Pharm 1

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic response.

What recommendation concerning vaccinations should the nurse provide a 50-year-old adult?

annual influenza vaccination

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness?

antihistamine

A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response?

antihistamines are not recommended for treating a cold.

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should:

assess for factors that may reduce absorption.

A landscaper has sought care because of a puncture wound to her foot and the provider has prescribed 250 units of the tetanus immune globulin. In preparation for administration, the nurse should:

assess the skin integrity of potential intramuscular injection sites.

To determine a client's self-care ability, it is most important for the nurse to perform what step of the nursing process?

assessment

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

asthma

A nurse is caring for a 77-year-old. The nurse would know that a normal physiologic change that must be considered when planning drug therapy, and is associated with aging is:

blood volume decreases.

The nurse administers a medication to the client that induces the secondary action of hypoglycemia. What organ will be most acutely affected by inadequate circulating glucose?

brain

Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?

epinephrine

The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first?

evaluate the client's ability to swallow.

Acetylcysteine is the antidote for aspirin toxicity.

false

A client is receiving antibiotics for treatment of infection. The nurse should assess for what potential indications of superinfection? Select all that apply.

fever glossitis

The nurse is aware that the most relevant way in which aging affects the pharmacokinetic process of drug administration is decreased:

function of vital organs.

A client has been prescribed oral cyclosporine following a successful liver transplant. When providing education, the nurse should advise the client to avoid mixing the drug with what liquid?

grapefruit juice

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:

grapefruit.

Which condition would contraindicate the use of oxymetazoline?

hypertension

A client has been brought to the emergency department (ED) following a cold water incident. Which would be a potential effect of medication absorption from this clinical manifestation?

less than therapeutic effect

Before teaching a client about diagnosis and therapy, what information is essential for the nurse to evaluate in the client?

level of education

A nurse is caring for a client following an organ transplant procedure. The client reports that oral cyclosporine tastes awful and that the client is unable to swallow it. The nurse tells the client that it is possible to make the medication more palatable by mixing it with:

orange juice.

The nurse is caring for a client who experienced a severe headache. When the prescribed dose of analgesics did not cause relief the client took double the dosage one hour later. The nurse should assess the client for what adverse effect?

poisoning

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?

rebound congestion

The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity?

reduced efficiency of renal function

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?

sedation

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

A client is being evaluated for possible rhinosinusitis. Which assessment question(s) asked by the nurse is most relevant to confirm this diagnosis? Select all that apply.

"Are you experiencing any facial pain?" "Are you feeling any sensation of pressure above your eyes?" "Are you able to breathe through your nose?" "Can you describe what your nasal drainage looks like?"

The 68-year-old client states, "I have been taking aspirin on occasion for my arthritis for many years but notice that it takes longer for it to start working now." What is the best response by the nurse?

"As you get older, absorption is prolonged and medications may take a little longer to act than normal.

A 42-year-old client is experiencing chemotherapy-induced thrombocytopenia. The nurse is providing information to the client regarding the medication oprelvekin. Which information would the nurse include in the explanation?

"Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?

"How much coffee, tea, and soda do you drink daily?"

The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification?

"I can take over-the-counter pseudoephedrine, too."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I'm glad that this medication will address all of my symptoms."

A client recently diagnosed with asthma anxiously reports that the symptoms of a recent episode were not relieved despite taking several puffs of the prescribed salmeterol. How should the nurse respond to the client's concern?

"Remember that your salmeterol isn't effective when you take it at the time of an asthma attack."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

A nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose?

"We want to make sure you get the benefits of the drug as quickly as possible."

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response?

"What are some of the safety risks that most concern you?"

The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize?

"When are you taking your medication?"

The nurse is reviewing several orders for medications. Which dosage would cause the nurse to be concerned about the accuracy of the order?

0.5 mg

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?

30 minutes

Fluoxetine is given to a client at a dosage of 500 mg every 6 hours. Assuming that the half-life of this drug is 3 hours, at what point would the drug level in the body be 62.5 mg of the original dose?

9 hours after the original dose

A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?

A 65-year-old male with asthma

A client asks the nurse about using dextromethorphan to relieve a cough. What type of cough would the nurse explain is best treated with the drug?

A dry, nonproductive cough

A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?

A modified dose of aminophylline

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.

A person can be allergic to any medication at any time. Medications can react with over-the-counter medications to cause toxicity. Medications can react with herbal supplements to cause adverse reactions. Medications can react with other medications prescribed for the client.

A health care worker has received an annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend?

Acetaminophen

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?

Adrenal insufficiency

An older adult client is known to be taking 14 different medications. What is the greatest risk for the client?

Adverse drug interaction

Tom, age 42, is prescribed ipratropium bromide as an anticholinergic agent for treating asthma. The nurse caring for Tom needs to develop a plan of care. What must be included in the plan? Select all that apply.

Advise the patient to avoid using ipratropium if allergic to soybeans, legumes, or soya lecithin. Remind the patient that ipratropium must be taken daily, despite the absence of symptoms of asthma.

What is the characteristic action of an agonist?

Agonists bind to receptors and cause a physiologic effect.

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

Which is an example of naturally acquired active immunity? (Select all that apply.)

An individual who is exposed to pertussis for the first time and has no immunity to the disease. An individual who is exposed to chickenpox for the first time and has no immunity to the disease.

One method of reducing bronchoconstriction is removing excessive secretions from the respiratory tract. Patients can take several actions on their own to help manage secretions. Which will not help manage secretions?

Asking the physician to prescribe inhaled corticosteroids

A client's drug level has reached critical concentration. What action should the nurse perform?

Assess for evidence of the expected therapeutic effects.

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention?

Assess the client for health problems that may contraindicate the use of a particular remedy.

A client has developed a tolerance to a drug. How should the nurse address this when providing care?

Assess whether the client needs larger doses to achieve the effect.

Which of the following would a nurse identify as a surfactant?

Beractant

Which would the nurse expect to administer orally?

Cyclosporine

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?

Decreased sedation

A patient tells you that a friend of theirs has recommended the use of caffeine to treat the patient's asthma. What would be the most important reason a nurse should counsel this patient not to delay prescribed treatment for the use of natural health products?

Delays in appropriate treatment can have serious, even fatal, consequences

Which of the following would be most likely to occur during the planning or implementation step of the nursing process?

Developing appropriate outcomes for drug response

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

Drugs cause unexpected or unacceptable reactions despite screening and testing

Serum sickness occurs more commonly with the use of vaccines than with immune sera.

False

The nurse is teaching a community group about prevention measures to protect against the common cold. Which preventive measure is most important to teach?

Frequent handwashing

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

Immune globulin

A client is prescribed filgrastim. Which is the nurse's best explanation of how this drug works?

It stimulates growth and production of WBCs to fight off infection.

The nurse educator is teaching an online pharmacology class. The topic of the online seminar is the contraindications for the use of colony stimulation factor. The nurse includes which contraindication?

Known hypersensitivity

A nurse notes a medication error. Which action would be most appropriate?

Make a report to the institution.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

A client is being treated for malignant melanoma and has been prescribed interferon alfa-2b. The client has complex medical history and the medication regimen includes aspirin, furosemide, bisoprolol and levothyroxine. When planning the client's care, what should the nurse prioritize?

Monitor the client's response to the medication and assess for adverse effects.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

An older adult client calls the health care provider's office and tells the nurse that prescriptions for three medications have run out and the pharmacy will not refill them this close together. A home health referral is made and the client is found to be taking the medication more often than prescribed. What is a priority nursing diagnosis for this client?

Nonadherence to therapeutic medication regimen

What statement is true concerning nursing diagnoses?

Nursing diagnoses can be actual or potential.

An older adult client must take a variety of medicines under different conditions and at different times of the day. The client's spouse is available to help most of the time. How can the couple best ensure that the client takes all medicines under the correct conditions?

Once a week, dispense all the medicines into a large, divided container.

A patient who is receiving an immune modulator has been admitted to the unit. What would be a priority action by the nurse?

Protect the patient from exposure to infection.

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation.

Which agent would the nurse instruct a client to use orally?

Pseudoephedrine

A nurse is performing the activities listed below. Place them in their proper sequence based on the steps of the nursing process.

Questioning the client about the use of over-the-counter medications Obtaining the client's weight Identifying the client is at risk for skin breakdown Instructing the client to take the medication with meals Analyzing the client for changes in the client's condition

A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger?

Rabies vaccine

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level.

A nurse is providing care to a client who has been admitted to the health care facility. When administering drugs to this client, what would be most important for the nurse to do before administering a drug to the client?

Review the subjective and objective data.

A child who is recovering from a chickenpox infection is given aspirin for the fever. Which condition develops following the simultaneous administration of salicylates and the varicella vaccine?

Reye syndrome

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?

Risk for falls related to sedation

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

Safety measures

What is an adverse effect of excessive immunosuppression?

Serious infection

A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is the nurse's priority action?

Stop the drug immediately.

When providing drug therapy to a client, what is a responsibility of the nurse?

Teach the client how to cope with the effects of the drug to ensure the best outcome.

A client who just picked up a prescription at the pharmacy asks the nurse why the client was prescribed a medication for mental health issues when the client sought treatment for allergies. What is the nurse's best response?

Tell me the name of your prescription please."

A clinic nurse is administering vaccines at well-baby check-ups. The nurse knows that before administering a DTP vaccine, the nurse should check what vital sign?

Temperature

When drugs are bound to proteins in the blood, they can be transported to different areas of the body. The protein-drug complex is relatively large and cannot enter into capillaries and into tissues to react. What must occur for drugs to do their job in the body?

The drug must be freed from the protein-binding site.

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin

Which statement is true about a nursing diagnosis?

The nursing diagnosis relates the client's status.

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness?

They come into direct contact with nasal mucosa.

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device?

Using a spacer

To prevent meningococcal infections, the nurse would administer:

Vaccine

The nurse is caring for a group of clients and is aware that which client may require a reduction in medication dosage? (Select all that apply.)

client with chronic hepatitis C client with cancer of the liver client with cirrhosis of the liver

A nurse is caring for a client who is prescribed multiple medications. Which clients are most likely to have adverse drug reactions?

clients who are very young or very old

The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?

coffee

The nurse is providing education to a client who has been prescribed an antiasthmatic drug. The nurse should instruct the client to avoid excessive intake of what beverage?

coffee

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?

cold, clammy skin

The nurse understands that an admission assessment is completed to accomplish what goal?

collect data

A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by:

consulting a drug guide for compatibility.

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications.

What function is associated with metabolism

converting fat-soluble drugs into water-soluble forms

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus.

A client reports to the nurse, "My head is stuffed up and I can't breathe through my nose." Nasal discharge is noted upon examination. The client is diagnosed with a common cold. The nurse should prepare to provide medication instructions related to what classification of medication directed at the client's nasal mucosa?

decongestant

The nurse is preparing to give an older adult client an IM injection. How will this client's history of heart failure affect the administration of this medication? (Select all that apply.)

decreased absorption of the medication abnormal blood concentrations of the medication

A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to

decreased blood flow to tissues and muscles.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate.

A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 PM. The nurse finds the patient drowsy and confused at 10 AM the next day. The nurse is aware that this behavior is most likely due to

decreased hepatic function.

After assessing a client, what step of the nursing process will the nurse perform before planning care?

diagnosis

An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes:

digoxin and Lanoxin are the same medications.

What physiological factors in older adults contribute to alterations in distribution of medications? (Select all that apply.)

diminished cardiac output increased body fat decreased body fluid

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?

diphenhydramine

A nurse has been assigned the task of preparing educational materials for clients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or the health care provider. Which information is essential to include in the educational materials?

drug administration method

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

dry mouth

The mentoring nurse is orienting a new graduate RN to the geriatric floor. What assessment technique will the new graduate nurse perform to identify an age-related physiological change associated with medication metabolism?

external palpation of the liver

A nurse has been administering a drug to a client intramuscularly (IM). The health care provider discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to:

first-pass effect.

A client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition?

gastroesophageal reflux disease

What is the most reliable measure to evaluate renal function?

glomerular filtration rate

"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process?

goal

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient

has a high coffee intake.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean that the drug will:

have a long duration of action.

What is the chemical mediator released in immune and inflammatory response to allergic reactions?

histamine

What client assessment finding will have the greatest effect on the half-life of methotrexate therapy?

history of chronic renal impairment

What would the nurse expect to assess if a client develops neuroleptic malignant syndrome?

hypertension

Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease. In what conditions is cautious use of these drugs recommended? Select all that apply.

hypertension seizure disorders diabetes mellitus

How are the nursing diagnoses developed by the North American Nursing Diagnosis Association (NANDA) most useful?

identifying problems related to drug therapy

To correctly administer a medication, when should the nurse compare the medication with the medication administration record (MAR)? (Select all that apply.)

immediately prior to medication administration when removing the medication from the medication cart when initially looking at the medication label

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

ineffective airway clearance

A 53-year-old man is receiving cyclosporine in order to prevent rejection of a transplanted kidney. The nurse should prioritize assessments related to:

infection.

The nurse is providing education to the parents of a child who has been newly diagnosed with asthma. During teaching, the nurse should explain that asthma attacks occur when mast cells release substances that cause what reaction?

inflammation

A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

inhalation

With buccal medications, what factor affects absorption?

integrity of the mucous membranes

What drug administration route should be used to assure the best bioavailability as any particular drug?

intravenous

A nurse who had been caring for a client with a cardiac disorder has to now provide care on an outpatient basis. What information should the nurse provide to this client who is willing and now able to manage the treatment regimen?

method of drug administration

The client is experiencing an adverse effect of a medication. What should the priority nurse action be?

monitor and intervene.

The nurse administers typical antipsychotic medications to the client who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drug? Select all that apply.

muscular tremors drooling changes in gait

A nurse is providing patient education to a 45-year-old man who is taking cyclosporine (Sandimmune). The nurse will provide the patient with education related to one of the most common and severe adverse effects of cyclosporine, which is:

nephrotoxicity.

What is the nursing diagnosis the framework for?

nursing interventions

The nurse knows that the pharmaceutic phase of drug activity must take place for which formulation of medication?

oral tablets

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

ototoxicity from the ibuprofen

A patient presents at the Emergency Department (ED) in acute respiratory distress. A quick assessment by the triage nurse indicates that the patient experienced difficulty breathing immediately after taking Combivent for the first time. The nurse suspects that the patient may be allergic to what?

peanuts

A nurse is reading an article that describes predictable differences in the effects of drugs in people of particular culture backgrounds due to their genetic makeup. The nurse is reading about:

pharmacogenomics.

The older client forgets to take medications as prescribed throughout the day. The client has medications prescribed several times each day. The nurse best aids the client to take medication by instructing the client to:

place medications in a pill box labeled by mealtime.

After teaching a group of students about the nursing process, the instructor determines that the teaching was successful when the students explain that establishment of goals and expected outcomes is part of which phase?

planning

A nurse is reviewing the laboratory values of a client admitted for gastrointestinal bleed. Which cells control bleeding?

platelets

Oprelvekin is a drug that stimulates the process of making which blood cells?

platelets

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisoning.

A nurse is caring for an 81-year-old client in a long-term care facility who takes nine different medications each day. The client has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the client is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to:

polypharmacy decreasing the number of available protein-binding sites.

The nurse is providing care for a client whose current medications include tacrolimus. The nurse should anticipate that this client is likely to be taking what medication concurrently?

prednisone

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

A nurse designing a drug regimen for a client should consider:

quality-of-life issues.

When determining the half-life of a drug, what must be taken into account? (Select all that apply.)

rate of absorption distribution to the tissues excretion rate

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

rebound bronchoconstriction.

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?

saba

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions

Penicillin causes bacterial cell death without disrupting normal human cell functioning. This is an example of:

selective toxicity

The nurse is caring for a client who has been prescribed mycophenolate mofetil following kidney transplant. What instruction should the nurse provide during client teaching to minimize the risk of undesired effects?

taking the pills on an empty stomach

Which statements best indicates the client understands recommended vaccines following the 65th birthday?

tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

The nurse is planning to educate a client about medication therapy. What is an essential part of the nursing process?

that the nurse perform all teaching and evaluation

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity

A client being vaccinated for measles asks the nurse about the contents of the vaccine. During the explanation, the nurse mentions a poisonous substance produced by some bacteria that is capable of stimulating antitoxin production. Which is the nurse referring to in the explanation?

toxin

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug?

urinary hesitancy

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?

"Consult with your primary care provider."

A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client?

"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

The nurse is providing medication information to a parent whose 9-year-old child has been prescribed dextromethorphan in liquid form. Which statement by the parent demonstrates the information has been received correctly?

"Eating and drinking within 30 minutes of taking the medication would minimize the effect of the medication."

The nurse is teaching a client receiving interferon therapy about measures to combat possible adverse effects. Which statement by the client indicates the need for more teaching?

"I need to be out in the sun so that I can get vitamin D."

The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?

"I need to shake the inhaler well before taking the medication."

A client is instructed to take diphenhydramine after an allergic reaction. Which statement by the client indicates successful teaching concerning the safe and effective use of diphenhydramine?

"I should not drive my car after taking this medication."

A nurse is teaching about filgrastim to a client. During the teach-back session, which statement by the client indicates a need for additional teaching?

"I will take this medication until it is all gone."

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?

"I'll keep the room warm and toasty."

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching?

"If you didn't have allergies as a child, you won't develop allergies later in life."

A client recently discovered that she is pregnant. She currently takes herbal medications to control her diabetes and the symptoms related to pregnancy. She asks the nurse if it is safe to take herbal medications while she is pregnant. What would the nurse tell this client?

"Most herbal and dietary supplements should be avoided during pregnancy or lactation."

A client who just picked up a prescription at the pharmacy asks the nurse why the client was prescribed a medication for mental health issues when the client sought treatment for allergies. What is the nurse's best response?

"Tell me the name of your prescription please."

A client has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension?

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

The nurse is visiting a female client in her home for treatment of a wound. The client is concerned that her husband, a truck driver, is bothered by his seasonal allergies. A friend suggested diphenhydramine. What is the nurse's best response?

"The drug may cause drowsiness and make driving unsafe."

A nurse is precepting a nursing student, and together they are caring for a patient who is to receive interleukins. The student nurse asks what happens physiologically when a patient receives interleukins. What would be the nurse's best response?

"The patient has increases in the number of natural killer cells."

The parents of a two month-old infant have brought their child in to the clinic for the first scheduled immunizations. The parents appear anxious and the child's father says, "We keep hearing about the link between vaccinations and autism. Is there a risk that it could happen to our child?

"There's been shown to be no genuine link between children receiving vaccinations and developing autism."

The parents of a two month-old infant have brought their child in to the clinic for the first scheduled immunizations. The parents appear anxious and the child's father says, "We keep hearing about the link between vaccinations and autism. Is there a risk that it could happen to our child?"

"There's been shown to be no genuine link between children receiving vaccinations and developing autism."

A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?

"You might find yourself more congested than ever as your body compensates for your use of these drugs."

The nurse is administering colony-stimulating factors to an older adult client after chemotherapy. The nurse should explain to the client that this medication is being administered for which reason?

"Your body is going to have trouble fighting off infections on it's own. This medication will help with that."

The health care provider suggests that a client use guaifenesin to help his cough. The nurse instructs the client to call the health care provider if he continues to have a productive cough after which amount of time?

1 week

The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?

15 mcg/mL

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?

15 minutes prior to exercising

The nurse understands that the dosage recommended by drug manufacturers is based on an individual weighing:

150 lb or 68 kg

The recommended dose of a drug is based on drug evaluation studies and targeted to which population?

150-pound person

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

A client is prescribed salmeterol as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

30 minutes before engaging in exercise

A client is receiving 250 mg of a drug that has a half-life of 8 hours. How much drug would remain after 24 hours?

31.25 mg

The nurse is aware that it requires approximately how many half-lives for a client to excrete a medication from the body?

4-5

A patient is receiving a topical nasal decongestant. The nurse instructs the patient to stop using the drug after which length of time?

5 days

The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Albuterol first, wait five minutes and then follow with flunisolide

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions

The client's spouse relays to the nurse a concern regarding having difficulty administering medications through the client's feeding tube and states, "I'm so concerned about doing it wrong, then I'm so flustered I forget how to do it." Which nursing diagnosis is most appropriate?

Anxiety

The nurse is preparing to administer a medication to a client and needs to confirm identification of the client. What may the nurse use to identify this client? (Select all that apply.)

Ask the client to state the birthdate. Check the client's wristband for the name Request that the client state their name.

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?

Ask the client, "What happens when you take a dose of tetracycline?"

The client has a daily antihypertensive medication prescribed. Taking the blood pressure prior to administration of the medication is which step of the nursing process?

Assessing

An adult client being treated for breast cancer inquired about required vaccinations. What information should the nurse provide to this client?

Avoid all live vaccines.

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.)

Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug

The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client?

Bacterial antibodies in serum

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

Be sure to drink plenty of fluids to prevent dehydration.

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.)

Benzonatate can cause GI upset and sedation. The client should drink plenty fluids.

A client is experiencing an acute asthmatic attack. Which agent would be most effective?

Beta-2 selective adrenergic agonist

The nurse is assessing a client who is taking diphenhydramine for relief of seasonal allergies. Which finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of the medication?

Blurry vision

A critically ill client with a diagnosis of ventilator-associated pneumonia has been administered acetylcysteine. The inhalation of acetylcysteine helps to liquefy secretions in the respiratory tract by what mechanism?

Breaking the protein bonds that exist in mucus

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

It is important for the nurse to stay current with the recommendations for immunizations. Which source is most accurate regarding immunization guidelines?

Centers for Disease Control and Prevention

The nurse educator is teaching a class of students about the actions and uses of colony stimulating factor. The nurse should inform students CSF is indicated for what secondary problem related to cancer treatment?

Chemotherapy-induced neutropenia

The nurse educator is teaching a class of community leaders about immunologic agents. To minimize the concern regarding adverse effects of vaccinations, the nurse should include which mild reactions in the teaching plan?

Chills and fever

A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?

Chocolate

A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated?

Client taking steroid therapy

Which agent acts directly on the medullary cough center?

Codeine

There are two types of antitussives, centrally acting and peripherally acting. Which are centrally acting antitussives? (Select all that apply.)

Codeine Dextromethorphan

What is conducted by the nurse during the evaluation step of the nursing process? (Select all that apply.)

Collection of objective data Collection of subjective data ongoing assessment

A group of students is reviewing class material in preparation for a test. The students demonstrate a need for additional teaching when they identify which of the following as part of phase I biotransformation?

Conjugation

The nurse receives an order for 2.5 mg of diphenhydramine for a client with a mild allergic reaction. The nurse is aware that this is an unusual order. What is the nurse's best action?

Contact the prescriber for clarification.

A client having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which process is occurring?

Contraction of smooth muscle in the bronchi

A 1-year-old child will receive a scheduled MMR vaccination shortly. The nurse should teach the child's parents that the child may develop what possible adverse effect related to the administration of this medication?

Cough and fever

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

Cromolyn

While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is:

Cyclosporine .

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

Which of the following effects would result from the action of montelukast?

Decreased eosinophil migration

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?

Dextromethorphan works in the medulla to suppress the cough reflex

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors?

Diphenhydramine

An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine?

Diphenhydramine

Which statement best describes drug efficacy and toxicity in pediatric clients?

Drug dosage is altered by disease state and weight in children.

The nurse's discussion of the role of cytochrome P-450 (CYP) enzymes is focusing on what aspect of pharmacokinetics?

Drug metabolism that takes place in the liver

An older adult client asks the nurse to explain the recommended schedule for influenza vaccination. Which statement should the nurse include in the response?

Each year a new vaccine is developed based on the strains most prevalent.

Which of the following would be most important to assess before administering calfactant? (Select all that apply.)

Endotracheal tube placement Lung sounds Oxygen saturation levels

A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?

Epinephrine

A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization?

Epinephrine

A nurse is working at a free vaccination clinic today and expects to give vaccinations to more than one hundred children. Which item is most important to have available?

Epinephrine pen

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?

Excessive salivation

An adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.

Exercise Allergens Mold Cigarette smoke

A nurse determines a nursing diagnosis of Altered Health Management is appropriate for a client. Which factors would the nurse point out as supporting this nursing diagnosis? Select all that apply.

Financial difficulty in obtaining the medication Lack of information about the drug therapy No therapeutic effect seen by client

A 45-year-old male patient is receiving interferon alfa-2a therapy for hepatitis C. The nurse should teach the patient that he may experience which adverse effect?

Flu-like symptoms

An 8-year-old client reports shortness of breath, cough, and chest tightness when participating in gym class. The client is diagnosed with exercise-induced asthma. What inhaled drug therapy is the health care provider most likely to prescribe?

Formoterol, a highly selective beta-2 agonist

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

Guaifenesin

A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?

Have epinephrine available during administration.

Which medication prescription by the health care provider will require the nurse to seek clarification?

Heparin 5,000 u SC every day

The perinatal nurse recognizes that what vaccine can be safely given to a neonate?

Hepatitis B

Which of the following would be least important to include when teaching a client about drug therapy?

How to report a medication error

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?

I'll keep taking my medications until I'm not experiencing any more symptoms."

The nurse is teaching the client to self-administer insulin. This occurs during which phase of the nursing process?

Implementation

The nursing instructor is discussing drug therapy in the older adult. The instructor would tell the students that what could affect therapeutic dosing in an older adult?

In older adults, drugs have decreased GI absorption.

After assessing a client, the nurse determines a nursing diagnosis of Deficient Knowledge related to drug self-administration applies to this client. Which findings would support this nursing diagnosis? Select all that apply.

Inability to remember Cognitive limitation Lack of interest in learning

A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?

Increased serum theophylline

The nurse is providing education to a client diagnosed with the common cold. What measure should the nurse recommend implementing to help liquefy cold-related secretions?

Increasing fluid intake

The nurse brings the client's afternoon medications and attempts to teach the client about them. The client states, "Just tell my wife about them, she will take care of me at home." What is the most appropriate nursing diagnosis for this client?

Ineffective Self Health Managemen

The nurse writes a care plan for a patient receiving vaccines. What would be an appropriate nursing diagnosis for this patient?

Ineffective tissue perfusion likely if severe reaction occurs

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?

Inform the health care provider that the client has toxic theophylline levels.

The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?

Inhaled corticosteroid agents reduce airway inflammation.

A client is being evaluated for reports of alteration in sleep pattern. When asking a client about current medications and supplements being taken, what is the nurse's best approach?

Inquire about all prescription medications, over the counter drugs, herbs and supplements.

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice?

Integrating the new drug into the client's existing schedule promotes adherence.

A group of students are reviewing information about immune modulators in preparation for a test. The students demonstrate understanding of the material when they identify what as an immune stimulant?

Interferon

A neonate is receiving beractant. The nurse understands that this agent is administered by which route?

Intratracheal

Which route of administration is most likely to cause toxic effects?

Intravenous

When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?

It is administered at 12 to 15 months.

A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's best response?

It is caused by a decrease in the number of RBCs.

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

A 68-year-old female who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication. The client has returned to the clinic for a follow-up visit. The nurse notes that the client's blood pressure is unchanged from her last clinic visit. When the client was asked if she was taking the new medication on a regular basis, she stated, "I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time." The most appropriate nursing diagnosis for this client would be which?

Knowledge, Deficient, due to the lack of understanding of treatment regimen

A client, diagnosed with asthma, is prescribed a leukotriene receptorantagonist. The nurse will discuss the importance of which diagnostic lab tests to determine how effectively the medication is being metabolized and excreted? Select all that apply.

Liver function Kidney function

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine?

Loratadine

What should be observed during ongoing assessment of a client taking an antitussive? (Select all that apply.)

Lung sounds Frequency of cough Therapeutic effect Pain assessment

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy?

Maintenance of effective airway clearance

Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness?

Meclizine

Which medication is used to treat acute airflow obstruction?

Metaproterenol

A client with a cardiac disorder is being discharged home. What information would the nurse include when teaching the client about administering the prescribed drug therapy at home?

Method of drug administration

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?

Misuse could result in overdose.

A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?

Monitoring respirations for bilateral chest movement

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?

Nausea and vomiting

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?

Nervousness

Decongestants are available in which dosage forms? (Select all that apply.)

Oral tablets Nasal sprays Nasal drops

Which is classified as a decongestant?

Oxymetazoline (Afrin)

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?

Parkinsonian symptoms

The nursing instructor is discussing immunity with the clinical group. What statement would the instructor make that would be an accurate statement concerning immunity?

Passive immunity is limited.

Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older?

Physiologic changes affecting all pharmacokinetic processes

To help understand immunostimulant drug therapy, the client has come to the clinic for a class on thrombopoiesis. The nurse explains that the term means the formation of which types of blood cells?

Platelets

What is a contraindication to an MMR booster for an adolescent female?

Pregnancy

Mycophenolate mofetil is being considered in the treatment of a 39-year-old female transplant recipient. Before the initiation of therapy, the nurse must assess the client for what information to ensure safety?

Pregnancy status

The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug?

Prevention of organ rejection

A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action?

Promptly inform the prescriber of the client's status.

Antivenins are used for passive, transient protection from which bites? (Select all that apply.)

Rattlesnake Copperhead black widow

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families?

Reduced risk for cervical cancer

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?

Rinse mouth with water after each use.

A client is receiving anakinra for treatment of rheumatoid arthritis. The client is scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing diagnosis for this client after the procedure?

Risk for infection

A client has begun taking an antidepressant that causes the client to be drowsy. What nursing diagnosis should the nurse prioritize related to drug therapy?

Risk for injury

A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?

Risk of birth defects

A nurse is administering IV acyclovir to a client. The pharmacy sent the correct dose in an IV bag with the instructions to give over one hour. The nurse realizes that the dose was ordered to be administered 1 PM and it is now 1:45 PM. What should the nurse do?

Run the infusion as directed (over one hour) and note the time that it was started in the chart. Fill out any medication discrepancy reports that the institution requires when a medication is given late.

A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?

Salmeterol is contraindicated based on his wife's condition.

A client develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?

Serum sickness

A 65-year-old male client lives in a long-term care facility. The infection control nurse identifies a cluster of clients on the unit diagnosed with shingles. What would the nurse expect the client's prescriber to order?

Shingles vaccine

When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited?

Slow-reacting substance of anaphylaxis

A female client is prescribed cyclosporine after her bone marrow transplant. What is the mechanism of action of cyclosporine that makes this an ideal drug for this patient?

Suppression of the normal effects of the immune system in the body

A group of students demonstrate understanding of topical decongestants, identifying them as:

Sympathomimetics

The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?

Tachycardia

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?

Take the tablet with food.

What would the nurse identify as a vaccine that is a toxoid?

Tetanus

Middle aged adults and health care workers should receive which immunizations?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually

The nurse is providing wellness information to a 50-year-old client who is employed as a paramedic. The client asks what, if any, vaccines the client should get. What is the nurse's best response?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually

What is the primary purpose associated with the use of the nursing process related to the implementation of medication therapy?

That holistic, evidence-informed care is given

Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing?

The North American Nursing Diagnosis Association-International (NANDA)

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider?

The client takes corticosteroids to treat rheumatoid arthritis

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

The nurse is caring for a client who has been admitted after an acetaminophen overdosage. Which of the nurse's assessment findings suggest liver damage? (Select all that apply.)

The client's skin and eyes are visibly jaundiced. The client's AST and ALT levels are elevated. The client's temperature is 102.5° F (39.2° C).

A client is receiving immunosuppressant therapy. Which adverse effects should the client be educated about regarding these effects?

The importance of keeping the home clean

A healthy 70-year-old man has been having trouble sleeping at night. Additionally, he has been having difficulties with gastresophageal reflux. He buys generic Benadryl to help him sleep and buys generic Tagamet for his reflux. After 7 days of taking these over-the-counter medications, he exhibits signs of confusion and disorientation. His wife calls the primary care facility to speak with the nurse. What should the nurse suspect first?

The older adult is experiencing mental changes as an adverse drug effect.

A hospital patient began treatment with interferon alfa-2a several days ago and the care team is pleased with the patient's response at this point in treatment. However, the patient has stated to the nurse that he feels increasingly despondent and claims to have lost all hope of recovering from his disease, despite being an optimistic person. How should the nurse best interpret the patient's statements?

The patient may be having psychological adverse effects of interferon alfa-2a.

The nursing instructor observes several nursing students administer medications to their assigned clients. What students are demonstrating safe practice? Select all that apply.

The student checks the drug's brand name and generic name before taking it to the client. The student documents the medication upon exiting the client's room. The student inspects the client's arm band prior to giving a medication. The student checks the label on the medication against the administration record three times.

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea?

There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.

While studying for a pharmacology test, a student asks peers about interferons. What statement about interferons is true?

They interfere with the ability of viruses in infected cells to replicate.

A nurse is teaching a group of clients about immunizations . What benefit of immunization should the nurse describe?

They provide the person with active immunity.

What is true concerning the "placebo effect" in drug administration?

Thinking that the drug will help the patient creates the placebo effect.

Why is it important for the nurse to obtain baseline information from a client, such as a drug profile, an accurate history of the client's usual abilities, and changes in abilities or health status?

To determine any new signs and symptoms in the client that could be related to drug therapy

What is the difference between toxoids and vaccines?

Toxoids always require occasional boosters.

Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children.

True

After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given?

Tuberculosis

When describing the use of vaccines to a local community group, what would the nurse include?

Vaccines are used to provide active immunity.

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?

Zoster vaccine

Which client, acknowledging the regular use of pseudoephedrine, should be assessed further for the possible risk of contraindications to the use of this medication?

a client currently being treated for depression

A client asks what neutropenia is. Which is the nurse's best response?

a condition when the neutrophil level is very low

A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client?

a larger-than-normal dose of the general anesthetic

A client is administered an oral contraceptive. What is the process that occurs between the time the drug enters the body and the time that it enters the bloodstream?

absorption

A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics?

absorption

A client has been prescribed an oral drug that is known to have a high first-pass effect. Which measure has the potential to increase the amount of the free drug that is available to body cells?

administering the drug intravenously rather than orally

A client is to receive a physical prior to starting immune sera therapy. What would the nurse assess for?

adventitious breath sounds

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?

albuterol

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

The nurse is scheduled to administer a tablet of medication to a client and the medication is available as a unit dose. Where would the nurse remove the wrappings of the unit dose?

at the client's bedside.

A nurse is discussing interferon alfa-2b with a patient. What will the nurse encourage the patient to do while taking this drug?

avoid alcohol

A client with complex health needs takes a large number of medications. In order to reduce the likelihood of drug-food interactions, the nurse should encourage the client to:

avoid drinking grapefruit juice.

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?

cardiovscular

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

cigarette smoking