medication can stain your contact lenses green." C) "The medication can color your urine dark brown" D) "Take an iron supplement when you take sulfasalazine to prevent anemia"
A) "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning
A nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. Which of the following instructions should the nurse include? A) "take a missed dose as soon as you remember" B) "Take the drug as needed at the first sign of anxious feelings" C) "Take the drug in the morning with a glass of grapefruit juice" D) "Drink a cup of chamomile tea at night with the drug"
A) "take a missed dose as soon as you remember" Rationale: Busprione should be taken on a regular scheduled basis to be therapeutic. If a client misses a dose, then they should take one as soon as they remember, as long as it is not close in time for the next scheduled dose.
A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for azathioprine to treat ulcerative colitis. For which of the following reasons should the nurse clarify these prescriptions with the provider? A) Allopurinol delays the conversion of azathioprine and can lead to toxicity B) Azathrioprine increases the effectiveness of allopurinol C) Allopurinol increases the metabolism of azathioprine and can require an increased dosage. D) Azathioprine decreases the effectiveness of allopurinol.
A) Allopurinol delays the conversion of azathioprine and can lead to toxicity Allopurinol delays the conversion of azathioprine to an inactive form and can lead to toxicity. If used concurrently, the dose pf azathioprine must be reduced.
A nurse is providing teaching to a client about instilling pilocarpine for managing open-angle glaucoma. Which of the following instructions should the nurse include in the teaching? A) Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops B) Do not touch the tip of the dropper C) Wash hands after instilling the drops D) Rub eyes gently after instilling the drops E) Remove contact lenses prior to instilling the drops.
A) Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops Rationale: Applying gentle pressure to the nasolacrimal duct for 1 to 2 min after instillation helps keep the drug from entering the systemic circulation B) Do not touch the tip of the dropper Rationale: The tip of the dropper should remain steril. It is important that clients avoid touching the dropper's tip or toucing it to the eye area. E) Remove contact lenses prior to instilling the drops Rationale: Clients should remove contact lenses before instilling eye drops because they can cause further irritation if left in place.
A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions? A) Gout B) Constipation C) Insomnia D) Hursutism
A) Gout An adverse effect of methotrexate is hyperuricemia, which causes gout, The nurse should instruct the client to drink plenty of fluids to minimize this effect, and to report edema or pain the joints.
A nurse is caring for a client who has a prescription for alprazolam. For which of the following adverse effects should the nurse monitor? (Select all that apply). A) Tolerance B) Anxiety C) Sedation D) Respiratory Depression E) Constipation
A) Tolerance Rationale: Tolerance and dependence can develop with benzodiazepines, such as alprazolam. Clients should use these drugs only as needed and for short periods of time. B) Anxiety Rationale: Paradoxical reactions, such as anxiety and insomnia, can develop when taking alprazolam, especially in older adults. Clients should report these findings C) Sedation Rationale: CNS depression, manifested as sedation and drowsiness, is an adverse effect of benzodiazepines, such as alprazolam. Clients should take a benzodiazepine 30 min prior to bedtime. E) Respiratory Depression Rationale: Benzodiazepines, such as alprazolam, can cause CNS depression when taken with other CNS depressants, especially for older adult clients. It is important to monitor for respiratory depression and recommend the lowest effective dose. Clients should avoid alcohol and other CNS depressants while taking benzodiazepine
A nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. The nurse should instruct the client to monitor for which of the following findings as indications of lithium toxicity? (Select all that apply) A) Tremors B) Confusion C) Bronchospasm D) Nausea E) Muscle weakness
A) Tremors Rationale: A fine hand tremor is an early indication of lithium toxicity. A coarse tremor indicates advanced toxicity that can lead to seizure activity B) Confusion Rationale: Confusion, slurred speech, an ataxia are indications of lithium toxicity that develop because of the drug's narrow therapeutic range C) Nausea Rationale: Nausea, vomiting, and diarrhea are early indications of lithium toxicity that develop because of the drug's narrow therapeutic range. Clients should report any of these adverse effects. D) Muscle weakness Rationale: Muscle weakness is an early indication of lithium toxicity that develops because of the drug's narrow therapeutic range. The nurse should monitor lithium levels periodically.
A nurse is caring for a client who has been taking amphetamine.dextroamphetamine sulfate for the treatment of attention deficit hyperactivity disorder (ADHD) for 2 weeks. The nurse should report which of the following findings to the provider? A) Weight loss of 2.3 kg (5lbs) B) BP 110/70 mm Hg C) Apical pulse 80/min D) Respiratory Rate 16/min
A) Weight loss of 2.3 kg (5lbs) Rationale: Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weight themself twice weekly and report unintended weight loss.
A nurse should recognize that sulfasalazine is contraindicated for clients who have which of the following conditions? A) Pancreatitis B) Aspirin sensitivity C) Bronchitis D) GERD
B) Aspirin sensitivity Any sensitivity to salicylates, sulfonamides, or trimethoprim is a contraindicated for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacteria metabolize the drug into 5-aminosalicylc acid, a salicylate. Aspirin is also a salicylate.
A nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following laboratory tests requires monitoring. A) C-reactive protein B) Creatinine clearance C) Thyroid Function D) CBC
B) Creatinine clearance Rationale: Pramipexole, a direct-acting receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.
A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (Select all that apply) A) Level of consciousness B) Skin integrity C) Temperature D) Urine output E) CBC
B) Skin integrity Sulfasalazine can cause a skin rash, so the nurse should check the client's skin for rashes. The drug can also cause nausea. If the client reports nausea, the nurse should suggest taking the drug with food or water C) Temperature Sulfasalazine can cause a fever, so the nurse should check the client's temperature and treat fever with an antipyretic E) CBC Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The nurse should check the client's CBC periodically during therapy and tell the client to report sore throat or fatigue
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 include? A) Take the medication with food B) Swallow the capsules whole C) Dissolve the tablets in water D) Take the medication at bedtime
B) Swallow the capsules whole Omeprazole, a proton pump inhibitor, is unstable in stomach acid. The nurse should instruct the client to swallow the capsules or tablets whole and not to crush or chew the capsules or tablets.
A nurse is providing teaching to a client who has a prescription for chlorpromazine. Which of the following instructions should the nurse include? A) Stop taking the drug immediately with the first sign of a sore throat B) Wear sunscreen when exposed to sunlight C) Take the drug with food to reduce gastrointestinal distress D) Take the drug in the morning to prevent nocturia
B) Wear sunscreen when exposed to sunlight Rationale: Chlorpromazine, a conventional antipsychotic, can cause photosensitivity, or increased susceptibility to sunburn, when exposed to sunlight. Clients should limit their exposure to sunlight and wear sunscreen and protective clothing while outdoors.
A nurse is providing teaching to a client who has a new prescription for dimenhydrinate to prevent motion sickness. Which of the following instructions should the nurse include? (Select all that apply) A) Sit upright for 30 min after taking the drug B) Avoid antacids C) Take the drug 30 to 60 minutes before activities that trigger nausea D) Avoid activities that require alertness E) Increase fluid and fiber intake
C & D are correctC) Take the drug 30 to 60 minutes before activities that trigger nausea The nurse should instruct the client to take dimenhydrinate 30 to 60 minutes before activities that trigger nausea, and again before meals and at bedtime.
A nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. Which of the following instructions should the nurse include? A) Consume a low-sodium diet B) Reduce fluid intake C) Avoid taking NSAIDS D) Take the drug with food.
C) Avoid taking NSAIDS Rationale: NSAIDS increase renal absorption of lithium and sodium. Clients who take lithium should not take NSAIDS
A nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. Which of the following client statements indicates an understanding of the teaching? A) "It is not a big deal if I forget my pills for a couple of days" B) "I should limit alcohol intake to one drink daily while taking this medication" C) "I will avoid salt because this medication can increase my blood pressure" D) "If I become pregnant, it is important to let my health care provider know"
D) "If I become pregnant, it is important to let my health care provider know" Rationale: Diazepam can increase the risk of congenital malformations and is contraindicated for clients who are pregnant.
A nurse is caring for a client who recently began taking chlorpromazine to treat schizophrenia and who was admitted to the emergency room with spasms of their face and back. Which of the following adverse reactions should the nurse suspect? A) Cholinergic Crisis B) Serotonin Syndrome C) Stevens-Johnson syndrome D) Acute dystonia
D) Acute Dystonia Rationale: Acute dystonia can develop during the first few days of treatment with chlorpromazine. Manifestation include muscle spasms of the back, neck, face, and tongue. Treatment include immediate administration of an anticholinergic drug, such as diphenhydramine.
Which of the following drugs has protocols that require clients to meet specific risk-management criteria and sign a treatment agreement before the nurse can administer the drug? A) Lubiprostone B) Azathioprine C) Sulfasalazine D) Alosetron
D) Alosetron Clients who take alosteron, a serotonin 5-HT3 receptor antagonist, can develop severe constipation that can lead to impaction, bowel obstruction, perforation, and potentially fatal ischemic colitis. Because of these risks, nurses must inform clients of the benefits and risks oft eh drug therapy, and clients must sign a treatment agreement
A nurse is caring for a client who has a new prescription for famotidine to treat GERD. The nurse should instruct the client to wait at least 1 hr between taking famotidine and which of the following over-the-counter drugs? A) Ginkgo biloba B) Antidiarrheals C) St. John's Wort D) Antacids
D) Antacids Antacids can decrease the absorption of famotidine, a histamine 2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking famotifdine and taking an antacid.
A nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include? A) Increase fluid intake to improve renal excretion B) Report memory loss of confusion C) Watch for sings of liver impairment, such as jaundice and abdominal pain D) Avoid taking over-the-counter antacids.
D) Avoid taking over-the-counter antacids. Rationale: Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity.
A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? A) Monitor for constipation B) The dosage will be increase weekly to provider optimum therapeutic effect C) Administering the drug first thing in the morning promotes effective D) Avoid the use of NASIDS for pain.
D) Avoid the use of NASIDS for pain. Rationale: Combining NSAIDS with donepezil can cause gastrointestinal bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs
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? A) Phenytoin increases the metabolism of sucralfate B) Phenytoin reduces the effectiveness of sucralfate C) Sucralfate increases the risk for phenytoin toxicity D) Sucralfate interferes with the absorption of phenytoin
D) Sucralfate interferes with the absorption of phenytoin Sucralfate decreases the absorption of phenytoin. The nurse should instruct the client to allow at least 2 hr between taking the two drugs and should monitor the client's phenytoin levels.
A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects? A) Anterograde Amnesia B) Respiratory Depression C) Paradoxical reaction D) Withdrawal symptoms
D) Withdrawal symptoms Rationale: Physical dependence can develop with extended use of alprazolam, a benzodiazepine. To prevent withdrawal symptoms, clients should taper the dose slowly over several weeks.
A nurse is assessing a client who has been taking alprazolam for several days. Which of the following findings should the nurse identify as an adverse drug reaction caused by alpazolam? A) Anxiety B) Ringing in the ears C) Increased appetite D) Muscle spasms
A) Anxiety Rationale: The client can experience a paradoxical effect when taking benzodiazepines or buspirone, indicated by increased anxiety rather than relief of anxiety. The nurse should report this to the provider, who might consider a different medication.
A nurse should identify that timolol is contraindicated for a client who has which of the following disorders? A) Asthma B) Seizure Disorder C) Diabetes mellitus D) Rheumatoid arthritis
A) Asthma Rationale: Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. Clients who have asthma or any disorder that compromises respiratory function should not use the drug.
A nurse is teaching a client who is taking levodopa/cabidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? A) Change position slowly to prevent orthostatic hypotension B) Eat a high-protein snack to increase absorption C) Take the drug at bedtime to avoid daytime drowsiness D) Expect eye twitching to develop with long-term therapy
A) Change position slowly to prevent orthostatic hypotension Rationale: Levodopa/Carbidopa can cause orthostatic hypotension
A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine IV. Which of the following client findings should the nurse monitor after administering the medication A) BUN level B) Blood pressure C) Urine Specific Gravity D) Pedal Pulse Strength
B) Blood pressure Rationale: Clients who receive chlorpromazine are at risk for hypotension during and immediately after IV administration. The client should remain supine for 30 min while the nurse monitors their blood pressure. The nurse should instruct the client to change positions slowly as a safety precaution to prevent client injury. This medication can also cause orthostatic hypotension.
A nurse is teaching a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects A) Hirsutism B) Drowisness D) Headache C) Ataxia D) Rash
B) Drowisness Rationale: Clients taking valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these adverse effects can indicate the need for a reduction in dose C) Headache Rationale: Valproic acid ca cause headache, along with other CNS adverse effects, such as sleep disturbances D) Rash Rationale: Skin rash is an adverse effect of valproic avid and other antieplieptic drugs.
A nurse is providing teaching for a client who has a prescriptions for phenelzine. The nurse should instruct the client to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions? A) Respiratory Depression B) Hypertensive crisis C) Neuroleptic malignant syndrome D) Serotonin Syndrome
B) Hypertensive Crisis Rationale: Tyramine-enriched foods, such as aged cheese and processed meat, can trigger severe hypertension in clients who are taking phenelzine. Manifestations inlcudes hypertension, headache, and nausea.
A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following adverse effects should the nurse include in the teaching? A) Constricted pupils B) Discoloration of the iris C) Hypertension D) Bradycardia
D) Bradycardia Rationale: Betaxolo and timolol can cause bradycardia because of the blockade of cardiac beta1 receptors. Clients should check their pulse rate regularly and report any sustained decreases.
A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug? A) Tinnitus B) Twitching eyelids C) Blue-green skin discoloration D) Fatigue
D) Fatigue Rationale: The nurse should identify that potential serious adverse effects of interferon beta 1-b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they ca indicate bone marrow suppression and decreased platelet count.
A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. the nurse should identify that the drug has which of the following pharmacologic effects? A) Increases available acetylcholine in the brain B) Inhibits norepinephrine metabolism in the brain C) Inhibits serotonin metabolism in the brain D) Increases available dopamine in the brain.
D) Increases available dopamine in the brain. Rationale: Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease.
A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? A) Avoid driving until the drug's effects are evident B) Stop taking the drug immediately if headache occurs. C) Take the drug as needed for spasticity D) Take the drug with antacids to reduce gastric effects
A) Avoid driving until the drug's effects are evident Rationale: Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Clients taking the drug should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the drug will affect them
A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? A) Begin taking the drug at a low dosage B) Discontinue the drug immediately if diarrhea occurs C) Have serum glucose levels checked regularly D) Take the drug on an empty stomach
A) Begin taking the drug at a low dosage Rationale: Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.
A nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. Which of the following instructions should the nurse include? (Select all that apply) A) Change positions slowly from sitting or lying to standing B) Do not stop taking the drug abruptly C) Avoid crushing the tablet D) Take the drug at bedtime to prevent daytime drowsiness E) Increase fiber and fluid intake.
A) Change positions slowly from sitting or lying to standing Rationale: Amitriptyline, a tricyclic antidepressant, can cause orthostatic hypotension. Clients should move slowly from sitting or lying to standing. B) Do not stop taking the drug abruptly Rationale: Relapse and withdrawal symtoms can occur with abrupt discontinuation of amitriptyline. When discontinuing the drug, it is important to reduce the dosage over a 2-week period to prevent or minimize withdrawal symtoms. E) Increase fiber and fluid intake Rationale: Amitriptyline, a tricyclic antidepressant, causes anticholinergic effects, such as dry mouth, constipation, and urinary retention. Clients should increase fiber and fluid intake during drug therapy and urinate before taking the drug.
A nurse is teaching a client who is about to being sumtriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects? A) Chest Pain B) Polyuria C) Joint Pain D) Insomnia
A) Chest Pain Rationale: Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.
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? A) Dizziness B) Bradycardia C) Tardive dyskinesia D) Dyspepsia
A) Dizziness Dizziness and lightheadedness are the most common adverse effects of ondansetron
A nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following findings should indicate to the nurse to monitor for lithium toxicity? A) Furosemide for hypertension B) Acetaminophen for headaches C) Ciprofloxacin for a urinary tract infection D) Montelukast for asthma
A) Furosemide for hypertension Rationale: Furosemide, a high-ceiling loop diuretic, increases sodium loss and can cause lithium reabsorption. The nurse should evaluate the client for lithium toxicity.
A nurse is caring for a client who has a prescription for fluxetine and who reports self-administering St. John's wort daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? A) Hallucinations B) Decreased temperature C) Hypersexual behavior D) Constipation
A) Hallucinations Rationale: Hallucinations are an expected finding of serotonin syndrome. SSRIs are contraindicated with ST. John's wort because the combination can increase the risk of developing serotonin syndrome.
A nurse should recognize that diphenoxylate/atropine should be used with caution for a client who has which of the following conditions? A) Inflammatory bowel disease B) Thrombophlebitis C) Agranulocytosis D) Immunization with a live virus vaccine within the last 6 weeks.
A) Inflammatory bowel disease Diphenooxylate is an opioid which can cause the severe complication of toxic megacolon in clients who have inflammatory bowel disease. The nurse should have the client monitor the consistency and frequency of stools throughout therapy.
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) A) Infuse the drug 30 min prior to chemotherapy B) Administer the drug when the client reports nausea C) Infuse the drug slowly over 15 min D) Administer the drug immediately following chemotherapy E) Repeat the dose 4 hr after chemotherapy.
A) Infuse the drug 30 min prior to chemotherapy The nurse should administer IV ondansetron, a serotonin antagonist, 30 min prior to chemotherapy to prevent chemotherapy-induced nausea and vomiting. When treating radiation-induced nausea and vomiting, the nurse should give the drug orally 1 to 2 hours prior to radiation therapy and again every 8 hr. C) Infuse the drug slowly over 15 min The nurse should infuse ondansetron slowly over 15 min to prevent chemotherapy-induced nausea E) Repeat the dose 4 hr after chemotherapy For maximum effectiveness, the nurse should administer ondansetron 4 hr after chemotherapy, and again 8 hr after chemotherapy. When treating anesthesia-induced nausea and vomiting the nurse can give the drug 1 hr before anesthesia induction
A nurse is caring for an older adult client who has kidney disease and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestations? A) Lethargy B) Cellulitis C) Dry mouth D) Myalgia
A) Lethargy Cimetidine is a histamine2 receptor antagonist, which can potentially cross the blood-brain barrier. Older adults who have kidney impairments are at risk for central nervous system (CNS) effects such as lethargy, depression, confusion, and seizures. The nurse should instruct the client to report these manifestations to their provider
A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions? A) Nausea B) Constipation C) Urinary Retention D) Sore Throat
A) Nausea Lubiprostone, a chloride channel activator, can cause nausea. Clients who develop this effect do not need to discontinue the drug but should take it with food and water to minimize GI upset.
A nurse is caring for a client who has a prescription for alosetron. The nurse should recognize that alosetron therapy is effective when then the client reports which of the following? A) One formed stool per day B) Urination without burning C) Cessation of nausea or vomiting D) Reduced GI reflux effects
A) One formed stool per day Alosetron, a serotonin 5-HT3 receptor antagonist, treats the diarrhea and pain of severe irritable bowel syndrome. One formed stool per day indicates effective therapy.
A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification? A) Renal function impairment B) Cataracts C) Recent weight loss D) Smoking
A) Renal function impairment Rationale: Alprazolam dosage should be decreased for clients who have renal or hepatic impairment.
A nurse is teaching a client who has a prescription for modafinil to treat nacrolepsy. Which of the following instructions should the nurse include? A) Take the drug in the morning B) Take the drug 30 min before bedtime C) Anticipate daytime drowsiness D) Expect urinary frequency
A) Take the drug in the morning Rationale: Mondafinil is a nonamphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work.
A nurse is caring for a male client who asks the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting 3 months. Which of the following information should the nurse provide the client about alosetron? A) The drug is prescribed to female clients who have IBS-D lasting more than 6 months B) The drug is prescribed to clients who have chronic diarrhea lasting more than 12 months C) The drug is most beneficial for male clients who have inflammatory bowel disease D) The drug is most beneficial in treating clients who have constipation-predominant IBS (IBS-C)
A) The drug is prescribed to female clients who have IBS-D lasting more than 6 months Alosetron is approved only to be prescribed to females who have IBS-D lasting 6 months or longer that has not been controlled by conventional treatment.
A nurse is reviewing the medical record of a client who has a new prescription for famotidine. The nurse should recognize that which of the following drugs interacts with famotidine? A) Phenobarbital sodium B) Ketoconazole C) Lisinopril D) Hydrochlorothiazide
B) Ketoconazole Famotidine reduces the absorption of ketoconazole
A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring? A) Serum Potassium B) Liver function C) Serum sodium D) Thyroid Function
B) Liver function Rationale: Liver toxicity is a serious adverse effect of dantrolene. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain.
A nurse is reviewing the medical record of a client who has newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between drugs? A) Hyperammonemia B) Phenytoin Toxicity C) Hypertension D) Peptic Ulcer Disease
B) Phenytoin Toxicity Rationale: Valproic acid can cause an increase in phenytoin blood levels, resulting isn phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range.
A nurse is preparing to administer sumatriptan to a client for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions? A) Tonic-Closure Seizure B) Presence of migraine headache C) Exacerbation of multiple sclerosis D) Alzheimer's Disease
B) Presence of a migraine headache Rationale: Sumatriptan is used in the treatment of migraine headaches
A nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects? A) Cardiac excitability B) Respiratory depression C) Hyperthermia D) Hypertension
B) Respiratory depression Rationale: Methohextial, a short-acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the drug.
When reviewing the indications for various antidepressants, a nurse should identify that burpropion hydrochloride is an appropriate choice for clients who have which of the following? (Select all that apply) A) Motion Sickness B) Seasonal affective disorder C) Insomnia D) Nicotine addiction E) Depression
B) Seasonal affective disorder Rationale: Bupropion, an atypical antidepressant, helps prevent and treat seasonal affective disorder, a type of depression associated with the reduction of natural light during winter months. D) Nicotine Rationale: Bupropion, an atypical antidpressant, is an appropriate adjunct for clients who are trying to quit smoking E) Depression Rationale: Bupropion, an atypical antidepressant, can help treat depression.
A nurse should recognize that misoprostol is contraindicated for a client who has which of the following conditions? A) A seizure disorder B) Rheumatoid arthritis C) A positive pregnancy test D) Heart Failure
C) A positive pregnancy test Misoprostol, a prostaglandin E1, is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion; therefore, providers must confirm that clients are not pregnant before prescribing the drug; the clients who take misoprostol must use contraception.
A nurse is providing teaching to a client who has a prescription for buspirone. Which of the following instructions should the nurse include? A) Take the drug with grapefruit juice to increase absorption B) Use the drug as needed for anxiety C) Allow 2 to 4 weeks for full therapeutic effects D) Take the drug on an empty stomach.
C) Allow 2 to 4 weeks for full therapeutic effects Rationale: It can take up to 4 weeks for a client to feel the drug's full therapeutic effects.
A nurse is providing teaching to a client who has a new prescriptions for loperamide. Which of the following instructions should the nurse include? A) Dissolve the powder thoroughly in 8 oz (237 mL) of water B) Take with diphenhydramine to prevent extrapyramidal effects C) Avoid activities that require alertness D) Take 30 min before activities that trigger nausea
C) Avoid activities that require alertness Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.
A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider? A) Pancreatic Cancer B) Hypotension C) Cirrhosis D) Osteoporosis
C) Cirrhosis Rationale: Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.
A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects? A) Slow heart rate B) Cough C) Diarrhea D) Hearing loss
C) Diarrhea Rationale: Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid balance and intervene accordingly.
A nurse is proving teaching to a client about the adverse effects of drug therapy. The nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs? A) Venlafaxine B) Bupropion C) Imipramine D) Valproic acid
C) Imipramine Rationale: Imipramine, a tricyclic antidepressant, can result in orthostatic (postural) hypotension. Clients take this drug should change positions slowly from sitting or typing to standing.
A nurse us providing teaching for a client who has new prescriptions for valproic acid to treat seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? A) Hirsutism B) Depression C) Jaundice D) Gum irritation
C) Jaundice Rationale: Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.
A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? A) Neostigmine B) Succinylcholine C) Naloxone D) Dantrolene
C) Naloxone Rationale: Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. the nurse should also have resuscitation equipment available when administering fentanyl to a client
A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? A) Confusion B) Dry Mouth C) Nausea D) Double Vision
C) Nausea Rationale: The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects.
A nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. The nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine? A) Alprazolam B) Phenytoin C) Phenelzine D) Pilocarpine
C) Phenelzine Rationale: Clients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever
A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects? A) Hypotension B) Tinnitus C) Tachycardia D) Bronchospasm
C) Tachycardia Rationale: Amphetamine Sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain.
A nurse is providing teaching to a client who is about to start taking psyllium to treat constipation. Which of the following instructions should the nurse include? (Select all that apply) A) Expect results in 6 to 12 hr B) Urinate every 4 hr. C) Take the drug with at least 8 oz (236 mL) of fluid D) Avoid activities that require alertness E) Increase fluid and fiber intake
C) Take the drug with at least 8 oz (236 mL) of fluid To prevent esophageal obstruction, clients should take psyllium with at least 8 oz of fluid; and after mixing the powdered form, clients should drink it immediately E) Increase fluid and fiber intake The nurse should tell the client to increase activity, fluid intake, and fiber intake, and to keep track of bowel function.
A nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which of the following diagnostic tests should the nurse recommend that the client undergo periodically? A) Chest x-ray B) Tonometry C) Thyroid function tests D) Endoscopic retrograde chloangioancratography (ERCP)
C) Thyroid function tests Rationale: Hypothyroidism is an adverse effect of lithium carbonate. Clients should report neck enlargement, weight gain, lethargy, and constipation. They should also have their thyroid checked before they begin taking lithium and annually thereafter.
A nurse is caring for a client who has a new prescription for alosetron to treat irritable bowel syndrome. The nurse should instruct the client to report which of the following adverse effects of the drug? A) Headache B) Drowsiness C)Abdominal Pain D) Sore Throat
C)Abdominal Pain Alosetron, a serotonin 5-HT3 receptor antagonist, can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding, and stop taking the drug if these manifestation occur.
A nurse is teaching a client who received a prescription for interferon beta-1a for the treatment of multiple sclerosis. Which of the following information should the nurse include? A) "Have kidney function tests done every month for a year" B) "Take an extra dose if muscle aches occur" C) "Store the drug at room temperature after mixing it" D) Administer the drug in your thigh or upper arm
D) Administer the drug in your thigh or upper arm Rationale: Interferon beta-1a is administered via subcutaneous route. Therefore, the nurse should instruct the client how to perform subcutaneous injections for self-administration.
A nurse is caring for a client who has been talking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? A) Frequent Urination B) Jaundice C) Cellulitis D) Muscle rigidity
D) Muscle rigidity Rationale: A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever
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? A) Reduces inflammation B) Reduces gastric acid C) Prevent diarrhea D) Prevents straining
D) Prevents straining Docusate sodium, a stool softener, prevents straining during defection and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools
A nurse is teaching for a client who was admitted to the emergency department with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at increased risk? A) Ischemic Stroke B) Drowsiness C) Respiratory depression D) Seizure activity
D) Seizure Activity Rationale: Bupropion, an atypical antidepressant, can cause seizure activity when clients take high doses or have a seizure disorder, a CNS tumor, or a history of head trauma.
