Pharm ATI
A nurse is caring for a client who has HF and is prescribed dobutamine hydrochloride by continuous IV infusion. the nurse should identify that which of the following is a therapeutic effect? a. improved o2 sat b. decreased BP c. decreased HR d. improved CO
answer: D
A nurse is caring for a client with hyperlipidemia who receives Simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the clients breakfast tray before it is delivered? a. grapefruit juice b. hardboiled eggs c. coffee d. oatmeal
answer: A
A nurse is in a long term care facility is administering medications to a group of older adult clients. Which of the following factors of pharmacokinetics should the nurse consider? a. the excretion of medication is reduced b. the percentage of medication absorbed is increased c. liver metabolizes meds more quickly d. rate at which liver metabolizes medication declines with age
answer: A
A nurse is caring for a client who is taking warfarin. Which of the following lab values should the nurse recognize as an effective response to this medication? a. Hct 45% b. Hgb 15 c. aPTT 35 seconds d. INR 3
answer: D aPTT monitors effectiveness of heparin.
A nurse is preapring a continuous IV infusion of Erythromycin Lactobinate for a client who has pertussis. Which of the following actions should the nurse take to minimize risk of thrombophlebitis? a. infuse medication slowly b. administer half the dosage c. avoid diluting the solution d. initiate intermittent dosing
answer: A
A nurse is providing teaching to a client who has a new prescription for Doxycycline. The nurse should instruct the client to monitor for which adverse effect? a. photosensitivity b. constipation c. ototoxicity d. blurred vision
answer: A
A nurse is caring for the parent of a newborn. The parents asks the nurse when their newborn should receive their DTaP. The nurse should instruct the parent that the newborn should receive it at which age? a. birth b. 2 months c. 6 months d. 15 months
answer: B
A nurse is caring for a client who has a new prescription for Amphotericin B. The nurse should monitor for which of the following adverse effects? a. hyperkalemia b. hypertension c. constipation d. nephrotoxicity
answer: D Antifungal - can be toxic to kidneys Causes hypokalemia, hypotension, and diarrhea.
A nurse is providing teaching to a newly licensed nurse about caring for a client on Gemfibrozil. The nurse should instruct the new nurse to monitor which lab test? a. platelet count b. electrolyte levels c. thyroid function d. liver function
answer: D Reduces triglycerides by decreasing liver uptake of fatty acids.
A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following following information should the nurse include in the teaching? a. chew on the medication stick to release medication b. leave the medication stick in one location of the mouth until melted c. allow medication 1 hour for analgesia effects to begin d. store unused medication sticks in storage container
answer: D The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.
A nurse is caring for a client who is recovering from DVT and is starting to take warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? a. HTN b. low INR c. constipation d. bleeding gums
answer: D The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant. The nurse should monitor for gastrointestinal irritation, which can include diarrhea, nausea, and vomiting.
A nurse is administering a prescription for nifedipine for a client who is pregnant. Which of the following should the nurse monitor and document? a. hypoglycemia b. uterine ripening c. increased BP d. number of uterine contractions
answer: D used for preterm labor to delay.
A nurse is teaching a client who has chemotherapy induced anemia and a prescription for Epoetin Alfa. The nurse should instruct the client to report which of the following adverse effects? a. HTN b. leukocytosis c. bone pain d. neutropenia
answer: A
a nurse is caring for a client who has prescription for a QT interval medication. Which of the following conditions should the nurse identify as an adverse effect? a. bradycardia b. jaundice c. low BP d. dark urine
answer: A
A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? a. metoprolol b. ondansetron c. lorazepam d. naloxone
answer: C Lorazepam can cause CNS depression which can lead to respiratory depression.
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? a. hold client's other oral medications for 8 hours post-administration b. inform the client that this medication can turn the stool a light tan color c. keep client's solution in the refrigerator for up to 72 hours d. monitor client for constipation
answer: D The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.
A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? a. gastric distress b. oliguria c. excessive bruising d. tinnitus
answer: D Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness. Excessive bruising is a possible adverse effect of aspirin therapy, caused by the antiplatelet effects of the medication. However, excessive bruising is not an indication of salicylism.
A nurse is caring for a client who takes scheduled morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following medication to treat breakthrough pain? a. meperidine b. buprenorphine c. methadone d. fentanyl
answer: D Transmucosal spray with rapid onset is used. Methadone has a duration for 4-12 hours.
A nurse is administering donepezil to a client who has alzheimer's disease. Which of the following findings should the nurse report immediately? a. dyspepsia b. diarrhea c. dizziness d. dyspnea
answer: D When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.
Nurse suspects a client is having an allergic reaction. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to the medication? a. this is the initial dose of the current prescription b. client received a large dose c. ROA was oral d. client had previous exposure to medication
answer: D immune system has developed sensitization to the medication.
A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements indicates that the client understands teaching? a. ill use a safety razor to shave each day b. ill eat lots of spinach b. ill avoid contact sports like football d. ill take ibuprofen if I get a headache
answer; B
A nurse is completing admission history for a client who reports drinking 1 pint of whiskey everyday for the last 6 years. The last drink was 10 hours ago. Which medication should be administered? a. chlordiazepoxide b. disulfiram c. naloxone d. acetaminophen
answer: A Facilitates alcohol withdrawal. Disulfiram is administered once detox is finished.
A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate effectiveness of therapy? a. increased neutrophil count b. increased RBC count c. decreased prothrombin time d. decreased triglycerides
answer: A Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized.
A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication that she should complete an incident report? a. client reports SOB b. client is taking lisinopril c. clients pulse is 60/min d. clients WBC is 14,000
answer: A A severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. Shortness of breath can indicate the client is developing anaphylaxis.
A nurse is caring for a client who has MS and is recieving interferon beta1. The nurse should identify that which indicates a potential adverse effects? a. my body aches all over b. I have abdominal cramping c. my hair is thinning d. it hurts when I urinate
answer: A Adverse effects are flu-like symptoms.
A nurse is caring for a client who is recivieng haloperidol. The nurse should identify which of the following as an adverse effect of the medication? a. akathisia b. paresthesia c. excess tear production d. anxiety
answer: A An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia.
A nurse is providing teaching to a client with HTN and type 1 diabetes who has a new prescription for Metoprolol. Which of the following statements indicates an understanding of teaching? a. I might have difficulty recognizing when my blood sugar is low b. I will have a lower risk of developing an infection when on this medication c. I should be concerned about losing excess weight while I take this medication d. I could have more problems with high blood sugar while on this medication
answer: A BB decreases HR, and tachycardia is a common symptom of hypoglycemia. Teach other manifestations, such as hunger, nausea, and sweating
A nurse is assessing a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement? a. client is having 1-2 bowel movements per day b. glucose level is elevated c. weight loss d. abdominal distension
answer: A Bowel movements indicate adequate absorption of food.
Nurse is reviewing medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? a. carbamazepine b. sumatriptan c. atenolol d. glipizide
answer: A Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking docusate sodium daily can minimize which of the following SE of morphine? a. constipation b. drowsiness c. facial flushing d. itching
answer: A Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.
A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise induced asthma. Which of the following medications should the nurse plan to instruct to the client to use prior to physical activity? a. cromolyn b. beclomethasone c. budesonide d. tiotropium
answer: A Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.
A nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. The nurse should anticipate that the client will receive which of the following medication delivery devices for the treatment of asthma? a. dry powder inhaler b. metered dose inhaler with spacer c. respimat d. nebulizer
answer: A DPI does not require hand breath coordination. Respimats require the patient to twist to deliver medicine.
A nurse is preparing to administers dantrolene to a client who has muscle spasticity. Which of the following findings from the medical historu should be identified as a contraindication? A. cirrhosis b. MS c. cerebral palsy d. malignant hyperthermia
answer: A Dantrolene is hepatotoxic.
A nurse is teaching a client who has a new prescription for docusate sodium about the medications MOA. Which of the following information should the nurse include in the teaching? a. docusate sodium reduces surface tension of stools to change consistency b. causes rectal contractions c. acts as a fiber agent, increasing bulk in intestines d. stimulates motility of intestines
answer: A Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.
A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? a. oral candidiasis b. headache c. joint pain d. adrenal suppression
answer: A Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.
A nurse administered digoxin immune Fab to a client who recievied the incorrect dosage of digoxin over 3 days. The nurse should identify that which of the following findings indicates that the antidote was effective? a. normal sinus rhythm b. digoxin level of 2.5 c. decreased BP d. potassium of 3.2
answer: A Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. The return of the heart to normal sinus rhythm indicates a therapeutic response to the antidote. Digoxin immune Fab is administered to a client who is experiencing severe digoxin toxicity. It binds with digoxin and works to reduce the client's blood digoxin level. A digoxin level of 2.5 ng/mL is above the expected reference range of 0.8 to 2 ng/mL. Therefore, this finding does not indicate a therapeutic response to the antidote.
A nurse is caring for a client who received Naloxone, which of the following is an adverse effect? a. report of pain b. RR 8/min c. report of numbness d. abdominal cramping and diarrhea
answer: A Excess doses can cause the return of pain, but improve the RR.
A nurse is caring for a client who is taking acarbose for T2 diabetes. Which of the following adverse effects should the nurse monitor for? a. insomnia b. diarrhea c. joint pain d. polycythemia
answer: B common GI side effects.
A nurse is educating a client with urethritis who has a new prescription for oral erythromycin. which of the following statements should the nurse include teaching? a. report persistent diarrhea to provider b. take with a full glass of milk c. some people who take erythromycin experience vision loss d. antacids will reduce absorption
answer: A GI disturbances are common, but persistent diarrhea can signal superinfection.
A nurse in a provider's office is assessing a client who has been taking feverfew. Which of the following statements by the client indicates a therapeutic effect of the supplement? a. I am having fewer migraine headaches b. my memory is getting better c. I have fewer infections d. I have not had another UTI since starting
answer: A Herb used for prophylaxis of migraines.
A nurse is planning care for a client who is receiving Gentamicin IM and has a new prescription for gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample for the peak? a. 1 hour after administering the IM injection b. just before administering the IM injection c. 12 hours after the last IM injection d. 30 minutes after administering the IM injection
answer: A IM - 1 hour after administration, IV - 30 minutes
A nurse is precepting a newly licensed nurse who is caring for 4 clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse? a. administers isosorbide mononitrate to a client who has a BP of 82/60 b. administers digoxin to a client who has a HR of 92 c. administers regular insulin to a client who has a blood glucose of 250 mg/dl d. administers heparin to a client who has an aPTT of 70 seconds
answer: A Isosorbide mononitrate is a nitrate used for clients with angina. Taking isosorbide mononitrate leads to vasodilation, which can result in hypotension. The nurse should withhold the medication and notify the provider if the client's systolic blood pressure is below the expected reference range of 120/80.
A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications? a. Naproxen b. Pegloticase c. Probenecid d. Allopurinol
answer: A Naproxen is an NSAID that will relieve manifestations. Allopurinol is for chronic gout.
A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is a priority? a. paresthesia b. alopecia c. stomatitis d. constipation
answer: A Risk of neurotoxicity from chemotherapy.
A nurse is caring for a patient with premenstrual disorder with a prescription of Fluoxetine. The client asks the nurse, "when should I notice the benefits of this medication?". Which of the following responses should the nurse make? a. you should expect decreased manifestations within a few days b. manifestations decrease after about 2 months c. you should expect decreased manifestations immediately d. manifestations will decrease after several weeks.
answer: A SSRI - when used to treat PMD, the manifestations decrease quicker than in treating depression
A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following information should be included in the teaching? a. pravastatin can be taken with grapefruit juice b. pravastatin can be continued during pregnancy c. pravastatin should be taken with evening meal d. lab testing to monitor WBC is required
answer: A Safe to take with grapefruit. Can cause anomalies during pregnancy, take at bedtime, monitor liver function
A nurse is caring for a client who has asthma and requires long term treatment. The nurse should identify that which of the following medications used for long term treatment puts the client at an increased risk of asthma related death? a. salmeterol b. fluticasone c. budesonide d. theophylline
answer: A Salmeterol is a LABA, client must take with a SABA to decrease this risk.
A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? a. chest pressure b. white patches on tongue c. bruising d. insomnia
answer: A Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.
A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following lab values should the nurse monitor? a. creatinine kinase b. ESR c. INR d. potassium
answer: A The client who is taking atorvastatin can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis. Creatinine kinase levels rise in response to enzymes released with muscle injury.
A nurse is teaching a client who is to begin taking Tamoxifen for breast cancer. Which of the following adverse effects should the nurse include in the teaching? a. hot flashes b. urinary retention c. constipation d. bradycardia
answer: A The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.
A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? a. turn client to a side lying position b. disconnect oxytocin from maintenance IV c. apply oxygen to client via face mask d. increase clients maintenance IV infusion rate
answer: A The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority action the nurse should take is to place the client in a lateral position. The nurse should discontinue the oxytocin to reduce uterine contractions. However, another action is the nurse's priority.
A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? a. perform a capillary blood glucose test b. provide the client with a protein rich snack c. give the client 120 mL of orange juice d. schedule an early meal tray
answer: A The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill till I get home today". Which of the following actions should the nurse take? a. document refusal and inform provider b. file incident report with risk manager c. contact pharmacist to pick up medication d. give client medication to take at home and document that it was administered
answer: A The nurse has the responsibility to verify that the client understands the risks of refusing the medication so that an informed decision can be made. The nurse should then document the refusal in the client's medical record and notify the health care provider.
A nurse is preparing to administer heparin SQ to a client. Which of the following actions should the nurse plan to take? a. administer medication outside 5cm radius of umbilicus b. aspirate for blood before injecting c. rub vigorously after injection to promote absorption d. place a pressure dressing on injection site to prevent bleeding
answer: A The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus.
A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using Midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? a. client's capnography has returned to baseline b. client can respond to their name when called c. client is passing flatus d. client is requesting oral intake
answer: A The nurse should identify that the client is ready for discharge when the capnography level indicates that gas exchange is adequate. A request for oral intake does not indicate the client is ready for discharge. The nurse should assess for a return of the gag reflex for a client who is postoperative following an endoscopy.
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? a. tingling of fingers b. constipation c. weight gain d. oliguria
answer: A The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide. Polyuria, rather than oliguria, is an adverse effect of acetazolamide.
A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take? a. ensure flumazenil is available to administer for toxicity management b. monitor for increased BP c. expect client to become unconscious within 30 seconds d. measure capnography level every hour until the client is awake and oriented
answer: A The nurse should monitor the client for manifestations of diazepam toxicity, such as respiratory depression and hypotension. The nurse should be prepared to administer flumazenil to reverse the effects of diazepam.
A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? a. temperature of 103.5 b. urinary retention c. HR of 56 d. muscle flaccidity
answer: A The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension. The nurse should report severe muscle rigidity as a manifestation of NMS.
A nurse is caring for a client who is refusing to take the scheduled morning furosemide. Which of the following statements should the nurse make? a. by not taking your furosemide, you might retain fluid and develop swelling b. You can double your dose of furosemide this evening if that would be better for you c. If you do not take your furosemide, we might get in trouble. d. "I'll go ahead and mix the furosemide into your breakfast cereal."
answer: A The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema.
A nurse is teaching a client who has a new prescription for phenytoin. The nurse should inform the client that which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? a. status epilepticus b. bleeding gums c. disorientation d. severe nausea
answer: A The other choices are adverse effects of phenytoin therapy.
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client recieved atenolol instead of allopurinol. Which of the following actions should the nurse take first? a. obtain clients BP b. contact provider c. inform charge nurse d. complete an incident report
answer: A When using the nursing process, the first action the nurse should take to prevent injury to the client is to assess the client for adverse effects of atenolol, such as hypotension.
A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. Which of the following findings should the nurse notify the provider immediately? a. hyperventilation b. heartburn c. anorexia d. swollen ankles
answer: A When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This finding indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.
A nurse is teaching about levodopa with a family member of a client who has Parkinson's. Which of the following pieces of information should the nurse include? a. a full therapeutic response may take several months to happen b. the medication should be taken with high protein foods c. a full therapeutic response might cause vivid dreams d. the medication is given at the onset of mild symptoms
answer: A mild symptoms are treated with selegiline. vivid dreams are an adverse effect.
A charge nurse is teaching a newly licensed nurse about purpose of being prescribed a transdermal fentanyl patch. Which of the following clients should be included in the teaching? a. opioid tolerant b. difficulty swallowing c. severe intermittent pain d. post-op following abdominal surgery
answer: A severe persistent pain would warrant a transdermal patch, less powerful analgesic given post-op
A nurse is preparing to administer a hydromorphine IV infusion to a client for pain. Which of the following actions should the nurse take? a. administer the medication for 4-5 minutes b. place the client in high fowler's position c. assess the client's pain level after administering the medication d. review the clients last set of vital signs
answer: A this will prevent RD and cardiac arrest. Patient placed in supine position to decrease hypotension.
A nurse at an urgent care clinic is collecting history from a female client who has a UTI. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? a. I have tendonitis, so I haven't been able to exercise b. I take a stool softener for chronic constipation c. I take medication for my thyroid d. I am allergic to sulfa
answer: A The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.
A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (SATA) a. report muscle pain to provider b. avoid taking with grapefruit juice c. take medication early in the morning d. expect a flushing of the skin as a reaction e. expect therapy to be lifelong
answer: A, B, E Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis. The nurse should instruct the client to report this to the provider. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months.
A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (SATA) a. blood glucose levels will need to be monitored during therapy b. avoid contact with persons who have known infections c. take medication 1 hour before a meal d. decrease intake of foods containing potassium e. grapefruit juice can increase blood levels of the medication
answer: A, B, E The nurse should instruct the client that their blood glucose levels will be monitored during therapy because corticosteroids, such as methylprednisolone, can raise blood glucose levels. The nurse should instruct the client to avoid contact with persons who have known infections because corticosteroids, such as methylprednisolone, suppress the immune response and mask manifestations of infection. The nurse should instruct the client that grapefruit juice increases the absorption of the medication, which can lead to toxicity and adrenal suppression.
A nurse is providing teaching to a client who has multiple sclerosis and a new presciption for methylprednisolone. Which of the following instrucitons should the nurse include? (SATA) a. blood glucose levels will be monitored during therapy b. avoid contact with people who have known infections c. take medicaiton 1 hour before breakfast d. decrease dietary intake of potassium e. grapefruit can increase effects of medication
answer: A, B, E The nurse should monitor the client for hyperglycemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body.
Nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (SATA) a. dry mouth b. tinnitus c. blurred vision d. bradycardia e. dry eyes
answer: A, C, E Oxybutynin is an anticholinergic agent that can cause dry mouth, blurred vision due to an increase in intraocular pressure, dry eyes and mydriasis, or pupil dilation.
A nurse is providing teaching for a client with metoprolol. Which of the following instructions should be included? (SATA) a. do not stop taking medication abruptly b. take the medication before bed time c. avoid exposure to sunlight d. count your radial pulse daily e. change positions slowly
answer: A, D, E
A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the HCP? (SATA) a. hgb 7 b. creatinine 1 c. RBC 4.7 million d. platelets 75,000 e. potassium 5.2
answer: A, D, E A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity. This hemoglobin level is below the expected reference range of 14 to 19 g/dL for a male client and 12 to 16 g/dL for a female client. Therefore, the nurse should report this finding to the provider. A platelet level of 75,000/mm3 indicates hydroxyurea toxicity. This platelet level is below the expected reference range of 150,00 to 400,000/mm3. Therefore, the nurse should report this finding to the provider.
A nurse contacts a clients provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take? a. write the order on a prescription pad designated for the provider b. have the provider spell out unfamiliar names c. read the prescription back to the provider using abbreviations d. consult with a second nurse for any questions regarding dosage
answer: B
A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? a. decreases gastric acid secretions b. forms a gel-like substance that protects ulcers c. inactivates H. pylori d. inhibits production of gastric acid
answer: B
A nurse is caring for a client in preterm labor with a prescription for nifedipine. The client states she is concerned because her father takes nifedipine for angina. The nurse should explain how the medication works using which explanation? a. decreases incidence of bacterial vaginosis b. inhibits uterine contractions by blocking entry of calcium into uterine cells c. decreases activity in CNS d. stimulates beta 2 receptors which decreases frequency of contractions
answer: B
A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication a. HTN b. cardiac dysrythmias c. gastric discomfort d. tachycardia
answer: B
A nurse is providing teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following indicates an understanding of teaching? a. I will be able to stop taking this medication within 6 months after my surgery b,. I am likely to develop increased BP while on this med c. I am likely to lose my hair while on this med d. I am taking this to boost my immune system
answer: B 10-15% increase in BP. Cyclosporine is continued for life. Immunosuppressive agent.
A nurse is administering baclofen for a client with a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome? a. increased seizure threshold b. decreased flexor and extensor spasticity c. increased cognitive function d. decrease in paralysis of extremities
answer: B A client who has a spinal cord injury and takes baclofen can experience a decrease in the frequency and severity of muscle spasms and in flexor and extensor spasticity.
Nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? a. vitamin K b. acetylcysteine c. benztropine d. physostigmine
answer: B Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.
A nurse is reviewing the medication history for a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? a. ipratropium b. albuterol sulfate c. tiotropium d. budesonide
answer: B Albuterol is a SABA. Ipratropium and Tiotropium are for COPD. Budesonide is an inhaled corticosteroid to decrease inflammation in severe forms of asthma.
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an effect of the medication? a. constipation b. tinnitus c. hypoglycemia d. joint pain
answer: B Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.
A nurse is teaching a client who has a new prescription for Amitriptyline to treat depression. Which of the following indicates an understanding of teaching? a. I should take this when I experience active symptoms b. I should take this before bedtime c. this may cause excess salivation d. I might experience weight loss while taking this medication
answer: B An adverse effect is sedation, taking it at bedtime will promote sleep. Med is taken daily, has anticholinergic effects (dry mouth, etc.), and can cause weight gain.
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking warfarin. Which of the following responses should the nurse make? a. it is safe to take enteric coated aspirin b. aspirin will increase the risk of bleeding c. acetaminophen may be substituted for aspirin d. the INR lab work must be monitored more frequently if aspirin is taken
answer: B Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding. Acetaminophen, an analgesic, can potentiate the action of the anticoagulant warfarin when administered in high doses and is not a safe substitute for aspirin.
A nurse is reviewing the medical record of a client who has HTN. The nurse should identify which of the following findings as contraindicated for receiving propranolol? a. cholelithiasis b. asthma c. angina pectoris d. tachycardia
answer: B Asthma is a contraindication for receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.
A nurse is caring for a client who as a fib and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications? a. amlodipine b. diltiazem c. nifedipine d. lidocaine
answer: B CCB - lowering BP, used to treat a fib
A nurse is instructing a client on the application of nitroglycerine transdermal patches. Which of the following statements by the client indicates understanding of the teaching? a. I should apply a patch every 5 minutes if I feel pain b. I will take the patch off right after my evening meal c. I will leave the patch off at least 1 day a week d. I should discard the patch by flushing it down the toilet.
answer: B Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects.
Nurse is assigned to care for several clients who are postoperative. The client taking which of the following medications is at risk for delayed wound healing? a. Nifedipine for HTN b. prednisone to treat persistent arthritis exacerbations c. albuterol to treat asthma d. chlorpromazine to treat schizophrenia
answer: B Corticosteroids delay wound healing.
A nurse is caring for a client who has heart failure and a prescription for enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? a. bradycardia b. hyperkalemia c. loss of smell d. hypoglycemia
answer: B Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys.
A nurse is caring for a client who has suspected adrenal suppression. Which medication should be anticipated in determining presence of adrenal insufficiency? a. prednisone b. cosyntropin c. dexamethasone d. ketoconazole
answer: B Inject, see if cortisol levels rise above 20.
Nurse is planning care for a client who has HTN and is starting to take metoprolol. Which of the following interventions should the nurse include in the plan of care? a. weigh the client weekly b. determine apical pulse prior to administering c. administer medication 30 minutes before breakfast d. monitor for jaundice
answer: B Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.
A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? a. muscle weakness b. sedation c. tinnitus d. peripheral edema
answer: B Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation. Tardive dyskinesia is an adverse effect of metoclopramide. However, metoclopramide does not cause muscle weakness.
Nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which OTC medication? a. aspirin b. ibuprofen c. ranitidine d. bisacodyl
answer: B Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently. Aspirin does not interact.
A nurse is providing teaching about antiretroviral medication therapy to a client with a new diagnosis of AIDS. Which of the following statements should be included? a. your provider will prescribe a single antiretroviral medication at a time b. you should take medications on a routine schedule c. you should increase your intake of raw fruits and veggies d. you provider will prescribe antiretroviral therapy to kill the HIV
answer: B Must take meds as prescribed without delaying or skipping doses to avoid resistance
A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication? a. positive Chvostek's sign b. client reports decreased paresthesias c. client reports increased thirst d. calcium level of 8.8 mg/dl
answer: B Paresthesia is a manifestation of hypocalcemia. A client report of a decrease in paresthesia is an indication of a therapeutic response to calcium citrate. The nurse should also monitor for a decrease in other manifestations of hypocalcemia, including muscle twitching and cardiac dysrhythmias. A calcium level of 8.8 mg/dL is below the reference range of 9.0 to 10.5 mg/dL and does not indicate a therapeutic response to calcium citrate.
A nurse is teaching a client who has a new diagnosis of angina and a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following indicates understanding of teaching? a. I can take my second dose no later than 9 pm b. I should change positions slowly when getting out of bed c. if I miss a dose, I should double the next dose d. I should notify my provider if I experience headache while taking this med
answer: B Produces vasodilation which causes orthostatic hypotension. Headaches are a common side effect.
A nurse is caring for a female client who has been taking clomiphene to treat infertility. Which of the following findings should indicate to the nurse that the medication is effective? a. decreased LH hormones b. follicular enlargement and conversion to corpus leuteum after ovulation c. increased hCG levels d. blocked endogenous release of LH and prevention of premature ovulation
answer: B Promotes follicular maturation.
A nurse is monitoring a client with asthma, taking albuterol, and recently started propranolol to treat a cardiovascular disorder. The client reports the albuterol being less effective, which explanation should the nurse provide? a. potentiative interaction b. detrimental inhibitory interaction c. increased adverse reaction d. toxicity reducing inhibitory interaction
answer: B Propranolol interferes with albuterol's therapeutic effects.
A nurse in a providers office is providing teaching to a client with osteoporosis with a prescription for alendronate sodium. Which of the following pieces of information should be included? a. alendronate sodium can be administered by IV once yearly b. take with a full glass of water on an empty stomach c. side effects include leukopenia d. taken with calcium containing foods to increase absorption
answer: B Remain in upright position after. Do not eat or drink anything but water for 30 min after taking med.
A nurse is teaching a client about taking tetracycline PO. Which of the following statements should the nurse include? a. take this medication on a full stomach b. limit consumption of dairy products while on this med c. take medication with regular iron supplement d. take antacids if you have an upset stomach
answer: B Separate ingestion of dairy by at least 2 hours. Take on empty stomach, iron interferes with absorption.
A nurse at the clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect? a. tingling toes b. sexual dysfunction c. absence of dreams d. Pica
answer: B Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant.
A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraines. Which of the following informaiton should the nurse include in the instructions? a. take one tabled 3 times per day before meals b. take one tablet with onset of migraine c. take up to 8 tablets as needed within 24 hours d. take one tablet every 15 minutes until migraine subsides
answer: B The client should take one tablet immediately after the onset of aura or headache. The client can take one sublingual tablet every 30 min for a maximum of three tablets in a 24-hr period to manage a migraine.
A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? a. administer epinephrine 0.5 mL via IV bolus b. discontinue this medication IV c. elevate legs above heart d. collect blood specimen for ABG
answer: B The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion. The nurse should administer epinephrine, which is a beta-adrenergic agonist that can stimulate the heart, cause vasoconstriction of blood vessels in the skin and mucous membranes, and cause bronchodilation in the lungs. However, there is another action the nurse should take first.
A nurse is caring for a client who received 0.9% sodium chloride 1L over 4 hours instead of over 8 hours as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? a. IV fluid infused over 4 hours instead of 8 hours. Client tolerated fluids well, provider notified. b. 0.9% sodium chloride 1L infused over 4 hours. Vital signs stable, provider notified. c. 1L of 0.9% sodium chloride completed at 0900. Client denies SOB. d. IV fluid initiated at 0500. Lungs clear to auscultation.
answer: B The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status.
A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect? a. hypoglycemia b. orthostatic hypotension c. bradycardia d. conjuctivitis
answer: B The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position. The nurse should identify palpitations as an adverse effect of hydrochlorothiazide, which is an antihypertensive thiazide diuretic medication.
Nurse is reviewing the ECG of a client who is receiving IV furosemide for HF. The nurse should identify which of the following findings as an indication of hypokalemia. a. tall, tented T waves b. presence of U waves c. widened QRS complex d. ST elevation
answer: B The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide.
A nurse receives a verbal order from the provider to administer morphine 5 milligrams ever 4 hours SQ for severe pain as needed. The nurse should identify which of the following entries as the correct format for medication administration record? a. MSO4 5mg subcut every 4 hours PRN severe pain b. morphine 5 mg subcut every 4 hours PRN severe pain c. MSO4 mg SQ every 4 hours PRN severe pain d. morphine 5.0 mg subcutaneously every 4 hours PRN severe pain
answer: B The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription.
Nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? a. serum calcium b. pregnancy c. 24 hour urine collection for protein d. aspartate aminotransferase level
answer: B The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.
A nurse is teaching a client who is to start taking ranitidine for PUD. Which of the following client statements should the nurse identify as an understanding of the teaching? a. I will stop taking ranitidine when my stomach pain is gone b. I know smoking makes ranitidine less effective c. I will take ranitidine anytime my stomach hurts. d. I know that ranitidine will turn my stools black
answer: B The nurse should instruct the client that smoking decreases the effectiveness of ranitidine by exacerbating the ulcer manifestations.
A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? a. schedule the client for the last surgery of the day b. place monitoring cords and tubes in a stockinet c. choose rubber injection ports for fluid administration d. ensure phenytoin IV is readily available
answer: B The nurse should place monitoring devices in a stockinet to prevent direct contact with the client's skin. The nurse should ensure that latex-free products are used in the care of this client. Rubber injection ports contain latex, which puts the client at risk for a severe allergic reaction.
a nurse is caring for a client who is recieving heparin via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication? a. vomiting b. blood in urine c. positive Chvostek's sign d. ringing in ears
answer: B The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.
A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following lab tests should the nurse review before administering the medication? a. troponin b. total cholesterol c. creatinine d. TSH
answer: B The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.
A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? a. paresthesia b. increased BP c. fever d. respiratory depression
answer: B The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.
A nurse is reviewing the medical record of a client who is scheduled for induced labor with misoprostol. Which of the following is a contraindications? a. gestational diabetes b. past C-section c. preeclampsia d. genital herpes
answer: B Used for cervical ripening, causes a higher incidence of uterine tachysystole. Increased risk of uterine rupture if client had a previous C section.
A nurse is teaching about zolpidem to a client who has insomnia. The nurse should identify that which of the following statements indicates an understanding of the teaching? a. I will need to get lab testing prior to getting a refill for this medication b. I will use this medication for a short period of time c. I will need to take this medication for 1 week before results are seen d. I will need to change the medications to prevent building up a tolerance
answer: B Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.
A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? a. take the second dose at bedtime b. increase intake of potassium rich foods c. obtain your weight weekly d. monitor for muscle weakness e. dangle your legs from the side of the bed before standing
answer: B, D, E Furosemide is a loop diuretic that causes diuresis. When taken twice daily, the client should take the second dose of furosemide by 1400 hr to prevent nocturia. Furosemide, a loop diuretic, causes a loss of potassium, which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider.
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider? a. nasal congestion b. tremors c. tinnitus d. frontal headache
answer: C
A nurse is caring for a client who was brought to the ED by friends after a reported heroin overdose. Which of the following findings should the nurse expect? a. temperature of 102.6 b. RR 30/min c. pinpoint pupils d. severe abdominal cramping
answer: C
A nurse is completing an incident report for a medication error. Which of the following information should the nurse include in the report? a. this could have been avoided if I had double checked the medication administration record with the clients ID band b. it was easy to get confused because another client is taking a similar sounding medication. c. administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication. d. while I rarely make medication errors, the client was given 80 mg of propranolol by mistake at 1800.
answer: C
A nurse is provifing teaching to a client with chronic constipation and a prescription for psyllium. Which instructions should be included? a. this medication is for short term use only b. eat a low residue diet while taking this c. mix medication with water and follow with an additional glass of liquid d. medications adverse effects of stomach cramps and nausea will go away.
answer: C
A nurse is teaching a client who has T2 diabetes about insulin lispro. Which of the following statements should be included? a. the effects can last 8-12 hours b. administer 30-60 minutes before eating c. onset is about 15 minutes d. this can be given as a continuous IV bolus
answer: C
A nurse is teaching a client who is to start taking amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? a. muscle twitching b. cough c. urinary retention d. increased libido
answer: C
A nurse in an emergency department is caring for a client who has myasthenia gravis and is in cholinergic crisis. Which of the following medications should the nurse plan to administer? a. potassium iodide b. glucagon c. atropine d. protamine
answer: C A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? a. diphenhydramine b. albuterol inhaler c. epinephrine d. prednisone
answer: C According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis. All should be administered eventually.
A nurse is preparing to administer the first DTaP vaccine to an infant. Which of the following should the nurse tell the guardian before administration? a. your child might develop diarrhea or vomiting within 24 hours b. I can either give your child all of the injections in this series at once or individually c. the vaccine will be injected into the infants thigh d. the injection contains a live virus
answer: C Administered in mediolateral thigh to diffuse inflammation.
A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following indicates an understanding of teaching? a. I will administer a spray into each nostril daily b. I should expect nasal bleeding for the first week c. I will need to depress the side arms to activate the pump d. I should expect to take this medication for a short term treatment
answer: C Administered into a single nostril, alternating. Nasal bleeding is an adverse effect and med should be stopped. Long term treatment
A nurse is teaching a client who has gout about a prescription for allopurinol. Which of the following statements by the client indicates that teaching was effective? a. I should start taking this medication at 800 mg daily b. I will need to have tests done on my liver due to the increased risk of liver failure c. I will increase my fluids to 2 liters per day d. I will take this medication twice daily
answer: C An adverse effect is renal injury. Initial dosage is 100 mg/day, usually once daily.
A nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of teaching? a. I should take this medication with meals and at bedtime b. I should only have to take this medication for 2 weeks c. I should wait at least 30 minutes before taking this medication after I take an antacid d. I should swallow these tablets whole
answer: C Antacids raise gastric pH and can interfere with effects of sucralfate.
A nurse is assessing a client who has received atropine eye drops during an eye exam. Which of the following findings should the nurse expect as an effect of this medication? a. difficulty seeing in the dark b. pinpoint pupils c. blurred vision d. excessive tearing
answer: C Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause near objects to appear blurry to the client.
A nurse is teaching about a new prescription for ciprofloxacin to a client who has a UTI. The nurse should identify which of the following statements as an indication that the client understands the teaching? a. I will take this medication with an antacid to prevent GI upset b. I will stop taking this medication when i no longer have pain upon urination c. I will report any signs of tendon pain or swelling d. I will take this medication with milk
answer: C Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling.
A nurse is assessing a client's vital signs prior to administration of PO digoxin. The client's BP is 144/86 mmHg, the HR is 55/min, the RR is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings. a. diastolic BP b. systolic BP c. HR d. RR
answer: C Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.
A nurse is caring for a client who has HF and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? a. decreased BP b. increased HR c. increased CO d. decreased potassium
answer: C Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion. Dopamine is an adrenergic that causes a receptor specificity effect, which increases blood pressure.
A nurse is teaching a client with a new diagnosis of PUD who has a prescription for bismuth subsalicylate. The client asks "how will this medication help my ulcer?". Which statement should the nurse make? a. this medication will decrease prostaglandins b. the amount of bicarbonate in your body will be increased c. this medication can decrease bacteria in the GI tract d. this medication acts by increasing blood flow to the stomach
answer: C Eliminates H. pylori. Decreased prostaglandins can progress PUD.
a nurse is preparing to administer hydrochlorothiazide to a client. Which of the following actions should the nurse take prior to administering the medication? a. ask the client to drink 8oz of water b. review the clients most recent Hgb level c. obtain the client's BP d. determine if the client is allergic to NSAIDs
answer: C HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema. The nurse should obtain the client's blood pressure prior to administration of the medication.
A nurse is teaching the parent of a child who has severe restrictive airway disease about glucocorticoids. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following information should the nurse provider? a.Inhaled glucocorticoids are less likely to cause thrush b. oral glucocorticoids are hazardous during times of stress c. oral glucocorticoids are more likely to slow linear growth in children d. inhaled glucocorticoids are more effective for acute bronchospasm
answer: C High doses decrease growth in children. Inhaled glucocorticoids are not used for acute situations.
A nurse is providing teaching to a client with a new diagnosis of HF who has a prescription for furosemide. Which of the following statements should be included in teaching? a. you can take ibuprofen for headaches while on this medication b. you may experience increased swelling in your lower extremities c. you should eat foods high in potassium which on this medication d. you should take this medication at bed time
answer: C NSAIDs decrease efficacy of furosemide. Avoid taking at bed time because it increases the need to urinate.
A nurse is teaching a client who has ADHD and is starting therapy with amphetamine/dextroamphetamine. Which of the following manifestations should the nurse instruct the client to identify as an adverse effect? a. restlessness b. insomnia c. palpitations d. weight gain
answer: C Palpitations require immediate intervention.
A nurse is teaching a client who has diabetes about a new prescription for Pioglitazone. Which of the following statements should the nurse include in the teaching? a. monitor for hypoglycemia 6 hours after medication b. this cannot be taken if you have a sulfa allergy c. this medication can be taken while using insulin d. this medication is effective for people with type 1 diabetes
answer: C Pioglitazone increases the cellular response to insulin, insulin is needed for it to be effective.
a nurse is providing teaching to a client who has a gastric ulcer and new prescription for rantidine. Which of the following instructions should the nurse include? a. take the medication on an empty stomach for full effectiveness b. you may discontinue this medication when stomach discomfort subsites c. report yellowing of the skin d. store medication in the fridge.
answer: C Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? a. decreases stomach acid production b. neutralizes acids in the stomach c. forms a protective barrier over ulcers d. eradicates H. pylori
answer: C Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.
A nurse is providing teaching to a client about the use of estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? a. I will apply with patch once a week for 2 weeks b. I will leave the existing patch on for 4 hours after applying the new patch c. I will fold the sticky side of the old patch together before disposing d. I will apply the patch within 14 days of menses
answer: C The client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe disposal of the patch. The client should apply the patch within 7 days of menses to prevent ovulation and the need for another contraceptive method.
a nurse is teaching about self administration of transdermal medication with a male client who has a new prescription for nitroglycerine. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? a. I can apply the patch to a chest area that has hair b. I can take this medication while using an erectile dysfunction product c. I will remove the patch after 14 hours d. I need to apply a new patch to the same area each day
answer: C The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.
nurse is providing discharge instructions to a client who has HF and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? a. I should take the medication with food. b. I should take naproxen if I develop joint pain c. I should tell my provider if I develop a sore throat d. I should expect the medication to cause my urine to look orange
answer: C The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued.
A nurse is providing discharge instructions to a client who is to self administer insulin at home. Which of the following client statements should indicate to the nurse that teaching is effective? a. I should avoid getting rid of the air bubble in the syringe b. I should inject the insulin into my thigh for the fastest absorption c. I will store my unopened bottles of insulin in the fridge d. I need to shake the insulin before using it to make sure it is well mixed
answer: C The client should store unopened vials of insulin in the refrigerator to maintain medication viability. Once opened, the insulin can remain at room temperature for up to 1 month. The nurse should instruct the client to mix insulin by rolling the insulin in the palm of their hand to prevent frothing, which can cause the drawing up of an inaccurate dose of insulin.
A nurse is teaching about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? a. I will have increased saliva production b. I will continue taking the medication until the rash disappears c. I will taper off the medication before discontinuing d. I will report any urinary incontinence.
answer: C The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia. The client should report any urinary retention because of the anticholinergic effects caused when taking cyclobenzaprine.
A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse take? a. infuse 0.9% sodium chloride 1,000 mL IV fluid bolus b. schedule the client for an electroencephalogram c. obtain WBC and neutrophil count d. place client on tyramine free diet
answer: C The client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytosis. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can occur every 2 weeks up to 1 year.
a nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? a. report the incident to the charge nurse b. notify provider c. check clients blood sugar d. fill out incident report
answer: C The first action the nurse should take using the nursing process is to assess the client. The client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia.
A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? a. ondansetron b. magnesium sulfate c. flumazenil d. protamine sulfate
answer: C The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam.
A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? a. clients provider is required to complete medication reconciliation b. medication reconciliation at discharge is limited to the medication ordered at the time of discharge c. transition in care requires the nurse to conduct medication reconciliation d. medical reconciliation is limited to the name of the medications that the client is currently taking
answer: C The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.
A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? a. tinnitus b. urinary frequency c. dry mouth d. exophthalmos
answer: C The nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses. Amitriptyline is a tricyclic antidepressant medication that has anticholinergic properties. The nurse should assess for sensory-neurologic adverse effects such as blurred vision or an increased sensitivity to light. However, tinnitus is not an expected finding.
A nurse is caring for a client who has a magnesium level of 3.1 mEq/L. The nurse should expect to administer which of the following medications? a. magnesium gluconate b. cinacalcet c. calcium gluconate d. regular insulin
answer: C The nurse should expect to administer IV calcium gluconate to the client and prepare to provide ventilatory support. This client is at risk for respiratory depression and cardiac dysrhythmias because a magnesium level of 3.1 mEq/L is above the expected reference range of 1.3 to 2.1 mEq/L.
A nurse is caring for a client who is to receive treatment for opioid use disorder. Which of the following medications should the nurse expect to administer? a. bupropion b. disulfiram c. methadone e. modafinil
answer: C The nurse should expect to administer methadone for treatment of opioid use disorder. Methadone can be administered for withdrawal and to assist with maintenance and suppressive therapy. The nurse should administer modafinil to assist with the fatigue and prolonged sleep from methamphetamine withdrawal.
The nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not in the client's medication drawer. The nurse should identify that the administration can occur at which of the following times without requiring an incident report? a. 1000 b. 0900 c. 0830 d. 1200
answer: C The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.
A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? a. felodipine b. guaifenesin c. digoxin d. regular insulin
answer: C The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity.
A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? a. plan to increase the dosage each week by 200 mg increments b. prolonged use of this medication can cause glaucoma c. drink 2L of water daily d. a fine red rash is transient and can be treated with antihistamines
answer: C The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys.
A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? a. take the medication with food b. expect a fine, red rash as a transient effect c. drink 8-10 glasses of water daily d. store the medication in the fridge
answer: C The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization.
A nurse is caring for a client who is experiencing seizure while in bed. Which of the following actions should the nurse take? a. raise the head of the bed b. restrain arms and legs c. turn clients head to side d. insert tongue blade into clients mouth
answer: C This prevents airway obstruction. allow client to move freely during seizure. Do not put blade in mouth - could chip teeth or cause them to bite tongue
A nurse is preparing to administer timolol eye drops to a patient with glaucoma. The nurse should recognize that which medical history is a contraindication? a. HTN b. peripheral vision loss c. asthma d. increased IOP
answer: C Timolol can cause bronchospasm.
A nurse is providing teaching about omeprazole for bleeding duodenal ulcers. Which of the following statements should be included? a. you need to take this medication for the next 6 months b. taking this medication will decrease your risk of acquiring pneumonia c. take this medication before breakfast daily d. watch for adverse effects of tachycardia and heart palpitations
answer: C Used for no more than 1-2 months due to risk of fractures. Adverse effects are infrequent, and usually NVD or headaches.
a nurse is preparing to administer a new prescription for amoxicillin/clavulanic to a client. The client tells the nurse that they are allergic to penicillin. Which of the following actions should the nurse take first? a. update clients medical record b. notify provider c. withhold medication d. inform pharmacist of clients allergy
answer: C When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority action is to withhold the medication to prevent injury to the client.
A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform before starting treatment? a. hearing exam b. glucose tolerance test c. electrocardiogram d. pulmonary function test
answer: C can cause tachycardia and ECG changes
A nurse is teaching a female client who has a new prescription for misoprostol for PUD. Which of the following shows that teaching was effective? a. I should avoid NSAIDs while on this medication b. used to treat stress induced ulcers c. I should avoid becoming pregnant while on this medication d. this medication is also used to treat dysmenorrhea
answer: C can stimulate uterine contractions;
A nurse is assessing a client 1 hour after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective. a. the client's vital signs are within normal limits b. the client has not requested additional medication c. the client is resting comfortably with eyes closed d. the client rates pain as a 3 on a scale from 1 to 10
answer: D
A nurse is caring for a client who is pregnant and inquiring about alternative therapies for nausea and vomiting. Which of the following options should be reccomended? a. eat 3 large meals per day b. if you are experiencing nausea when you wake up, wait to eat until lunch c. you may need to take additional supplements to alleviate nausea d. ginger is effective in treatment of N&V
answer: D
A nurse is teaching a client with asthma who has a new prescription for a SABA. Which of the following information should be included. a. SABA will provide prolonged control of asthma attacks b. SABAs are available in oral form c. SABA will be taken with inhaled glucocorticoids d. notify provider if SABA is needed more than 2 times per week
answer: D
A nurse is reviewing the laboratory results of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider? a. potassium 4.1 b. 24 hour urine glucose 300 mg/day c. carbamazepine level 7mcg/mL d. WBC 3,500
answer: D A WBC count of 3,500/mm3 is below the expected reference range of 5,000 to 10,000/mm3. Leukopenia is an adverse effect of carbamazepine. The nurse should report this finding to the provider and monitor the client for manifestations of infection. A carbamazepine level of 7 mcg/mL is within the expected reference range of 5 to 12 mcg/mL and is an expected finding.
A nurse is assessing a client who is taking propylthiouracil for Grave's disease. Which of the following findings should the nurse identify as an indication that the medication is effective? a. decrease in WBC b. decrease in amount of time sleeping c. increase in appetite d. increase in ability to focus
answer: D A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective.
Nurse is reviewing the lab results for a client who is recieving heparin via continuous IV infusion for DVT. The nurse should discontinue the medication infusion for which of the following findings? a. potassium 5.0 b. PTT 2 times control c. Hgb 15 d. platelets 96,000
answer: D A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion.
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect? a. cough b. joint pain c. alopecia d. insomnia
answer: D Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia.
a nurse is reviewing lab results for a client who is to receive a dose of ceftazidime via intermittent IV bolus. Which of the following lab findings is the priority for the nurse to report to the provider before administering the medication? a. total bilirubin 0.4 b. alanine aminotransferase 26 c. platelet count 360,000 d. creatinine 2.6
answer: D Ceftazidime is excreted primarily by the renal system. A serum creatinine level above 1.3 mg/dL can indicate a kidney disorder requiring a reduction in the dose administered. The nurse should notify the provider, who is likely to prescribe a lowered dose of medication.
A nurse is caring for a client who is receiving end of life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family? a. the provider will prescribe naloxone at home for respiratory depression b. remove the patch to reverse the adverse effects immediately c. expect an increase in urinary output d. take a stool softener on a daily basis
answer: D Constipation is an adverse effect of opioid use. Stool softeners can decrease the severity of this adverse effect. Naloxone is only for use in an acute care setting for the reversal of severe respiratory depression.
A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. I will stop taking the medication if I get dizzy b. I should not drink orange juice with this medication c. I should expect to gain weight while taking this medication d. I will check my HR before I take the med
answer: D Diltiazem, a calcium channel blocker, has cardio-suppressant effects at the SA and AV nodes, which can lead to bradycardia. The client should check their heart rate before taking the medication and notify the provider if it falls below the expected reference range. Diltiazem, a calcium channel blocker, can decrease myocardial contraction, which can lead to heart failure. If the client gains weight or develops shortness of breath, they should notify the provider.
A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not yet told her provider. The nurse should identify that pregnancy is a contraindication for which of the following medications? a. acetaminophen b. ipratroprium c. benzonatate d. doxycycline
answer: D Doxycycline is a tetracycline antibiotic. The nurse should identify that doxycycline can cause teratogenic effects such as staining of the infant's teeth when exposed to this medication. Therefore, this medication is contraindicated for the client.
A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements indicates an understanding of the teaching? a. I should start to feel better within 24 hours of this medication b. I will be sure to follow a strict diet to avoid foods with tyramine c. I will continue to take St. John's Wort to increase the effects of this medication d. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication
answer: D Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking fluoxetine should take acetaminophen for headaches or pain, since acetaminophen does not suppress platelet aggregation.
A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed Gabapentin. Which of the following therapeutic effects should the nurse identify? a. reduced cancer related bone pain b. decreased anxiety and insomnia c. decreased inflammatory response to cancer tumors d. reduced cramping, aching, and burning neuropathic pain
answer: D Gabapentin treats neuropathic pain.
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which adverse effect? a. weight loss b. increased IOP c. auditory hallucinations d. bibasilar crackles
answer: D Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.
A nurse is monitoring a client who is receiving terbutaline to suppress preterm labor. Which of the following is an adverse effect? a. BP 132/84 b. blood glucose 106 c. decreased DTR d. maternal HR >120
answer: D Medication stopped if tachycardia occurs. Hypotension and hyperglycemia are side effects, but the findings are WNL. Decreased DTR is from elevated magnesium.,
Nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should the nurse indicate as an adverse effect? a. tachycardia b. oliguria c. xerostomia d. miosis
answer: D Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.
A nurse is reviewing the lab results of a client who is taking digoxin for HF. Which of the following results should the nurse report to the provider? a. calcium 9.2 b. mag 1.6 c. digoxin 1.1 d. potassium 2.8
answer: D Potassium level 2.8 mEq/L MY ANSWER A potassium level of 2.8 mEq/L is below the expected reference range of 3.5 to 5 mEq/L. The nurse should notify the provider if a client has hypokalemia prior to administration of digoxin due to the increased risk of developing digoxin toxicity and cardiac dysrhythmias. A digoxin level of 1.1 ng/mL is within the expected reference range of 0.8 to 2 ng/mL. The nurse should report a digoxin level that is outside the expected reference range to the provider for a dosage adjustment.
A nurse is caring for a female client with osteoporosis who is taking raloxifene. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? a. severe leg cramps b. urinary frequency c. jaw pain d. sudden onset of dyspnea
answer: D SERM - increased risk of DVT, PE or stroke.
a nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? a. "I will drink a glass of milk when I take it" b. "I will take it 15 minutes after my evening meal" c. "I should take an antacid with it to avoid nausea" d. "I should sit up for 30 minutes after taking it"
answer: D Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time. The absorption of risedronate, a bisphosphonate, will be reduced if it is taken with antacids containing calcium, aluminum, or magnesium. The nurse should instruct the client to take the antacid 2 hr after taking risedronate.
A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching. a. take beclomethasone to avoid an acute attack b. use beclomethasone 5 minutes before using albuterol c. limit your calcium and vitamin D intake when taking beclomethasone d. rinse your mouth after inhaling beclomethasone
answer: D The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.
A nurse is planning discharge teaching to a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? a. this medication increases your risk for HTN b. avoid potassium rich foods in your diet c. take each dose of this medication in the evening before bed d. drink a glass of milk with each dose of medication
answer: D The client should take furosemide with food or milk to reduce gastric irritation.
a nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? a. minimize diaphoresis b. maintain abstinence c. lessen craving d. prevent delirium tremens
answer: D The client should take propranolol to decrease cravings during alcohol withdrawal. The client should take acamprosate to help maintain abstinence from alcohol by decreasing anxiety and other uncomfortable manifestations. The client should take clonidine or a beta-adrenergic blocker, such as atenolol, to minimize autonomic components, such as diaphoresis, during alcohol withdrawal.
A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings should the nurse report to the provider? A. hot flashes b. GI irritation c. vaginal dryness d. leg tenderness
answer: D The greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and shortness of breath.
A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia. Which of the following actions should the nurse take? a. administer medication slowly over 5 minutes b. store medication in fridge c. use medication within 12 hours d. reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent
answer: D The nurse should dilute the medication with 60 mL of sterile water without a bacteriostatic agent and inject rapidly.
A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instructions should the nurse include? a. take the medication on an empty stomach b. avoid crowds c. discontinue medication if palpitations occur d. change positions slowly
answer: D The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope. The nurse should instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client should never discontinue the medication abruptly because the client might experience chest pain.
A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? a. dry cough b. pedal edema c. bruising d. yellow tinged vision
answer: D The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.
A nurse is caring for a client who has developed hypomagnesemia due to longer term lansoprazole therapy. The nurse should monitor the client for which of the following manifestations? a. bradycardia b. hypotension c. muscle weakness d. disorientation
answer: D The nurse should monitor the client for disorientation and confusion as manifestations of hypomagnesemia. The nurse should also assess the client for a positive Chvostek's and Trousseau's signs.
A nurse is teaching a client who is starting to take hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching. a. this medication should be taken 1 hr prior to eating b. it takes 48 hours for therapeutic effects to occur c. tablets should not be crushed or chewed d. decreased respirations may occur
answer: D The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.