PHARM EXAM 4
Oral contraceptives may interact with some antibiotics causing a decreased effectiveness of the oral contraceptive which could result in pregnancy. Select one: True False
true
A client has been prescribed Premarin. What medication information should the nurse provide? Select all that apply. a. "You may notice a decrease in your libido while on this medication." b. "If you notice pain in your abdomen that goes through to your back, be certain to notify the clinic." c. "Do not become pregnant while on this drug." d. "If you add the herbal black cohosh to this therapy, the results will be better."
A, B, C The correct answers are: "You may notice a decrease in your libido while on this medication.", "If you notice pain in your abdomen that goes through to your back, be certain to notify the clinic." , "Do not become pregnant while on this drug."
Aminocaproic acid
Antifibrinolytic/hemostatics
A patient with hemophilia A may receive which of the following medications to treat their condition? Select one: a. glycoprotein IIb/IIIA inhibitor b. aminocaproic acid c. aspirin d. alteplase
B
The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders. What will the best plan of the nurse include? a. Body movement depends on an intact spinal cord. b. Body movement depends on proper functioning of muscles. c. Body movement depends on intact nerves. d. Body movement depends on proper endocrine functioning. e. Body movement depends on the level of consciousness.
B and C Body movement depends on proper functioning of muscles. Rationale 3: Body movement depends on intact nerves.
The client takes a bisphosphonate for osteoporosis. Which assessment is best in determining the effectiveness of the medication? Select one: a. Normal serum calcium levels b. Absence of fractures c. Bone density scan d. Absence of bone pain
C The bone density scan is the best assessment tool to determine the effectiveness of bisphosphonates. Calcium level, absence of fractures, and absence of bone pain are not the best assessment measures to determine the effectiveness of bisphosphonates.
A child has rickets and is being treated at the clinic. In addition to taking vitamin D as prescribed, what is the best information the nurse can provide? Select one: a. Avoid dairy products while taking vitamin D. b. Be sure to take brand name, not generic, vitamin D. c. Spend at least 20 minutes/day in the sunlight. d. Take your vitamin D on an empty stomach.
C Twenty minutes/day in the sun will provide all the vitamin D that is required.
The nurse is managing care for a patient with cirrhosis of the liver. The nurse teaches the patient about how to avoid injury that may result in bleeding. The patient asks the nurse why he is at risk to start bleeding. What is the best response by the nurse? Select one: a. "Because your liver is breaking down your clotting factors too quickly." b. "Because your liver is injured and unable to manufacture platelets." c. "Because your liver thickens your blood so it is less likely to clot." d. "Because your liver is injured and cannot make clotting factors."
D
The process of fibrinolysis is to Select one: a. increase blood flow. b. promote enzymes. c. stop blood flow. d. remove a blood clot
D
epoetin alpha
hematopoietic growth factor
Oprelvekin
platelet enhancer
alteplase
thrombolytics
A nurse is caring for a client who has chronic kidney disease (CKD) and states she has heartburn. The provider prescribes aluminum hydroxide. The client asks, "Why can't I just take the antacid magaldrate my husband has at home?" The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following? Select one: a. Serum phosphorus levels b. Serum potassium levels c. Serum magnesium levels d. Serum calcium levels
A ) Serum phosphorus levels Answer Rationale: Aluminum-based formulas are also a phosphate binder, helping to lower serum phosphorus levels in clients who have CKD.
A nurse is providing teaching to a client who has renal failure and an elevated phosphorus level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client? Select one: a. Constipation b. Metallic taste c. Headache d. Muscle spasms
A 1) Constipation Answer Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed.
A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions? Select one: a. Constipation b. Flatulence c. Palpitations d. Headache
A 1) Constipation (correct) Answer Rationale: Aluminum hydroxide can cause constipation. The nurse should tell the client to increase fluid and fiber intake to reduce the risk for constipation.
The nurse manages care for several clients receiving hormone replacement therapy (HRT). What will the priority assessment by the nurse include as related to side effects? Select one: a. Pain in the calf b. Chronic fatigue c. Low-back pain d. Decreased libido
A Hormone replacement therapy: Because of the risk of thromboembolism, monitor the patient closely for signs and symptoms of thrombus or embolus, such as pain in calves, limited movement in legs, dyspnea, sudden severe chest pain, or anxiety. Encourage the patient to report signs of depression, decreased libido, headache, fatigue, and weight gain. Because current controversy surrounds the long-term use of these drugs as hormone replacement therapy, it is imperative for women to be aware of current research and to discuss treatment alternatives with healthcare providers before beginning pharmacotherapy. When using HRT to treat male patients, inform them that secondary female characteristics, such as a higher voice, sparse body hair, and increased breast size, may develop. Inform the patient that impotence may also
A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? Select one: a. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." b. "I will call the provider to get a prescription for discontinuing the IV heparin today." c. "Both heparin and warfarin work together to dissolve the clots." d. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
A Heparin and warfarin are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood vessels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued.
A client has been prescribed an estrogen-progestin combination oral contraceptive. How should the nurse explain the mechanism of action of this pill? Select all that apply. a. "This pill will prevent you from ovulating." b. "This pill makes it less likely that an embryo will implant." c. "The spermicide in this pill will kill sperm before fertilization." d. "The progestin in the pill will kill the egg before fertilization." e. "The estrogen-progestin combination causes irritability of the uterine lining so implanted embryos are expelled."
A and B
The posterior pituitary is responsible for secreting which of the following hormones? Select one or more: a. ADH b. oxytocin c. corticotropin releasing hormone d. ACTH e. Thyroid stimulating hormone
A and B
he nurse would plan to most closely observe which patients for the development of liver toxicity after dantrolene (Dantrium) is initiated? a. A 49-year-old woman who has a history of esophagitis. b. A 60-year-old man with pneumonia. c. A 38-year-old woman who has type 2 diabetes d. An 18-year-old who injured his leg playing soccer. e. A 26-year-old woman who has an ostomy
A and B Women over age 35 are at high risk for development of hepatotoxicity. While risk is present for all patients, there is nothing in the other scenarios that indicates risk is particularly high.
The nurse understands that there are adverse effects when patients take corticosteroids for a long period of time. These include which of the following? a. development of peptic ulcers b. muscle wasting c. cataract development d. increased serum glucose e. increased suicidal ideation f. weight loss
A, B, C, D, and E
A client has been taking low-dose oral contraceptives. She calls the clinic and reports that she is mid-cycle and has noticed some slight spotting. What information should the nurse provide? Select all that apply. a. "Monitor the bleeding and contact us again if it becomes continuous or heavy." b. "You must have gotten the wrong pills at the pharmacy." c. "Slight spotting may occur, especially with low-dose oral contraceptives." d. "You may be pregnant; please stop taking these pills and come to the clinic" e. "This is an adverse reaction; stop using the pills."
A and C Prototype drug: estradiol and norethindrone (Ortho-Novum, others) Mechanism of action: to inhibit release of FSH and LH, thus preventing ovulation Primary use: as contraceptive, for improvement in menstrual cycle regularity, to decrease incidence of dysmenorrhea Adverse effects: edema, nausea, abdominal cramps Dysmenorrhea, breast tenderness, fatigue Skin rash, acne, headache, weight gain Midcycle breakthrough bleeding, vaginal candidiasis Photosensitivity, changes in urinary patterns Serious cardiovascular side effects more common in smokers
The nurse is administering a glucocorticoid. The nurse knows that all of the following may be effects of glucocorticoids, EXCEPT? a. increase of the matrix in bones b. possible development of cushing's syndrome c. suppression of the immune system d. increased breakdown of proteins e. decreased blood glucose
A and E
A nurse is teaching a patient about the possible adverse effects of oral contraceptives. The nurse evaluates that the patient understands this teaching if which statement is made? Select all that apply a. "I may experience increased acne while on oral contraceptives." b. "If I experience chest pain, I will call the clinic immediately." c. "If I begin to lose more hair than is normal, my dose may need to be adjusted." d. "Any blurry vision or loss of vision should be reported immediately." e. "If I notice swelling in my feet, hands, or face, I will notify the clinic."
A, B, D, and E \ The correct answers are: "I may experience increased acne while on oral contraceptives." , "If I experience chest pain, I will call the clinic immediately." , "Any blurry vision or loss of vision should be reported immediately." , "If I notice swelling in my feet, hands, or face, I will notify the clinic."
Diabetes insipidus will have which of the following findings? a. decreased urine osmolality b. increased serum osmolality c. increased serum sodium d. increased urine specific gravity e. decreased urine output
A, B, and C
A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.) a. Cranial enlargement b. Skeletal pain c. Abnormal gait d. Cold extremities e. Visual loss
A, B, and C Cranial enlargement is correct. When the skull is involved, Paget's disease causes thickening and enlargement of the skull bones and enlargement of the cranium.Skeletal pain is correct. Paget's disease causes pain and tenderness over the affected bones.Abnormal gait is correct. When the legs are involved, Paget's disease causes bowing of the legs and an abnormal gait.
Side effects of propylthiouracil include which of the following? a. rash b. leukopenia c. tachycardia d. agranulocytosis e. weight loss
A, B, and D
The client receives alendronate (Fosamax) as treatment for osteoporosis. The nurse has completed medication education and evaluates learning has occurred when the client makes which statements? a. "I cannot lie down for at least 30 minutes after taking the medication." b. "Milk will help with the absorption of this medication." c. "I should call my doctor if I experience heartburn." d. "I must take this with a full glass of water." e. "The medication can be taken with or without food."
A, C, and D Global Rationale: The client must stay upright for at least 30 minutes to prevent GI upset. Alendronate (Fosamax) is irritating to the esophagus; the client must contact the physician if heartburn occurs. Alendronate (Fosamax) must be taken on an empty stomach with a full glass of water to ensure absorption. Milk will interfere with the absorption of alendronate (Fosamax); it should be taken on an empty stomach. Food will interfere with the absorption of alendronate (Fosamax); it should be taken on an empty stomach.
The nurse plans to teach a class about Alzheimer's disease to a caregiver's support group. What will the best plan by the nurse include? Select all that apply. a. Depression and aggressive behavior are common with the disease. b. Glutamergic inhibitors are the most common class of drugs for treating Alzheimer's disease. c. Alzheimer's disease accounts for about 50% of all dementias. d. Memory difficulties are an early symptom of the disease. e. Chronic inflammation of the brain may be a cause of the disease.
A, D, and E
A nurse is teaching a client who has a new prescription for ranitidine to treat peptic ulcer disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) a. "I can take this medication with or without food." b. "I will take this medication in the morning." c. "I should expect my stools to turn black." d. "I will take this medication with an antacid." e. "I will take this medication when I need it for pain." f. "I will eat five small meals each day."
A, F "I can take this medication with or without food." is correct. Food does not affect the absorption of ranitidine. "I will eat five small meals each day" is correct. The client should eat 5 to 6 small meals each day to enhance the therapeutic effects of ranitidine.
A nurse is caring for a client who is receiving Oprelvekin. The nurse will monitor which of the following laboratory values to evaluate the effectiveness of this medication? Select one: a. absolute neutrophil count b. platelet count c. total white blood count d. hemoglobin
B
The patient is diagnosed with Parkinson's disease. The patient's wife asks the nurse how taking medicine will help her husband. What is the best response by the nurse? Select one: a. "The medications will balance serotonin and acetylcholine in your husband's brain." b. "The medications will help your husband to eat and walk." c. "The medications will help prevent muscle wasting in your husband." d. "The medications will boost your husband's appetite and energy."
B
A nurse is teaching a client who taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following adverse effects? Select one: a. Excess salivation b. Difficulty voiding c. Diarrhea d. Slow pulse
B the nurse should instruct the client to report difficulty voiding, which may indicate urinary retention, as an adverse effect of benztropine. Benztropine is an anticholinergic medication that helps decrease the rigidity and tremors of Parkinson's disease.
A nurse is administering sucralfate to a client who has a gastric ulcer. Which of the following actions should the nurse take? Select one: a. Instruct the client to chew the sucralfate for fasting absorption. b. Administer the medication without food or fluids. c. Limit the client's fluids while on sucralfate therapy d. Administer sucralfate with an antacid
B 2) Administer the medication without food or fluids. (correct) Answer Rationale: The nurse should administer the medication to the client on an empty stomach for best absorption.
A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition? Select one: a. History of bulimia b. History of NSAID use c. Drinks chamomile tea d. Has a glass of wine with dinner a couple times a week
B 2) History of NSAID use Answer Rationale: The nurse should recognize that long-term use of NSAIDs is a risk factor for peptic ulcer disease. NSAIDs break down the mucosal barrier and cause production of prostaglandins to decrease, which results in local gastric mucosal injury.
The client receives hydroxychloroquine sulfate (Plaquenil). Which test does the nurse tell the client should be done on a regular basis? Select one: a. Serum potassium b. Eye exams c. Serum glucose d. Blood pressure
B Blurred vision, inability to read, and visual field disturbances can occur when receiving hydroxychloroquine sulfate (Plaquenil) so the client must have regular eye exams. Serum potassium monitoring, serum glucose monitoring, and blood pressure
The symptoms of gout are due to Select one: a. an increase in the excretion of uric acid. b. buildup of uric acid in the blood. c. cartilage loss in the joints. d. a decrease in uric acid in the blood.
B Gout is due to buildup of uric acid in blood or joints. An increase in excretion would not cause gout. Cartilage loss is characterized by osteoarthritis. A decrease in uric acid would not cause gout.
A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect? Select one: a. Flaccid muscles b. Client reports numbness in his hands c. Negative Chvostek's sign d. Client report of anorexia
B Numbness and tingling in the client's hands and feet are manifestations of hypoparathyroidism due to hypocalcemia. INCORRECT
A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make? Select one: a. High-impact aerobics b. Walking briskly c. Riding a bicycle d. Stretching exercises
B Weight-bearing exercises are essential for maintaining bone mass. Walking is an appropriate activity for an older client to promote weight bearing and to maintain bone mass.
A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? Select one: a. Hyperactive bowel sounds b. Sudden abdominal pain c. Increased blood pressure d. Bradycardia
B 2) Sudden abdominal pain (correct) Answer Rationale: Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.
A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? Select one: a. Hemoglobin (Hgb) b. Prothrombin time (PT) c. Bleeding time d. Activated partial thromboplastin time (aPTT)
B This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy, the PT should typically be approximately two to three times the normal value, depending on the indication for therapeutic anticoagulation.
A patient is diagnosed with multiple sclerosis. What symptoms will the nurse most likely assess in this patient? Select all that apply. a. Atrophy of the hands and legs b. Muscle weakness c. Progressive chorea d. Difficulty maintaining balance e. Slow shuffling gait
B and D
The nurse teaches a class on pregnancy to the client in their first trimester. The nurse evaluates that learning has occurred when the clients make which statements? Select all that apply. a. "Ovulation is caused by a surge of human chorionic gonadotropin." b. "Ovulation is caused by a surge of luteinizing hormone." c. "The pituitary gland secretes gonadotropin-releasing hormone." d. "Ovulation occurs on approximately Day 21 of the ovarian cycle." e. "Follicle-stimulating hormone causes ovarian follicles to develop."
B and E Regulation of the female reproductive system is achieved by hormones from the hypothalamus, pituitary gland, and ovary. The hypothalamus secretes gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Both of these pituitary hormones act on the ovary and cause immature ovarian follicles to begin developing. The rising and falling levels of pituitary hormones create two interrelated cycles that occur on a periodic, monthly basis, the ovarian and uterine cycles
Which of the following therapeutic drug classifications will either decrease the formation of clots or promote the removal of existing clots in the body? SATA a. hemostatic drugs b. antiplatelet drugs c. thrombolytic drugs d. anticoagulant drugs
B, C and D
A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? Select all that apply. Select one or more: a. Blurred vision b. Hypertension c. Thrombosis d. Leukocytosis e. Edema f. Headache
B, C, F
A patient reports having "arthritis." The nurse would determine that the patient's arthritis is rheumatoid arthritis if which findings are reported by history? a. Joint pain b. Frequent fever c. Pulmonary disease d. Pericarditis e. Inflammation in joints
B, C, and D Frequent fever, pulmonary disease, and pericarditis are associated with rheumatoid arthritis. Joint pain and inflammation are common to both diseases.
A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods? Select one: a. Whole grain breads b. Fresh fruits c. Red meat and organ meat d. Milk and cheese
C This client has a deficiency in iron and needs instruction about foods that are rich sources of iron. A diet rich in red and organ meat provides iron, which is what the client needs to improve anemia.
A client calls the clinic and tells the nurse she has nausea and breast tenderness and is afraid she might be pregnant. She is taking oral contraceptives and has taken them exactly as prescribed. What is the best response by the nurse? Select one: a. Tell the client to purchase an at-home pregnancy test to determine pregnancy. b. .Tell the client to come in for an evaluation and to discuss birth control c. Tell the client that these symptoms can be side effects of oral contraceptives. d. Verify with the client that she has taken all her pills just as prescribed.
C
A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client? Select one: a. "Please come into the clinic immediately to have a pregnancy test done." b. "You might consider another form of birth control if you keep missing your pills." c. "You should use an alternative form of birth control for the rest of this cycle." d. 1."If you have missed fewer than three of your pills, you do not need to worry."
C
Heat sensitivity, spasticity, and visual impairment are symptoms most likely associated with which disorder? Select one: a. Alzheimer's disease (AD) b. Parkinson's disease c. Multiple sclerosis (MS) d. Amyotrophic lateral sclerosis (ALS)
C
The client plans to use an estrogen/progestin oral contraceptive for birth control. Which client behavior would the nurse be most concerned about? Select one: a. The client drinks two glasses of wine a day. b. The client is being treated for bipolar disorder. c. The client smokes one-half pack of cigarettes per day d. The client has several sexual partners
C
he patient receives donepezil (Aricept) as a treatment for Alzheimer's disease. Which laboratory test(s) will the nurse primarily assess? Select one: a. Serum amylase levels b. Pulmonary function tests c. Liver function tests d. Complete blood count
C
A nurse is teaching a client who has a new prescription for omeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? Select one: a. "I won't pass gas as often now that I am taking this medication." b. "I will take this medication each morning with my breakfast." c. "I have an increased risk of getting pneumonia while taking this medication." d. "I will need to take a daily stool softener while taking this medication."
C 3) "I have an increased risk of getting pneumonia while taking this medication." (correct) Answer Rationale: The client taking omeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur.
A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Select one: a. Impaired skin integrity b. Fluid retention c. Pathologic fractures d. Dysphagia
C A client who has hyperparathyroidism is at risk for pathological fractures due to the release of calcium and phosphate into the blood, which reduces bone density and places the client at risk for pathologic fractures.
A nurse is caring for a client who has osteoporosis and takes a daily calcium supplement. Which of the following adverse effects of calcium should the nurse suspect when the client reports having flank pain? Select one: a. Hepatitis b. Hip Fracture c. Renal Stones d. Pancreatitis
C Calcium supplements can cause renal stones. Clients should increase their water intake while taking calcium supplements to hydrate the kidneys and should report any blood in the urine or flank pain.
Progestins are primarily used in the treatment of which of the following disorders? Select one: a. Breast cancer b. Amenorrhea c. Dysfunctional uterine bleeding d. Menopause
C Dysfunctional uterine bleeding is a condition in which hemorrhage occurs on a noncyclic basis or in abnormal amounts. It is the health problem most frequently reported by women and a common reason for hysterectomy. The cause is often an imbalance between estrogen and progesterone. Whereas the function of estrogen is to cause proliferation of the endometrium, progesterone limits and stabilizes endometrial growth. Progestins are the drugs of choice for treating uterine abnormalities. In cases of heavy bleeding, high doses of conjugated estrogens may be administered.
A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? Select one: a. "Taking the medication between meals will help you avoid becoming constipated." b. "Taking the medication with food increases the risk of esophagitis." c. "Taking the medication between meals will help you absorb the medication more efficiently." d. "The medication can cause nausea if taken with food."
C Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron.
The client receives estrogen for prostate cancer. He asks the nurse why he is receiving a female hormone. What is the best response by the nurse? Select one: a. "It shrinks your cancer by making the cells die at a faster rate." b. "It eliminates the testosterone that feeds your cancer." c. "It suppresses secretion of the androgens that make your cancer grow." d. "It keeps nutrients from getting to, and feeding, your cancer."
C Prostate cancer is usually dependent on androgens for growth; administration of estrogens will suppress androgen secretion. As an antineoplastic hormone, estrogen is rarely used alone. It is one of many agents used in combination for the chemotherapy of cancer.
The nurse would monitor a client with pernicious anemia for which of the following symptoms? Select one: a. flushing b. dark stool c. numbness or tingling in the extremities d. bradycardia
C Signs and symptoms of vitamin B12 deficiency can include neuropathy, pallor, fatigue, or beefy red tongue on examination.
An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse? Select one: a. 2 months b. 6 months c. 3 months d. 1 year
C Depot injections (Depo-Provera) - 3 months Subdermal implants - 3 years Transdermal patches - 1 patch/week for 3 weeks, followed by patch-free week Vaginal device (NuvaRing) - 3 weeks (removed in week 4) Intrauterine device (Mirena) - 5 years
The nurse suspects that a patient is developing malignant hyperthermia. Arrange these interventions in the correct order of priority. Control associated symptoms Identify any signs and symptoms that support this suspicion. Start dantrolene therapy Discontinue medication that may cause malignant hyperthermia Maintain intravenous dantrolene
Control associated symptoms → 4, Identify any signs and symptoms that support this suspicion. → 1, Start dantrolene therapy → 3, Discontinue medication that may cause malignant hyperthermia → 2, Maintain intravenous dantrolene → 5
A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority? Select one: a. Left upper epigastrium pain b. Dyspepsia c. Epigastric discomfort d. Hematemesis
D 4) Hematemesis (correct)Answer Rationale:When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.
A nurse is providing teaching to a client who has gastroesophageal reflux disease and a new prescription for omeprazole. Which of the following instructions should the nurse provide? Select one: a. Take NSAIDs if headaches occur. b. Decrease intake of vitamin D. c. Expect muscle cramps for several weeks. d. Report diarrhea to the provider.
D 4) Report diarrhea to the provider. (correct) Answer Rationale: Omeprazole is associated with an increased risk of C. difficileinfection. The nurse should instruct the client to contact the provider if diarrhea occurs.
A nurse is providing teaching to the family of a client who has Parkinson's disease. Which of the following information should the nurse include in the teaching? Select one: a. Leave the television on continuously. b. Speak loudly to the client. c. Limit client physical activity. d. Provide client supervision.
D Because the client's voluntary motor control is affected by the disease, the nurse should recommend that the family provide client supervision to create a safe and respectful environment.
he client receives alendronate (Fosamax) as treatment for osteoporosis. Which symptoms, caused by an adverse effect of the medication, does the nurse teach should be reported to the physician? Select one: a. Ringing of the ears b. Hot and dry skin c. Vision changes and photophobia d. Muscle spasms and facial twitching
D Muscle spasms and facial twitching indicate a low calcium level, which can be caused by alendronate (Fosamax), and should be reported immediately before the client has seizures. Ringing of the ears and hot, dry skin are not associated with alendronate (Fosamax). Vision changes and photophobia are not adverse effects of alendronate (Fosamax).
A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement? Select one: a. Vitamin B6 supplements b. Blood transfusions c. Iron supplements d. Vitamin B12 injections
D The nurse should administer vitamin B12 injections to treat pernicious anemia when diet fails to improve the anemia due to poor absorption
A nurse is presenting discharge instructions to a client who has multiple sclerosis (MS). The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate? Select one: a. "Plan to relax in a hot tub spa each day." b. "Engage in a vigorous exercise program." c. "Wear an eye patch on the right eye at all times." d. "Implement a schedule to include periods of rest."
D The nurse should assist the client in developing a schedule that includes periods of exercise followed by periods of rest to maintain muscle strength and coordination.
The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication? Select one: a. To stop the patient's muscle spasms b. To improve the patient's appearance c. To promote exercise in the patient d. To allow the patient increased independence
D The therapeutic goals of pharmacotherapy include minimizing pain and discomfort, increasing range of motion, and improving the patient's ability to function independently.
A nurse is assessing a client who is on long term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective? Select one: a. Increased appetite b. Regular bowel movements c. Absence of headache d. Reduced dyspepsia
D ) Reduced dyspepsia (correct) Answer Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.
A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? Select one: a. Sweat test b. Haptoglobin c. Antinuclear antibodies d. Schilling test
D The Schilling test helps determine the cause of vitamin B12deficiency, which leads to pernicious anemia.
Heparin
anticoagulant
enoxaparin sodium
anticoagulant
warfarin
anticoagulant
ferrous sulfate
antinomic agent (iron supplement)
cyanocobalamin
antinomic agent (vitamin b12)
clopidogrel
antiplatelet
Which change is a common adverse effect of cyclobenzaprine (Flexeril)? Select one: a. Alopecia b. Tongue swelling c. Drowsiness d. Hypotension
c All centrally acting agents have the potential to cause sedation.
Filgrastim (Neupogen)
colony stimulating factor
