NUR354:Pharm2:Module3(Q/A)

A nurse is preparing to administer ampicillin 500 mg via intermittent IV bolus over 30 min. Available is 500 mg ampicillin in 50 mL dextrose 5% in water (D5W). The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

100 mL

A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching? -"Glucosamine can help relieve urinary frequency." -"Glucosamine is used to treat viral infections." -"Glucosamine can help relieve hot flashes." -"Glucosamine can suppress joint inflammation."

"Glucosamine can suppress joint inflammation." MY ANSWER The nurse should include in the teaching that glucosamine suppresses joint inflammation and cartilage degradation by stimulating the activity of chondrocytes.

A nurse is teaching a client who has a new prescription for amoxicillin-clavulanate to treat pharyngitis. Which of the following statements by the client indicates an understanding of the teaching? -"I will take this medication until my sore throat goes away." -"I should take this medication on an empty stomach between meals." -"I will stop taking this medication if I develop itching." -"I will double my dose, if I miss one."

"I will stop taking this medication if I develop itching." MY ANSWER Penicillin-derived medications are a common cause of medication allergic reactions. Manifestations of allergic reactions include rashes, hives, itchy and watery eyes, and swollen lips, tongue, or face. Anaphylactic reactions can develop within 1 hr of taking the dose, and include difficulty breathing, shortness of breath, stridor, and angioedema. The client should discontinue the medication and notify the provider if these manifestations occur.

A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? -"Take this medication with food if nausea develops." -"Monitor for muscle pain." -"Expect to have increased bruising." -"Increase your intake of grapefruit juice."

"Monitor for muscle pain." MY ANSWER This medication can cause rhabdomyolysis. The client should monitor and report muscle pain.

A nurse is teaching a client who has a new prescription for erythromycin. Which of the following information should the nurse include? -"Take this medication with a glass of grapefruit juice." -"Expect your skin to turn yellow." -"Monitor for ringing in your ears." -"Increase fiber intake to prevent constipation."

"Monitor for ringing in your ears." MY ANSWER Ototoxicity is an adverse effect of erythromycin. The client should monitor and report manifestations of ototoxicity, such as tinnitus, dizziness, and vertigo.

A nurse is caring for a 1-month-old infant who weighs 3500 g and is prescribed a dose of cephazolin 50 mg/kg by intermittent IV bolus three times daily. How many mg should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

175 mg

A nurse is preparing to administer hydrocortisone sodium succinate 250 mg via IV bolus every 6 hr. Available is hydrocortisone sodium succinate 1000 mg/8 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

A nurse is preparing to administer fosamprenavir 1400 mg PO bid. Available is fosamprenavir 700 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 tab

A nurse is preparing to administer erythromycin ethylsuccinate 800 mg PO every 4 hr. Available is erythromycin ethylsuccinate 200 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

20 mL

A nurse is preparing to administer ceftriaxone 1 g via intermittent IV bolus over 30 min. Available is 1 g ceftriaxone sodium in 100 mL dextrose 5% in water. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

200 mL

A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5 mg/kg PO every 12 hr for 5 days. The client weighs 88 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

200 mg

A nurse is to preparing to administer cefazolin 1 g by intermittent IV bolus over 30 min. Available is cefazolin 1 g in 100 mL dextrose 5% in water (D5W). The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

33 gtt/min

A nurse is preparing to administer cefprozil 15 mg/kg PO every 12 hr to a child. The child weighs 45 lb. Available is cefprozil 250 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

6 mL

A nurse is preparing to administer liquid mycostatin 600,000 units PO TID. Available is mycostatin 100,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

6 mL

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)

7 mL

A nurse is reviewing the medical record of a client who is to receive the first dose of cefoxitin via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive cefoxitin and report to the provider? -A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride -A recent history of diarrhea for 3 days -Serum creatinine 0.8 mg/dL -A severe allergy to amoxicillin

A severe allergy to amoxicillin MY ANSWER A client who has a suspected or documented history of severe allergy to penicillins may also have an allergy to cephalosporins that could result in anaphylaxis. The nurse should withhold the dose and notify the provider.

A nurse manager is providing an educational program on antibiotic sensitivity to bacterial infections. The nurse should include in the teaching that vancomycin is indicated for which of the following infections? -Pseudomonas aeruginosa -Klebsiella -Candida -Methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus MY ANSWER The nurse should teach that vancomycin is sensitive to the infection methicillin-resistant Staphylococcus aureus and Clostridium difficile infections, and should be the antibiotic of choice to treat this organism.

A nurse is preparing to administer lamivudine 150 mg PO BID. Available is lamivudine 100 mg tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

1.5 tab

A nurse is preparing to administer aspirin 650 mg PO every 12 hr. The amount available is aspirin 325 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 tabs

A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching? -"I need to apply a sunscreen when I go outside." -"I can take an over-the-counter antihistamine for allergies when I'm taking this drug." -"I should take this medication when my spasms are bad." -"My muscle strength should improve a lot in 2 to 3 days."

"I need to apply a sunscreen when I go outside." MY ANSWER This medication can cause photosensitivity; therefore, the client should protect her skin by wearing a hat and using sunscreen while in sunlight.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? -"If I get a rash from this medication, I will take my usual antihistamine." -"I need to increase my fluid intake while taking this medication." -"I should take this medicine on an empty stomach." -"If I get a fever while taking this medication, I will take some aspirin."

"I need to increase my fluid intake while taking this medication." MY ANSWER Clients who have gout should increase their fluid intake to 2 to 3L per day to prevent toxicity of allopurinol and decrease uric acid levels.

A nurse is teaching a client who has diabetes mellitus and a new prescription for prednisone for a rash. Which of the following statements by the client indicates the need for further teaching? -"I might need to increase my regular insulin during this time." -"I will gradually stop the prednisone when my rash goes away." -"I might feel a little emotional when I am on this medicine." -"I might have a hard time falling asleep while taking prednisone."

"I will gradually stop the prednisone when my rash goes away." The client should discontinue glucocorticoids gradually to reduce the risk for adrenal insufficiency. Manifestations of adrenal insufficiency include nausea, vomiting, confusion, and hypotension.

FLAG A nurse is preparing to administer 250 mg of an antibiotic IM. Available is 3 g/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.4 mL

A nurse is preparing to administer dexamethasone 8 mg IM divided into 4 equal doses QID. The amount available is dexamethasone 4 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.5 mL

A nurse is preparing to administer vancomycin 500 mg PO daily divided into four equal doses. The amount available is vancomycin 125 mg capsules. How many capsules should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

1 cap

A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? -Zolpidem -Alprazolam -Spironolactone -Allopurinol

Allopurinol MY ANSWER Allopurinol is a xanthene oxidase inhibitor that reduces uric acid synthesis. The medication is prescribed to treat gout.

A nurse is caring for a client who received an injection of penicillin G procaine. The client begins to experience dyspnea and tongue swelling. Which of the following actions should the nurse perform first? -Obtain intravenous fluids for administration. -Record the observed data in medical record. -Deliver a dose of aminophylline by inhalation. -Administer epinephrine subcutaneously.

Administer epinephrine subcutaneously. MY ANSWER The priority action the nurse should take when using the airway, breathing, circulation approach to client care is to administer epinephrine. The effect of the epinephrine is to act on adrenergic receptors, causing bronchodilation of the lungs and an elevation of blood pressure. By stimulating both alpha and beta adrenergic receptors to cause these effects, it accomplishes more of the goals of treatment of anaphylaxis than any other single therapy.

A nurse is planning to administer ceftriaxone IM to an adult client. Which of the following actions should the nurse plan to take? -Administer the medication using a 5/8-inch needle. -Administer the medication at a 45° angle. -Administer the medication in the deltoid muscle. -Administer the medication using a Z-track technique.

Administer the medication using a Z-track technique. MY ANSWER The Z-tract technique is used to reduce pain and prevent medication to leak into subcutaneous tissue.

A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider? -Amoxicillin-clavulanate -Gentamicin -Erythromycin -Amphotericin B

Amoxicillin-clavulanate MY ANSWER Penicillin is the most common medication allergy. Clients who are allergic to one penicillin medication should be considered allergic to all penicillins, which would include amoxicillin-clavulanate. Reactions may mild or life-threatening.

A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? -Cardiac dysrhythmia -Metabolic alkalosis -Renal failure -Aplastic anemia

Aplastic anemia MY ANSWER Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.

A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the following information should the nurse include in the teaching? -Discontinue medication if nausea occurs. -Expect urine to turn orange. -Monitor for increased muscle spasms. -Avoid driving until effects are known.

Avoid driving until effects are known. MY ANSWER Cyclobenzaprine can cause drowsiness and dizziness. Instruct the client to avoid driving if these effects occur.

A nurse is teaching a client who has a new prescription for aspirin to treat rheumatoid arthritis. The nurse should include to monitor for which of the following adverse effects of this medication? -Constipation -Bleeding -Blurred vision -Insomnia

Bleeding MY ANSWER Aspirin can cause bleeding, tinnitus, gastric ulceration, nausea, and heartburn. The client should monitor and report manifestations of bleeding, such as black tarry stools.

A nurse is preparing to administer cephalexin oral suspension to an older adult client who has difficulty swallowing pills. Which of the following actions should the nurse take? -Check the client for a penicillin allergy. -Monitor the client for constipation. -Store the medication at room temperature. -Avoid shaking the medication before administering.

Check the client for a penicillin allergy. MY ANSWER The nurse should check the client for a penicillin allergy because cephalexin is a beta-lactam antibiotic that is similar in actions and structure to penicillin.

A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication? -Reduces risk of infection -Decreases inflammation -Improves peripheral blood flow -Increases bone density

Decreases inflammation MY ANSWER Prednisone is used to treat rheumatoid arthritis because it produces anti-inflammatory and immunosuppressive effects, which reduces inflammation, decreases pain, and increases mobility.

A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include? (Select all that apply.) -Expect to feel the medication's effects immediately. -Do not drink alcoholic beverages while taking this medication. -Report unexplained bruising to the provider. -Avoid people who have infections. -Take NSAIDS to help minimize the adverse effects of the medication.

Do not drink alcoholic beverages while taking this medication is correct. Alcohol ingestion can increase the risk of liver damage. Report unexplained bruising to the provider is correct. Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae as they may indicate a low platelet count. Avoid people who have infections is correct. Methotrexate causes bone marrow suppression and increases the risk for infection.

A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide? -Expect to have a fever for the first days of therapy. -Drink 2 to 3 L of water per day while on the medication. -Administer the medication with an NSAID to enhance effectiveness. -Take the medication in the morning to prevent insomnia.

Drink 2 to 3 L of water per day while on the medication. Methotrexate can cause renal toxicity. Adequate hydration promotes its excretion and helps prevent this adverse effect.

A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? -Take an antiemetic 1 hr following administration. -Drink 2 to 3 L of water per day. -Take the medication with an NSAID. -Rinse mouth 2 times per day with an alcohol based mouthwash.

Drink 2 to 3 L of water per day. Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per day to promote excretion of the medication.

A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select all that apply.) -Tinnitus -Jaw pain -Blurred vision -Drowsiness -Dysphagia

Dysphagia is correct. Alendronate can cause esophagitis, so the client should report any difficulty or pain with swallowing. Jaw pain is correct. Alendronate can cause osteonecrosis of the jaw, so the client should report this adverse effect to the provider. Blurred vision is correct. Alendronate can cause ocular inflammation, so the client should report vision problems to the provider.

A nurse is assessing a client who has a peripheral IV with a continuous infusion. Which of the following findings is a manifestation of phlebitis? (Select all that apply.) -Erythema -Damp dressing -Throbbing -Warmth at insertion site -Streak formation

Erythema is correct. Erythema is a reddened area at the insertion site and is a manifestation of phlebitis. Other manifestations can include throbbing, burning, and increased skin temperature. Throbbing is correct. Throbbing and pain at the insertion site are manifestations of vein inflammation and phlebitis. Warmth at insertion site is correct. Responses to inflammation include warmth and redness of the affected tissue. Streak formation is correct. Streak formation is a classic indicator of advanced phlebitis.

A nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication? -Pepperoni -Orange juice -Grapefruit juice -Smoked salmon

Grapefruit juice Clients taking cyclosporine should avoid drinking grapefruit juice because it can increase the therapeutic effect leading to renal and hepatic toxicity.

A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? -Report of recent migraine headaches -History of gastric ulcers -Current diagnosis of glaucoma -Prior reports of amenorrhea

History of gastric ulcers MY ANSWER Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding.

A nurse is preparing to administer ampicillin and gentamicin sulfate via IV infusion. Which of the following resources should the nurse consult first regarding medication compatibility? -Nurse manager -Hospital pharmacist -Health care provider -Medication sales representative

Hospital pharmacist MY ANSWER The greatest risk to the client is injury form medication error; therefore, the nurse should consult the hospital pharmacist first. The pharmacist will have information about medications, including adverse effects, recommended dosages, and drug incompatibilities.

A nurse is assessing a client who is taking oxacillin to treat an infection. The nurse should recognize which of the following findings is a manifestation of an allergic reaction? -Pruritus -Diarrhea -Dark urine

Pruritus MY ANSWER An allergic reaction is an immune response that can manifest as pruritus and urticaria and can progress to anaphylaxis.

A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse suspect? -Hepatitis -Peptic ulcer fracture -Renal stones -Pancreatitis

Renal stones MY ANSWER Hypercalcemia due to calcium supplements can cause renal stones. Clients should increase their water intake while taking calcium supplements to hydrate the kidneys and should report any blood in the urine or flank pain.

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report? -Dry cough -Swelling of the tongue -Nausea -Nasal congestion

Swelling of the tongue MY ANSWER When using the urgent vs non-urgent approach to client care, the nurse determines that the priority finding is swelling of the tongue, which is a manifestation of angioedema. The nurse should withhold the medication and notify the provider immediately if the client reports swelling of the tongue or throat. Other manifestations include giant wheals and edema of the tongue, glottis, and pharynx. Severe reactions are treated with subcutaneous epinephrine. If angioedema develops, ACE inhibitors are discontinued.

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? -Weigh weekly to monitor therapeutic effect. -Take the medication on an empty stomach. -Take the medication early in the day. -Muscle pain is an expected adverse effect.

Take the medication early in the day. The nurse should instruct the client to take hydrochlorothiazide early in the day to avoid nocturia.

A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen? -Take the medication with an aspirin to increase effectiveness. -Take the medication with food. -Taking the maximum dose will offer stroke prevention. -Sustained-release forms may be crushed for easier administration.

Take the medication with food. MY ANSWER To minimize gastric irritation, the nurse should instruct the client to take ibuprofen with food, water, or milk.

A nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? -Expect ringing in your ears. -Take the medication with food. -Store the medication in the refrigerator. -Monitor for weight loss.

Take the medication with food. To minimize gastric irritation, the client should take ibuprofen with food or immediately after a meal.

A nurse is preparing to administer amoxicillin 100 mg PO every 8 hr to a toddler who weighs 20 kg. The recommended dosage range is 20 to 25 mg/kg/day. Which of the following actions by the nurse is appropriate? -The nurse administers the prescribed dosage. -The nurse determines the prescription is above the recommended dosage range. -The nurse contacts the pharmacist to adjust the prescribed dosage. -The nurse determines the prescription is insufficient to achieve the desired effect.

The nurse determines the prescription is insufficient to achieve the desired effect. MY ANSWER The dose is below the recommended range: 20 kg x 20 mg = 400 mg/kg/day; 20 kg x 25 mg = 500 mg/kg/day. Based on the toddler's weight, it would be safe for the client to receive 400 to 500 mg/day of amoxicillin. The toddler is receiving a total of 300 mg/day (100 mg x 3 doses daily). The nurse should notify the provider as the prescribed dose is below the recommended dosage range.

A nurse is assessing a client after administering a dose of losartan. The client has a hoarse voice, and swollen lips and tongue. In which order should the nurse take the following actions? Move the nursing actions into the box on the right, placing them in the selected order of performance. All steps must be used.)

The nurse should first assess the client's airway and oxygen saturation to determine the need for respiratory support. Intubation or tracheotomy is considered if adequate oxygenation is not maintained. The second step the nurse should take is to call the rapid response team to provide emergency treatment in case of cardiac or respiratory arrest. Next, the nurse should apply high-flow oxygen to increase oxygenation and then initiate an IV site, if one is not present, and administer isotonic IV fluids to prevent hypotension and provide access for IV medications. The nurse should then administer IV epinephrine to constrict blood vessels, dilate bronchioles, and increase cardiac function. And finally, the nurse should administer IV antihistamines and corticosteroids to block the effects of histamine and decrease edema.