Pharm ATI Prep Wk 3

*A nurse is caring for a client who has tuberculosis and is taking rifampin. Which of the following client statements indicate to the nurse that the client is experiencing an adverse effect of the medication? a. "I have noticed my urine is orange in color." b. "I sleep more than I used to." c. "My tongue and mouth are sore." d. "My voice seems hoarse."

a. "I have noticed my urine is orange in color." The nurse should identify that an adverse effect of rifampin can be red-orange colored urine, saliva, sweat, and tears as the medication is excreted from the body. The nurse should also inform the client that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The client should inform the provider if urine becomes dark in color since this can be an indication of hepatotoxicity.

A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective? a. "I should let my doctor know if I have yellowing of my eyes." b. "This medication will stop my liver from making cholesterol." c. "I should expect to experience some bruising when I begin this medication." d. "I will take this medication at the same time as my gemfibrozil."

a. "I should let my doctor know if I have yellowing of my eyes." The nurse should include in the teaching that jaundice can be an adverse effect of ezetimibe as a result of hepatitis. The client should notify the provider if this occurs.

*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 in the teaching? a. "Report persistent diarrhea to the provider." b. "Take this medication with a full glass of milk." c. "Some people who take erythromycin experience vision loss." d. "Antacids will reduce the extent of absorption of this medication."

a. "Report persistent diarrhea to the provider." Although gastrointestinal disturbances are the most common adverse effects of erythromycin, clients should report persistent or severe gastrointestinal reactions to the provider. Erythromycin can cause superinfection of the bowel because it destroys some sensitive flora in the GI system.

A nurse is teaching a client about a new prescription for extended-release oxycodone for pain management. Which of the following statements should the nurse include in the teaching? a. "Swallow this medication whole." b. "Take this medication before meals and at bedtime." c. "Constipation decreases with continued use." d. "Avoid taking other supplemental analgesics with this medication."

a. "Swallow this medication whole." The nurse should tell the client that extended-release oxycodone is a long-acting opioid medication and should not be cut in half or crushed to prevent immediate absorption of the entire dose. This medication should be swallowed whole and is administered every 12 hours.

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-life facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? a. Amantadine b. Buproprion c. Phenelzine d. Hydroxyzine

a. Amantidine The client is experiencing Parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantidine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? a. Anti-estrogenic b. Antimicrobial c. Androgenic d. Anti-inflammatory

a. Anti-estrogenic Tamoxifen is an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk.

*A nurse is preparing to administer dantrolene to a client who has muscle spasticity. Which of the following findings from the client's medical history should the nurse identify as a contraindication to the administration of this medication? a. History of cirrhosis b. History of multiple sclerosis c. History of cerebral palsy d. History of malignant hyperthermia

a. History of cirrhosis The nurse should identify that dantrolene is contraindicated for clients who have active liver disease because it is hepatotoxic and can cause liver failure. Liver function tests are monitored for clients throughout treatment with this medication.

A nurse is preparing a continuous IV infusion of erythromycin lactobionate for a client who has a Bordetella pertussis infection. Which of the following actions should the nurse take to minimize the risk of thrombophlebitis? a. Infuse the medication slowly b. Administer half the dosage c. Avoid diluting the solution d. Initiate intermittent dosing

a. Infuse the medication slowly The nurse should infuse erythromycin slowly to minimize the risk of thrombophlebitis, which is an inflammatory process resulting from the formation of a blood clot in a vein. These blood clots usually form in the legs.

A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? a. Jaundice b. Constipation c. Oral candidiasis d. Sedation

a. Jaundice Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur.

A nurse is caring for a client who takes a combination oral contraceptive (OC). Which of the following findings should indicate to the nurse that the client is experiencing a deficiency of estrogen in the OC? a. Mid-cycle breakthrough bleeding or spotting b. Breast tenderness c. Migraine headaches d. Nausea

a. Mid-cycle breakthrough bleeding or spotting If a client has mid-cycle breakthrough bleeding or spotting while taking a combination OC, the nurse should recognize that the OC is deficient in the amount of estrogen for the client.

*A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following findings is the nurse's priority? a. Mood changes b. Nausea c. Altered sense of taste d. Skin rash

a. Mood changes The greatest risk to the client is the development of neuropsychiatric effects that can progress to depression and suicide. Therefore, the highest priority is a change in the client's mood.

A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medications? a. Weight loss b. Hypotension c. Lethargy d. Osteoporosis

a. Osteoporosis Long-term use of steroid medications such as glucocorticoid medication can inhibit bone growth and result in the adverse effect of osteoporosis with long-term treatment.

*A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority? a. Pulmonary function b. CBC c. Urinary ouput d. Peripheral edema

a. Pulmonary function Bleomycin can cause severe lung injury, including pneumonitis and pulmonary fibrosis, which affects a significant percentage of clients receiving this medication; therefore, pulmonary function is the priority assessment.

*A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this medication? a. Report of pain b. Respiratory rate 8/min c. Report of numbness d. Report of abdominal cramping and diarrhea

a. Report of pain The nurse should identify that naloxone is used to reverse the effects of an opioid overdose administered for pain, sedation euphoria, and respiratory depression. Excess doses of naloxone can cause the return of pain but can improve the client's respiratory rate.

A nurse is caring for a client who has a prescription for subnormal etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history? a. Takes St. John's wort b. Breastfeeds a 6-month-old infant c. Has a parent with hypertension d. Has a positive HPV test result

a. Takes St. John's wort St. John's wort can reduce the effects of subnormal etonogestrel because it stimulates hepatic drug-metabolizing enzymes. Therefore, the nurse should alert the prover about the client's use of St. John's wort, and it should be discontinued.

*A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care? a. The client must sign an agreement with the provider before beginning alosetron b. The client must stop taking alosetron if diarrhea continues for 1 week after beginning the medication c. The client should expect to have a slower heart rate while taking alosetron d. The client should use a barrier birth control method because alosetron interacts with oral contraceptives

a. The client must sign an agreement with the provider before beginning alosetron Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron.

A nurse is providing teaching about food-drug interactions to a client who is prescribed sirolimus following a kidney transplant. Which of the following pieces of information should the nurse include in the teaching? a. "Increase your intake of high-fat foods." b. "Avoid eating grapefruit while taking sirolimus." c. "Drink apple juice just before dosing." d. "Reduce your intake of gluten."

b. "Avoid eating grapefruit while taking sirolimus." The nurse should inform the client that grapefruit and grapefruit juice can inhibit the metabolism of sirolimus. This means that consuming grapefruit and grapefruit juice would cause the levels of the medication to rise in the client's body, which could have adverse effects. Therefore, grapefruits should be avoided.

A nurse is providing teaching to a client who has a new prescription for sodium phosphate. The client is scheduled for a colonoscopy and is currently taking furosemide for hypertension. Which of the following client statements should indicate to the nurse that the teaching has been effective? a. "I can take my water pill as prescribed." b. "I can experience an imbalance in my electrolytes from this medication." c. "I should drink 8 ounces of bowel cleanser every 10 minutes until I drink a total of 4 liters." d. "I can experience rebound constipation after using this medication."

b. "I can experience an imbalance in my electrolytes from this medication." Sodium phosphate can cause excess fluid loss as a result of cleansing the bowel of stool. Therefore, the client is at risk for electrolyte imbalance and should be monitored closely.

A nurse is teaching a client about the proper placement of a nitroglycerin patch. Which of the following statements by the client indicates an understanding of the teaching? a. I'll apply the patch over areas of my body with little fatty tissue." b. "I can place the patch on any area of my body without hair." c. "I'll put the patch on the same site as the previous patch." d. "I have to apply the patch directly over my heart"

b. "I can place the patch on any area of my body without hair." The nitroglycerin transdermal patch should be applied to skin that is free from hair because hair creates a physical barrier to absorption.

A nurse is teaching a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching? a. "Take this medication on a full stomach." b. "Limit your consumption of dairy products while taking this medicine." c. "Take the medication with your regular iron supplement." d. "Take antacids if you have an upset stomach from using tetracycline."

b. "Limit your consumption of dairy products while taking this medicine." The nurse should tell the client to avoid or limit the consumption of dairy products while taking tetracycline. An interval of at least 2 hours should separate tetracycline ingestion and the ingestion of products that can chelate this medication such as milk or calcium.

*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. "Sucralfate decreases gastric acid secretions." b. "Sucralfate forms a gel-like substance that protects ulcers." c. "Sucralfate inactivates Helicobacter pylori." d. "Sucralfate inhibits the production of gastric acid."

b. "Sucralfate forms a gel-like substance that protects ulcers." The primary action of sucralfate is the formation of a gel0like protectant that adheres to the ulcer surface. This protective mechanism lasts for 6 hours and allows the ulcer to heal.

A nurse is administering an enteric-coated tablet to a client and explaining the pharmaceutical preparation. Which of the following statements should the nurse make? a. "This coated tablet dissolves better in your stomach and intestines." b. "You are less likely to have an upset stomach with this pill because of the coating on the tablet." c. "The coating on the tablet improves the absorption of the medication." d. "The coating on the tablet allows a gradual release of the medication."

b. "You are less likely to have an upset stomach with this pill because of the coating on the tablet." Enteric-coated preparations have an outside coating of a substance that dissolves in the intestines instead of in the stomach. This protects the medication from acids and enzymes in the stomach and protects the stomach from ingredients in the medication that can cause gastric upset.

A nurse is teaching a client who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of information should the nurse include in the teaching? a. "Report gastrointestinal disturbances immediately." b. "You might find that you develop a dry mouth." c. "You should not experience any central nervous system alterations." d. "Increased urinary frequency is an expected effect."

b. "You might find that you develop a dry mouth." A client who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid or sucking on a hard, sugarless candy can help relieve dry mouth.

A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine? a. Apply a dressing after covering the affected areas with topical lidocaine b. Apply topical lidocaine to affected areas that are intact c. Apply topical lidocaine in a thick layer to affected areas d. Apply topical lidocaine frequently to large affected areas

b. Apply topical lidocaine to affected areas that are intact The nurse should tell the client to apply topical lidocaine to skin that is intact rather than blistered, broken, or irritated to prevent a large amount of medication from being absorbed and to decrease the risk of systemic toxicity.

A nurse is monitoring a client who is receiving phenytoin IV for the treatment of epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication? a. Hypertension b. Cardiac dysrhythmias c. Gastric discomfort d. Tachycardia

b. Cardiac dysrhythmias Then nurse should identify cardiac dysrhythmias as an adverse effect of phenytoin IV. As a result of this potential complication, cardiac monitoring is required.

*A nurse is caring for a client who is taking streptomycin. Which of the following medications increases the client's risk of developing ototoxicity when taken with streptomycin? a. Cefoxitin b. Furosemide c. Naproxen d. Amphotericin B

b. Furosemide Furosemide, a high-ceiling (loop) diuretic, increases the risk of developing ototoxicity when taken with streptomycin, an aminoglycoside.

*A nurse in a provider's office is reviewing a client's medication history. The client asks the nurse if she should begin taking high-dose vitamins as she ages. Which of the following pieces of information should the nurse provide about high doses of vitamin supplements? a. High doses of water-soluble vitamins enhance their therapeutic actions b. High doses of water-soluble vitamins can have adverse effects c. High doses of vitamin supplements are restricted to use during pregnancy d. Tolerance might develop, resulting in an increased vitamin need

b. High doses of water-soluble vitamins can have adverse effects High doses of vitamins can cause harm to the body. Any vitamin supplements consumed should not exceed the recommended dietary allowance. Elevated levels of vitamin A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. Excessive intake of beta-carotene can increase the risk of lung cancer in clients who smoke. In addition, increased doses of vitamin E can increase the risk of death in clients who have chronic illnesses.

A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0 to 10. Which of the following routes of administration will deliver the medication with the shortest time of onset? a. Oral b. IV c. IM d. SQ

b. IV The nurse should identify that meperidine given intravenously has no barriers to absorption because it is deposited directly into the circulatory system. An instantaneous time of onset and absorption gives the client immediate relief.

A nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing withdrawal. The nurse should anticipate a prescription for which of the following medications from the provider? a. Methylnaltrexone b. Methadone c. Naloxone d. Hydromorphone

b. Methadone The nurse should anticipate a prescription from the provider for methadone for a client who is experiencing opioid withdrawal. Methadone is an opioid medication that is used for pain management and treatment of withdrawal manifestations in clients who have opioid use disorder.

*A nurse is assessing a client who is receiving IV gentamicin 3 times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication? a. Hypoglycemia b. Proteinuria c. Nasal congestion d. Visual disturbances

b. Proteinuria Proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should monitor for oliguria and hematuria.

*A nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. The client asks the nurse why the provider prescribed an enteric-coated medication. Which of the following responses should the nurse give? a. "The enteric coating allows a lower dosage to be given." b. "Enteric-coated medications have better absorption in the body." c. "Enteric-coated medications cause less gastric irritation." d. "The enteric coating provides a steady release of the medication over time."

c. "Enteric-coated medications cause less gastric irritation." Enteric-coated medications do not dissolve until they reach the small intestine, which reduces the risk of gastric irritation.

A nurse is teaching a female client who has a new prescription for misoprostol to treat peptic ulcer disease. Which of the following client statements should indicate to the nurse that the teaching was effective? a. "I should avoid taking NSAIDs while using this medication." b. "Misoprostol is used to treat stress-induced gastric ulcers." c. "I should avoid becoming pregnant while taking this medication." d. "This medication is also used to treat dysmenorrhea."

c. "I should avoid becoming pregnant while taking this medication." The nurse should identify that misoprostol is contraindicated during pregnancy and is classified as pregnancy category X by the FDA. It has the potential to stimulate uterine contractions, and the use of misoprostol during pregnancy has been known to cause partial or complete expulsion of the developing fetus

A nurse is providing teaching to a client with chronic bronchitis about administering acetylcysteine using a hand-held nebulizer (HHN). Which of the following client statements indicates an understanding of the teaching? a. "I should discard an open vial of the medication after 24 hr." b. "I should limit my fluid intake while taking this medication." c. "I should try to cough productively just before I begin the treatment." d. "If the medication becomes discolored, I should throw it out and get a new supply."

c. "I should try to cough productively just before I begin the treatment." A productive cough prior to beginning the treatment will clear sputum from lung surfaces, allowing better absorption of the medication.

*A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following client statements indicates that the teaching was effective? a. "I should take the medication with a glass of orange juice." b. "I will allow the medication to dissolve in my mouth." c. "I will sit upright for 30 minutes after taking the medication." d. "I should take the medication right after eating breakfast."

c. "I will sit upright for 30 minutes after taking the medication." The nurse should instruct the client to sit upright or stand for at least 30 minutes after taking the medication to prevent esophagitis.

A nurse is preparing to administer the first injection of DTaP vaccine to an infant. Which of the following pieces of information should the nurse tell the guardian prior to administering the immunization? a. "Your child might develop diarrhea or vomiting within 24 hours of receiving this vaccine." 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 infant's thigh." d. "This injection contains a live virus."

c. "The vaccine will be injected into the infant's thigh." The DTaP vaccine is administered IM in the deltoid or mediolateral thigh because these are larger muscles that can better diffuse inflammation. Therefore, the nurse should prepare to administer the IM injection in the mediolateral thigh.

*A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication? a. Hypertension b. Peripheral vision loss c. Asthma d. Increased intracranial pressure

c. Asthma The nurse should identify that asthma is a contraindication to receiving timolol. Timolol is a beta-blocker that can cause blocking of the beta2-receptors, causing bronchospasm. A client who has a history of asthma is a candidate for an alternate medication to treat this condition such as betaxolol.

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? a. Insomnia b. Hypotension c. Bleeding d. Constipation

c. Bleeding Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee-ground emesis, black tarry stools, ecchymosis, or any indication of bleeding

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 prior to starting the client on this medication? a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function tests

c. Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effect while using amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

*A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? a. Nausea b. Metallic taste c. Fever d. Drowsiness

c. Fever A fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue allopurinol and notify the provider if a fever or rash develops.

A nurse is teaching a newly licensed nurse about caring for a client who is receiving patient-controlled analgesia (PCA). Which of the following actions by the newly licensed nurse indicates an understanding of the teaching? a. Assessing the client's vital signs every 6 hours b. Instructing the client's family to press the PCA button when the client is asleep c. Having a second nurse check the PCA setting d. Administering the PCA through a free-flow infusion system

c. Having a second nurse check the PCA setting The nurse should have a second nurse check the PCA settings to ensure the correct amount of medication is being administered to the client.

*A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. Which of the following pieces of information should the nurse include in the teaching? a. Lidocaine toxicity will cause the client to develop tachycardia b. Most clients develop a headache from spinal anesthesia c. Hypotension is an adverse effect of spinal anesthesia d. Urinary urgency occurs when the client has spinal anesthesia

c. Hypotension is an adverse effect of spinal anesthesia The local anesthetic can cause the client's blood pressure to decrease due to venous dilation secondary to a sympathetic nervous system response. If hypotension occurs, the nurse should lower the head of the client's bed, increase fluids if applicable, and administer vasoconstrictive medication as indicated by the provider.

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? a. Thrombophlebitis b. Hyperactive reflexes c. Muscle weakness d. Hypoglycemia

c. Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

A nurse is teaching a client who has ADHD and is starting therapy with an amphetamine/dextroamphetamine mixture. Which of the following manifestations should the nurse instruct the client to identify as an adverse effect and report to the provider? a. Restlessness b. Insomnia c. Palpitations d. Weight gain

c. Palpitations The nurse should instruct the client that palpitations can be a sign of cardiovascular adverse reaction and requires immediate attention. The nurse should instruct the client to contact the provider if palpitations develop.

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. A severe allergy to which of the following medications is a contraindication to ceftriaxone? a. Gentamicin b. Clindamycin c. Piperacillin d. Sulfamethoxaxole-trimethoprim

c. Piperacillin Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross-sensitivity reaction to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for a client who has an allergy to cephalosporin or a severe allergy to penicillin.

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take? a. Place the client leaning forward in a chair b. Hold the medication dropper 2.5 cm (1 in) from the client's ear canal c. Pull the pinna of the client's ear upward and outward d. Have the client to remain still for 30 seconds after the medication is administered

c. Pull the pinna of the client's ear upward and outward The nurse should pull the pinna of the client's ear upward and outward so the nurse can instill the medication into the client's ear canal.

A nurse is assessing a client with rheumatoid arthritis who has been taking high doses of prescribed hydroxychloroquine. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of hydroxychloroquine? a. "I have developed sores in my mouth." b. "I often feel like the room is spinning." c. "I noticed that the whites of my eyes look yellow." d. "I have had a change in my vision recently."

d. "I have had a change in my vision recently." The nurse should identify that hydroxychloroquine is an antimalarial medication used to treat rheumatoid arthritis. Clients who take hydroxychloroquine in high doses are at risk for developing retinopathy, which can be irreversible and cause blindness.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? a. "Take hydrochlorothiazide as needed for edema." b. "Check your weight once each week." c. "Take hydrochlorothiazide on an empty stomach." d. "Take hydrochlorothiazide in the morning."

d. "Take hydrochlorothiazide in the morning." The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and to prevent nocturia.

A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are in potassium. Which of the following statements by the client indicates an understanding of the teaching? a. "This medication will not work unless I have enough potassium." b. "Potassium will increase the therapeutic effect of my blood pressure medication." c. "Potassium will lower my blood pressure." d. "This medication can cause a loss of potassium."

d. "This medication can cause a loss of potassium." Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.

*A nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching? a. "If you miss a pill, take the missed pill with your next dose." b. "If you miss 2 pills during the second and third week, discard the inactive placebo pills and begin a new pack." c. "If you miss 3 pills during the second week, take a pill as soon as possible and continue with your scheduled doses." d. "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks."

d. "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks." The nurse should instruct this client that up to 7 days can be missed with little or no increase in the chance of getting pregnant, provided that the client took the pills continuously for the previous 3 weeks.

*A nurse is planing to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse include? a. Choose an IV port for IV bolus injection of diphenhydramine as near as possible to the client's hanging IV bag b. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine c. Allow the infusion to keep running while administering the diphenhydramine via IV bolus d. Aspirate to check for IV potency before administering the diphenhydramine

d. Aspirate to check for IV potency before administering the diphenhydramine It is important to confirm IV latency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse is providing teaching to a client with tuberculosis who has prescriptions for rifampin and ethambutol. Which of the following findings is an adverse effect of these medications that the client should report to the provider? a. Red-orange discoloration of urine b. Unexpected weight gain c. Ringing in the ears d. Decreased visual acuity

d. Decreased visual acuity The nurse should identify optic neuritis as an adverse effect of ethambutol. The nurse should instruct the client to monitor for changes in visual acuity or color identification as indications of optic neuritis to report to the provider. This adverse effect necessitates termination of ethambutol therapy because irreversible blindness can result.

A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as a rationale for increasing the client's daily intake of fiber? a. Fiber binds with the medication to relieve pain b. Dietary fiber prevents nausea caused by opioids c. Fiber promotes the absorption of opioids d. Dietary fiber helps prevent constipation

d. Dietary fiber helps prevent constipation The nurse should inform the client that constipation is an adverse effect of opioids. Increasing dietary fiber consumption can help manage opioid-induced constipation. The nurse should also instruct the client to increase physical activity and fluid intake.

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect? a. Diarrhea b. Anxiety c. Nausea and vomiting d. Dry mouth

d. Dry mouth Hydroxyzine has anticholinergic properties. Dry mouth is a common adverse effect of this medication. The nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.

A nurse is caring for a client who takes schedule morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following medications to treat breakthrough pain? a. Meperidine b. Buprenorphine c. Methadone d. Fentanyl

d. Fentanyl The nurse should expect a prescription for fentanyl trans mucosal (nasal spray) to treat breakthrough pain. Fentanyl is an opioid agonist with a rapid onset and a duration of 2 to 4 hours. Fentanyl should not interfere with the client's long-term opioid medication but should relieve breakthrough pain.

A nurse is preparing to administer oxytocin to a client who is at 41 weeks gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take? a. Place the oxytocin from a pre-filled spring into the posterior fornix of the vagina every 10 min until effective labor occurs b. Check the client's blood pressure and pulse every 15 min while induction of labor is occurring c. Stop oxytocin for contractions that continue for more than 30 sec d. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min

d. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min Effective uterine contractions should occur every 2 to 3 minutes.

A nurse is monitoring a client who his receiving terbutaline to suppress preterm labor. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of the medication? a. BP 132/84 mmHg b. Blood glucose 106 mg/dL c. Decreased DTRs d. Maternal heart rate > 120/min

d. Maternal heart rate > 120/min A client who is receiving terbutaline can experience tachycardia, which poses a significant risk to the mother. Therefore, when the maternal heart rate exceeds 120/min, the medication should be stopped. Adverse effects result from activating beta1 receptors as well as beta2 receptors

A nurse is teaching a client who is taking levothyroxine for hypothyroidism about a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching? a. The calcium supplement will enhance the effect of levothyroxine b. The calcium supplement will accelerate the metabolism of the levothyroxine c. Take the medication together at 1700 for the greatest effect d. Take the calcium supplement 4 hr after taking the levothyroxine

d. Take the calcium supplement 4 hr after taking the levothyroxine Levothyroxine should be taken in the morning on an empty stomach, and the calcium supplement should be taken at least 4 hours later. Food or supplements containing iron, magnesium, or zinc also bind to levothyroxine and prevent complete absorption of the medication.

A nurse is preparing to administer azithromycin 150 mg liquid suspension PO every 12 hr to a client. The amount available is azithromycin 50 mg/5 mL. How many mL should the nurse administer per dose?

15 mL

A nurse is preparing to administer desmopressin 0.3 mcg/kg in 0.9% sodium chloride 50 mL IV over 30 min to a client who weighs 154 lb. How many mcg of medication should the client receive?

21 mcg

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 fever migraine headaches since I started taking feverfew." b. "My memory seems to be getting better since I started taking feverfew." c. "I have fewer infections when I take feverfew." d. "I have not had another urinary tract infection since starting feverfew."

a. "I am having fever migraine headaches since I started taking feverfew." Feverfew is an herb that is used for the prophylaxis of migraine headaches. It can reduce the frequency of migraines and decrease the severity of accompanying manifestations such as nausea and photophobia.