Pharm Exam 4

Which has a longer half-life? A. Warfarin B. Heparin

A. Warfarin

Later that day, you and the student nurse are discussing the medication administration plan for several patients that are prescribed insulins. Of the following patients, which should the nurse NOT give insulin to at this time? (Select all that apply) A. The patient with insulin lispro scheduled and who's meal tray is being delivered to the unit. B. The patient with NPH scheduled and blood glucose of 200mg/dL who does not have a working IV site. C. The patient scheduled to receive insulin glargine who's blood glucose is currently 72mg/dL D. The patient with a blood glucose of 180 mg/dL who is NPO and scheduled for surgery with orders for regular insulin.

A and D Rationale: A - For RAPID ACTING, the meal tray needs to be physically sitting in front of the patient before administering the insulin B - NPH has a long time before it begins to peak, so you will have time to start an IV C - There is no peak for insulin glargine. While 72 is on the lower end of the spectrum, it is still a NORMAL range and we want them to stay around there. D - Patients with NPO cannot eat or drink anything to raise their blood glucose if they were to become hypoglycemic

A nurse is caring for a client who is taking somatropin to stimulate growth. The nurse should plan to monitor which of the following (Select all that apply)? A. The client's urine for calcium B. The client's height and weight C. The client for signs/symptoms of hyperglycemia D. The client for flank pain and dysuria E. The client's pancreatic function

A, B, C, D Rationale: A - Somatropin can cause renal calculi (calcium in the urine) B - This is used to treat growth hormone deficiencies, so monitoring growth is essential C - This medications cause hyperglycemia D - Symptoms associated with the renal calculi E - This medication does not affect the pancreas

Which medication instructions should the nurse provide to client who has been prescribed Levothyroxine? (Select all that apply) A. Monitor your own pulse rate B. Take the medication in the morning C. Take the medication at the same time each day D. Notify the HCP if chest pain occurs E. Expect the pulse rate to be greater than 100 bpm F. It may take 1-3 weeks for a full therapeutic effect to occur

A, B, C, D, F

A client is taking enoxaparin (Lovenox) daily. Which client statement requires additional monitoring? A. "I take aspirin daily for headaches." B. "I take ibuprofen (Motrin) at least once a week for joint pain." C. "Whenever I have a fever, I take acetaminophen (Tylenol)." D. "I take my medicine first thing in the morning."

A. "I take aspirin daily for headaches."

A 70-year-old woman with chronic heart failure and atrial fibrillation asks the nurse why warfarin (Coumadin) has been prescribed for her to continue at home. Which response by the nurse is accurate? A. "The medication prevents blood clots from forming in your heart." B. "The medication dissolves clots that develop in your coronary arteries." C. "The medication reduces clotting by decreasing serum potassium levels." D. "The medication increases your heart rate so that clots do not form in your heart."

A. "The medication prevents blood clots from forming in your heart."

A client with diabetes mellitus receives Humulin R regular insulin 8 units subcutaneously at 7:30 am. The nurse should be *most* alert to signs of hypoglycemia at what time during the day? A. 9:30 am to 11:30 am B. 11:30 am to 1:30 pm C. 1:30 pm to 3:30 pm D. 3:30 pm to 5:30 pm

A. 9:30 am to 11:30 am

The client has an international normalized ratio (INR) value of 1.5. What action will the nurse take? A. Administer an additional dose of warfarin (Coumadin). B. Hold the next dose of warfarin (Coumadin). C. Increase the heparin drip rate. D. Administer protamine sulfate.

A. Administer an additional dose of warfarin (Coumadin). Rationale: The INR should be between 2 and 3

Which drug is an direct thrombin inhibitor that is used in place of heparin when Heparin Induced Thrombocytopenia (HIT) is an issue? A. Argatroban (Acova) B. Bivalirudin (Angiomax) C. Lepirudin (Refludan) D. Desirudin (Iparavask)

A. Argatroban (Acova)

A physician has written an order for ranitidine (Zantac) once daily. The nurse schedules the medications for which of the following times? A. At bed time B. After lunch C. With supper D. Before breakfast

A. At bed time

A nurse is providing instruction to a client who is prescribed with Repaglinide (Prandin). All of which is true regarding this medication, except? A. Do not skip the dose when a meal is not taken. B. Dizziness may occur while taking it. C. Has quicker and shorter duration of action. D. Use to treat type II diabetes mellitus.

A. Do not skip the dose when a meal is not taken.

The nurse is preparing the client's morning NPH insulin dose and notices a clumpy precipitate inside the insulin vial. What should the nurse do? A. Draw up the dose from a new vial B. Draw up and administer the dose C. Shake the vial in an attempt to disperse the clumps D. Warm the bottle under running water to dissolve the clump

A. Draw up the dose from a new vial

A client with acute MI receives therapy with alteplase. Which finding indicates to the nurse that the client is experiencing a possible complication? A. Epistaxis (nose bleed) B. Vomiting C. ECG changes D. Absent pedal pulses

A. Epistaxis (nose bleed)

Which is the symptom that a client is anemic? A. Fatigue B. Dyspnea C. Bradycardia D. Muscle cramps

A. Fatigue

The nurse is developing a plan of care for a client receiving anticoagulant agents. What should the nurse identify as a potential problem for this client? A. Injury B. Fatigue C. Infection D. Dehydration

A. Injury

Which of the following insulin cannot be mixed with any other type of insulin in a syringe? A. Insulin glargine. B. Insulin aspart. C. Insulin isophane. D. Insulin lispro.

A. Insulin glargine.

What intervention is essential before the nurse administers tenecteplase (TNKase)? A. Perform all necessary venipunctures. B. Administer aminocaproic acid (Amicar). C. Have the client void. D. Assess for allergies to iodine.

A. Perform all necessary venipunctures.

A 52-year-old male patient has received a bolus dose and an infusion of alteplase (Activase) for an ST-segment elevation myocardial infarction (STEMI). To determine the effectiveness of this medication, the nurse should assess the patient for the _______. A. Presence of chest pain. B. Blood in the urine or stool. C. Tachycardia with hypotension. D. Decreased level of consciousness

A. Presence of chest pain.

A client with a diagnosis of thrombophlebitis is being treated with heparin sodium therapy. In planning a safe environment, the nurse should ensure that which medication is available if the client develops a significant bleeding problem? A. Protamine sulfate B. Fresh frozen plasma C. Retavase (Reteplase) D. Phytonadione (Vitamin K)

A. Protamine sulfate

A client has been taking Ibuprofen for some quite time and was given Misoprostol (Cytotec). Which of the following is exhibiting the therapeutic effect of Cytotec? A. Relief of gastric ulcer. B. Relief of diarrhea. C. Relief of vomiting. D. Relief of constipation.

A. Relief of gastric ulcer.

The nurse checks a unit of blood received from the blood bank and notes the presence of gas bubbles in the bag. What should the nurse do? A. Return the bag to the blood bank B. Infuse the blood using filter tubing C. Add 10 mL normal saline to the bag D. Agitate the bag to mix contents gently

A. Return the bag to the blood bank

A client began receiving an intravenous infusion of packed red blood cells 30 minutes ago. The client complains of difficulty breathing, itching, and a tight sensation in the chest. Which is the first action of the nurse? A. Stop the transfusion B. Call the health care provider C. Check the client's temperature D. Recheck the unit of blood for compatibility

A. Stop the transfusion

The physician prescribes docusate sodium (Colace) fo the client. The client asks the nurse to explain why the medication is needed. Which explanation given by the nurse correctly states the purpose of medication? A. To ease bowel evacuation and its related discomfort B. To irriatate the bowel and promote stool elimination C. To stimulate peristalsis to remove wastes after the digestion D. To reduce intestinal activity and decrease stool size

A. To ease bowel evacuation and its related discomfort

A client has been given Ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative patient? A. Vomiting. B. Incisional pain. C. Abdominal infection. D. Atelectasis.

A. Vomiting.

A client is diagnosed with hypothyroidism. The nurse performs an assessment on the client, expecting to note which findings? (Select all that apply) A. Weight loss B. Bradycardia C. Hypotension D. Dry, scaly skin E. Heat intolerance F. Decreased body temperature

B, C, D, F

A nurse has completed instructions with a client who will be taking warfarin sodium (Coumadin) indefinitely. Which statement by the client indicates the need for further teaching? A. "I must use a soft toothbrush" B. "I must use a straight razor for shaving" C. "I must avoid drinking alcohol while on this medication" D. "I must carry identification regarding the medication being taken"

B. "I must use a straight razor for shaving"

A client is started on warfarin (Coumadin) therapy while still receiving intravenous heparin. The client questions the nurse about the risk for bleeding. How should the nurse respond? A. "Your concern is valid. I will call the doctor to discontinue the heparin." B. "It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic." C. "Because of your valve replacement, it is especially important for you to be anticoagulated. The heparin and warfarin together are more effective than one alone." D. "Because you are now up and walking, you have a higher risk of blood clots and therefore need to be on both medications."

B. "It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic."

A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin (Wymox), Pantoprazole (Prevacid), and Clarithromycin (Biaxin). Which statement made by the nurse correctly explains the purpose of these medications? A. "These medicines will minimize acid production and will coat the ulcer". B. "These medicines will stop the acid production and will kill the bacteria". C. "The ulcer will heal because the medications will kill the bacteria". D. "These medicines will control the ulcer and motion sickness".

B. "These medicines will stop the acid production and will kill the bacteria".

The nurse checks the gauge of the client's intravenous catheter. Which is the *smallest* gauge catheter that the nurse can use to administer blood? A. 12-Gauge B. 20-Gauge C. 22-Gauge D. 24-Gauge

B. 20-Gauge

A client is receiving an intravenous heparin drip. Which laboratory value will require immediate action by the nurse? A. Platelet count of 150,000 B. Activated partial thromboplastin time (aPTT) of 120 seconds C. INR of 1.0 D. Blood urea nitrogen (BUN) level of 12 mg/dL

B. Activated partial thromboplastin time (aPTT) of 120 seconds

A nurse provide instructions to a client regarding the administration of the prednisone and instructs the client that the best time to take the medication is during? A. Any time of the day. B. Early morning. C. Lunch. D. Before bedtime.

B. Early morning. Rationale: Prednisone is a corticosteroid (glucocorticoids) is administered early in the morning because it helps in reducing adrenal insufficiency and simulate the burst of glucocorticoids released naturally by the adrenal glands each morning.

What anatomical site and method should the nurse use to administer an injection of iron? A. Deltoid muscle using an air lock B. Gluteal muscle using the Z-Track technique C. Anterolateral thigh with 5/8 inch needle D. Subcutaneous tissue of the abdomen with a 5/8 inch needle

B. Gluteal muscle using the Z-Track technique

A client has been taking lansoprazole (Prevacid) for 4 weeks. The nurse should monitor the client for relief from which problem? A. Diarrhea B. Heartburn C. Flatulence D. Constipation

B. Heartburn

A client with a history of duodenal ulcers is taking calcium carbonate chewable tablets. The nurse monitors the client for relief of which symptoms? A. Flatus B. Heartburn C. Rectal pain D. Muscle twitching

B. Heartburn

Somatropin (Humatrope) is being given to a female patient with turner syndrome. Which of the following findings is associated with this medication? A. Decreases ALT and AST level. B. Mild hyperglycemia. C. Hypotension. D. Water intoxication.

B. Mild hyperglycemia.

A client receiving heparin therapy for acute myocardial infarction has an activated partial thromboplastin time (aPTT) value of 100 seconds. Before reporting the results to the healthcare provider, the nurse verified that which medication is available for use if prescribed? A. Methylene blue B. Protamine sulfate C. Phytonadione (Vitamin K) D. Cyanocobalamin (Vitamin B12)

B. Protamine sulfate

A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? A. Reduction in abdominal pain B. Reduction in straining with bowel movements C. Reduction in diarrhea D. Reduction in incontinent episodes

B. Reduction in straining with bowel movements

A client who is taking warfarin (Coumadin) requests an aspirin for headache relief. What is the nurse's best response? A. Administer 650 mg of acetylsalicylic acid (ASA) and reassess pain in 30 minutes. B. Teach the client of potential drug interactions with anticoagulants. C. Explain to the client that aspirin is contraindicated and administer ibuprofen as ordered. D. Explain that the headache is an expected side effect and will subside shortly.

B. Teach the client of potential drug interactions with anticoagulants. Rationale: Clients taking an anticoagulant should not use medications that would further increase the risk of bleeding, which includes aspirin as well as ibuprofen. Aspirin should not be administered to the client taking other anticoagulants, unless it is ordered specifically as a low dose daily therapy. Ibuprofen is not the best choice of medication for the client receiving Coumadin. Tylenol (acetaminophen) would be preferred for pain relief. Headache is not an expected side effect of Coumadin therapy.

A patient adrenal insufficiency is to be discharged and is given Prednisone as a home medication. The nurse instruct the patient the following, except? A. To avoid aspirin-containing products. B. To avoid foods rich in potassium. C. To avoid caffeinated drinks. D. To avoid individuals with respiratory infections.

B. To avoid foods rich in potassium.

A nurse is giving discharge instructions a patient who is taking levothyroxine (Synthroid). The nurse instruct the client to notify the physician if which of the following occurs? A. Cold intolerance. B. Tremors. C. Coarse, dry hair. D. Muscle cramps.

B. Tremors.

A nurse is teaching a patient on how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the patient , indicates the need for further teaching? A. Withdraws regular insulin first. B. Withdraws NPH insulin first. C. Injects an amount of air equivalent to the desired dose of insulin. D. Injects air into the NPH insulin first.

B. Withdraws NPH insulin first.

A client being discharged from the hospital will be taking warfarin sodium (Coumadin) on a daily basis. The nurse has provided instructions to the client about the medication and determines that further teaching is needed if the client makes which statement? A. "I need to have a prothrombin time checked in 2 weeks" B. "This medication thins my blood and allows me to clot more slowly" C. "I need to increase the intake of foods high in vitamin K in my diet" D. "If I notice any increased bleeding or bruising I need to call my doctor"

C. "I need to increase the intake of foods high in vitamin K in my diet"

A client is receiving warfarin (Coumadin) for a chronic condition. Which client statement requires immediate action by the nurse? A. "I will avoid contact sports." B. "I will take my medication in the early evening each day." C. "I will increase dark-green, leafy vegetables in my diet." D. "I will contact my health care provider if I develop excessive bruising."

C. "I will increase dark-green, leafy vegetables in my diet."

A nurse administers 30 units of NPH insulin to a client with a blood glucose level of 200 mg/dL. The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration? A. 1 hour B. 2 to 3 hours C. 4 to 12 hours D. 16 to 24 hours

C. 4 to 12 hours

A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse determines that the client best understands this disorder and the medication regimen if the client states to take which product for pain? A. Naprosyn (Aleve) B. Ibuprofen (Motrin) C. Acetaminophen (Tylenol) D. Acetylsalicylic Acid (Aspirin)

C. Acetaminophen (Tylenol)

Glipizide (Glucotrol) is prescribed to a patient with diabetes mellitus. The nurse instruct the patient to avoid which of the following? A. Soft drinks. B. Whole grain cereals. C. Alcohol. D. Organ meats.

C. Alcohol.

Vasopressin promotes which action? A. Vasodilation B. Decrease in peristalsis C. Decrease in urinary output D. Inhibit smooth muscle contraction

C. Decrease in urinary output

Desmopressin acetate (DDAVP) is given to a patient with diabetes insipidus. Which of the following therapeutic response should you expect? A. Decreased blood pressure. B. Decreased attention span. C. Decreased urinary output. D. Decreased blood sugar.

C. Decreased urinary output.

A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: A. Constipation B. Abdominal pain C. Episodes of diarrhea D. Hematest-positive nasogastric tube drainage

C. Episodes of diarrhea Rationale: Loperamide is an antidiarrheal

A nurse is performing an assessment on a newly admit patient who is taking propylthiouracil (PTU) daily. The nurse suspects that the client has a history of? A. Addison's disease. B. Cushing's syndrome. C. Grave's disease. D. Myxedema.

C. Grave's disease.

A low dose of ondanstron (Zofran) is prescribed for relief of nausea a client receiving chemotherapy. The nurse anticipates that the health care provider will most likely prescribe the medication by which route? A. Oral B. Intranasal C. Intravenous D. Subcutaneous

C. Intravenous

The patient asks how stool softeners relieve constipation. Which of the following would be the best response by the nurse? Stool softeners relieve constipation by: A. Stimulating the walls of the intestine B. Promoting the retention of sodium in the fecal mass C. Promoting the retention of water in the fecal mass D. Lubricating the intestinal walls

C. Promoting the retention of water in the fecal mass

A private nurse visits a client who is taking Humulin NPH insulin daily. The client asks the nurse on how is the storage of the unopened vials of insulin. The nurse tells the client to: A. Store it at room temperature. B. Store it in the freezer. C. Store it in the refrigerator. D. Keep the insulin in a sunlight, dry place.

C. Store it in the refrigerator.

A nurse teaches a client taking metoclopramide (Reglan) to discontinue the medication immediately and call the physician if which side effect occurs with long- term use? A. Excessive excitability B. Anxiety or irritability C. Uncontrolled rhythmic movements of the face or limbs D. Dry mouth not helped by the use of sugar-free hard candy

C. Uncontrolled rhythmic movements of the face or limbs

The nurse performing an initial assessment notes that a client has been taking metoclopramide for a prolonged period. The nurse should immediately call the HCP if which of these signs/symptoms were then noted by the nurse? A. Anxiety or irritability B. Excessive drowsiness C. Uncontrolled rhythmic movements of the face or limbs D. Dry mouth relieved with the use of sugar-free hard candy

C. Uncontrolled rhythmic movements of the face or limbs

Pernicious anemia is caused by a deficiency in... A. Iron B. Folate C. Vitamin B12 D. Ferrous sulfate

C. Vitamin B12

Thrombolytic therapy reduces mortality and limits infarct size in patients with AMI. The greatest benefit occurs if treatment is initiated: A. Within the first 3 days B. Within the first 30 days C. Within the first 3 hours D. Within 30 minutes

C. Within the first 3 hours

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this result is: A. The same as the client's own baseline level B. Lower than the needed therapeutic level C. Within the therapeutic range D. Higher than the therapeutic range

C. Within the therapeutic range Rationale: The therapeutic range for prothrombin time is 1.5 to 2 times the control for clients at risk for thrombus. Based on the client's control value, the therapeutic range for this individual would be 16.5 to 22 seconds. Therefore the result is within therapeutic range.

The nurse has given client directions for proper use of aluminum hydroxide tablets. The client indicates an understanding of the medication if which statement is made? A. "I should take the tablet at the same time as an antacid" B. "I should swallow the tablet whole with 4-8 ounces of water" C. "I should take each dose with a laxative to prevent constipation" D. "I should chew the tablet thoroughly then drink 4-8 ounces of water"

D. "I should chew the tablet thoroughly then drink 4-8 ounces of water"

The nurse evaluates that the client understood discharge teaching regarding warfarin (Coumadin) based on which statement? A. "I will double my dose if I forget to take it the day before." B. "I should keep taking ibuprofen for my arthritis." C. "I should decrease the dose if I start bruising easily." D. "I should use a soft toothbrush for dental hygiene."

D. "I should use a soft toothbrush for dental hygiene."

The nurse is instructing a client with diabetes mellitus regarding hypoglycemia. Which statement by the client indicates the need for further teaching? A. "Hypoglycemia can occur at any time of the day or night" B. "I can drink 6 to 8 ounces of milk if hypoglycemia occurs" C. "If I feel sweaty or shaky, I might be experiencing hypoglycemia" D. "If hypoglycemia occurs, I need to take my regular insulin as prescribed"

D. "If hypoglycemia occurs, I need to take my regular insulin as prescribed"

How much time is required for peak anticoagulant effect of Warfarin? A. 3 hours B. 1 day C. 1 week D. 3 days

D. 3 days

Which instruction should the nurse include in the teaching plan for a client taking iron supplements to correct iron deficiency anemia? A. Eat a low fiber diet B. Limit the intake of fluids C. Limit the intake of fish, meat, and poultry D. Avoid taking the supplements with milk or antacids

D. Avoid taking the supplements with milk or antacids

Which drug is a direct thrombin reversible inhibitor given in combination with aspirin to prevent clot formation with unstable angina undergoing coronary angioplasty? A. Argatroban (Acova) B. Lepirudin (Refludan) C. Desirudin (Iparavask) D. Bivalirudin (Angiomax)

D. Bivalirudin (Angiomax)

The nurse is preparing to administer heparin sodium 5000 units subcutaneously. Which action should the nurse take to safely administer the medication? A. Inject via an infusion device B. Inject within 1 inch of the umbilicus C. Massage the injection site after administration for a full minute D. Change the needle on the syringe after withdrawing the medication from the vial

D. Change the needle on the syringe after withdrawing the medication from the vial

A client takes aluminum hydroxide tablets as needed for heartburn. The nurse teaches the client that which is the most common side effect of this medication? A. Dizziness B. Excitability C. Muscle pain D. Constipation

D. Constipation

A client is hospitalized with a diagnosis of thrombophlebitis and is being treated with heparin infusion therapy. About 24 hours after the infusion has begun, the nurse notes that the client's partial thromboplastin time (PTT) is 65 seconds with a control of 30 seconds. What is the appropriate nursing action? A. Discontinue the heparin infusion B. Prepare to administer protamine sulfate C. Notify the health care provider of the laboratory results D. Do nothing because the client is adequately anticoagulated

D. Do nothing because the client is adequately anticoagulated

A client with diabetes insipidus is taking antidiuretic hormone. Which of the following symptoms would alert the need to decrease the dosage? A. Alopecia. B. Jaundice. C. Diarrhea. D. Drowsiness.

D. Drowsiness.

A client with diabetes mellitus type I was prescribed with Exenatide (Bydureon). The nurse will take which of the following appropriate actions? A. Withdraw the insulin from the prefilled pen into an insulin syringe. B. Monitor for signs of nausea, vomiting, and gastric upset. C. Administer the medication twice a day during pre-meals. D. Hold the medication and call the physician to question the prescription.

D. Hold the medication and call the physician to question the prescription Rationale: Exenatide (Bydureon) is only used to treat diabetes mellitus type 2 only. Therefore, holding the medication and calling the physician to question the order.

To increase medication effectiveness, the nurse should instruct the client taking oral bisacodyl (Ducolax) to take the medication via which procedure? A. At bedtime B. With a large meal C. With a glass of milk D. On an empty stomach

D. On an empty stomach

A client being discharged from the hospital with a diagnosis of gastric ulcer has a prescription for sucralfate (Carafate) 1 gram by mouth 4 times daily. The nurse determines that the client understands proper use of the medication if the client states to take it at which time? A. With meals and at bedtime B. Every 6 hours around the clock C. One hour after meals and at bedtime D. One hour before meals and at bedtime

D. One hour before meals and at bedtime

A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: A. Relief of nausea and vomiting. B. Decrease diarrheal episodes. C. The absence of constipation. D. Relief from GERD.

D. Relief from GERD.

What should the nurse assess in a client who has pernicious anemia? A. Constipation B. Shortness of breath C. Dusky lips and gums D. Smooth, sore, red tongue

D. Smooth, sore, red tongue

A nurse is giving instructions a patient who is taking levothyroxine (Synthroid). The nurse tells the client that the best time to take this medication is? A. During bedtime. B. After lunch. C. Taken with food. D. Taken on an empty stomach.

D. Taken on an empty stomach.

Which of the following are signs of hyperglycemia? A. High-grade fever, chills, and decreased urination. B. Fatigue, increased sweating, and heat intolerance. C. Coarse dry hair, weakness, and fatigue. D. Thirst, blurred vision, and diuresis.

D. Thirst, blurred vision, and diuresis.

Two hours after self-administering regular insulin subcutaneously, the patient contacts you at the provider's office to report that she is sweating, shaky, and has a rapid pulse. Which of the following actions should you advise her to take? (select all that apply) a. Drink 4 oz of orange juice. b. Check her blood glucose level. c. Take an oral hypoglycemic. d. Measure her urine output. e. Self-administer a long-acting insulin.

a, b

A patient is starting therapy with misoprostol (Cytotec) to prevent a gastric ulcer. Since she is a 30-year-old woman, you should give her which of the following instructions? (Select all that apply.) a. Report mid-cycle bleeding. b. Take a pregnancy test prior to therapy. c. Report excessive menstrual pain. d. Use effective contraception. e. Avoid taking the drug at bedtime.

a, b, c, d

A patient is about to start taking hydrocortisone (Cortef) to treat adrenocortical insufficiency. You should instruct the patient to do which of the following to help reduce her risk for adverse effects of this drug? (Select all that apply.) a. Expect lifelong therapy. b. Carry extra doses of the drug. c. Expect periodic blood sampling. e. Urinate every 4 hr. f. Report increased stress.

a, b, c, e

You should monitor a patient throughout continuous heparin therapy for which of the following adverse reactions? (Select all that apply) a. Thrombocytopenia b. Hypotension c. Hypokalemia d. Deep-vein thrombosis e. Fever

a, b, d, e

You are caring for a patient who is receiving alteplase (Activase) to dissolve a thrombus. Which of the following should you include in the care plan for the patient? (Select all that apply.) a. Monitor blood pressure. b. Reposition frequently. c. Limit venipunctures. d. Check level of consciousness. e. Apply pressure to oozing sites.

a, c, d, e

The provider discharges the patient to home with a prescription for warfarin (Coumadin). You should advise the patient to do which of the following? (Select all that apply.) a. Avoid taking NSAIDs. b. Use a disposable razor. c. Brush his teeth with a soft toothbrush. d. Increase intake of dark green, leafy vegetables. e. Ask the provider before taking over-the-counter drugs. f. Check bowel movements for signs of bleeding.

a, c, e, f

You give the patient five units of lispro insulin (Humalog) and 10 units of insulin glargine subcutaneously at 1400. Based on your instructions, the patient should expect her blood glucose level to be the lowest at which of the following times? a. 1430 b. 1530 c. 1630 d. 1730

a. 1430

The health care professional instructs the patient about the therapeutic actions of sucralfate (Carafate). She explains that this drug promotes ulcer healing by which of the following actions? a. Creates a protective barrier b. Increases gastric pH c. Inhibits the proton pump d.Neutralizes gastric acid

a. Creates a protective barrier

You are caring for a patient who is about to begin taking cyanocobalamin (Nascobal), a vitamin B12 preparation. You should understand that the drug treats which of the following types of anemia? a. Pernicious b. ​Sickle cell c. Aplastic d. Iron-deficiency

a. Pernicious

While the patient is still receiving continuous IV heparin, the provider prescribes oral warfarin (Coumadin). This is because a. Warfarin takes 3 to 5 days to achieve therapeutic effects. b. IV heparin alone becomes ineffective after the first 1 to 2 days. c. Abrupt cessation of heparin therapy increases the risk for thrombocytopenia. d. Warfarin reduces the risk for hemorrhage.

a. Warfarin takes 3 to 5 days to achieve therapeutic effects

A patient is about to start taking aluminum hydroxide (Amphojel) to reduce gastric acid. Which of the following instructions should you include when talking with the patient about taking this drug? (Select all that apply.) a. Take it with a large meal. b. Chew the tablets thoroughly. c. Drink 4 oz of water after taking it. d. Increase fluid and fiber intake. e. Take it once daily.

b, c, d

As you continue to talk with the patient about managing her diabetes with regular insulin (Humulin R), you should include which of the following instructions? (Select all that apply.) a. Self-inject chilled insulin. b. Carry a carbohydrate snack. c. Rotate injection sites. d. Wear a medical alert bracelet. e. Expect to adjust the dosage during illness.

b, c, d, e

You are talking to a patient who is about to begin taking liquid ferrous sulfate (Feosol) to treat iron-deficiency anemia. Which of the following instructions should you include about the drug? (Select all that apply.) a. Swish it in your mouth before swallowing it. b. Drink it through a straw. c. Do not rinse your mouth after taking it. d. Dilute it first with water. e. Take it with food.

b, d

A patient is about to start taking sustained release glipizide (Glucotrol) to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking with the patient about taking this drug? a. Chew the tablet completely before swallowing it. b. Take it once a day, 30 min before selected meals. c. Take it in the evening before bedtime. d. Drink 16 oz of water right after taking it.

b. Take it once a day, 30 min before selected meals

You are caring for a patient who takes acarbose (Precose) and a sulfonylurea to treat type 2 diabetes mellitus. Which of the following is an indication of an adverse reaction to this drug combination? a. Polyuria b. Tremors c. Bradycardia d. Thirst

b. Tremors

A provider prescribes IV heparin for this patient. Which of the following parameters should you monitor for in regard to determining if a therapeutic dose is being administered? a. INR, two to three times the patient's baseline b. aPTT, one and a half to two times the patient's baseline c. Platelet count of 100,000 mm3 d. PT 11-12.5 sec

b. aPTT, one and a half to two times the patient's baseline

A patient is about to start taking somatropin (Genotropin). You plan to evaluate the effectiveness of this drug therapy with which of the following assessments? a. Level of consciousness b. ECG c. Height and weight d. Breath sounds and respiratory rate

c. Height and weight

Which of the following instructions should the health care professional give the patient about taking sucralfate (Carafate) to treat an acute duodenal ulcer? a. Take it with a prescribed antacid. b. Reduce potassium intake. c. Take it with food. d. Increase fluid and fiber intake.

d. Increase fluid and fiber intake.

When talking with a patient about self-administering regular insulin (Humulin R), you should include which of the following instructions? a. Shake the vial vigorously. b. Expect the solution to appear cloudy. c. Store unopened vials at room temperature. d. Inject the insulin subcutaneously.

d. Inject the insulin subcutaneously.

You are caring for a patient who is taking exenatide (Byetta) to treat type 2 diabetes mellitus. The patient reports severe abdominal pain. You suspect which of the following adverse reactions to this drug? a. Peptic ulcer disease b. Hyperkalemia c. Hyperglycemia d. Pancreatitis

d. Pancreatitis