Pharm Final

A RN in a providers clinic is caring for a client who reports erectile dysfunction and requests a prescription for slidenafil. Which of the following meds currently prescribed for the client is a contraindication to taking slidenafil?

A: Isosorbide B: Phenytoin C: Metronidazole D: Prednisone A

A RN is teaching a client who is taking metronidazole. Which of the following sense alterations should the RN include as an adverse effect of metronidazole?

A: Olfactory changes B: Metallic taste C: Alterations in touch D: Hearing loss B

A Rn is planning care for a client who has a detached retina and is preoperative for a surgical repair. The RN should prepare to administer which of the following medications?

A: Phenylephrine B: Latanoprost C: Pilocarpine D: Timolol A (All other choices are for tx of glaucoma)

A Rn is admitting a client who states he takes ginko bilboa every day to improve his memory. The RN should identify a potential interaction with which of the following meds the client is taking?

A: Ranitidine B: Levothyroxine C: Warfarin D: Loratadine C

A RN is taking a health hx of a client who reports occasionally taking several OTC meds, including an H2 receptor antagonist. Which of the following outcomes indicates the H2RA is therapeutic?

A: Relief of heartburn B: Cessation of diarrhea C: Passage of flatus D: Absence of constipation A (Ranitidine used to tx duodenal ulcers and prevent their return)

A RN is caring for a 2-year old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the Rn take before administering?

A: Shake the container vigorously. B: Be sure the child has not eaten within the house. C: Perform mouth care D: Check the child's BP. A

A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin B. Which of the following lab values should the Rn report to the provider before initiating the medication?

A: Sodium 140 mEq/L B: Potassium 4.5 mEq/L C: BUN 55 mg/dL D: Glucose 120 mg/dL C

A charge RN is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed RBC. The RN suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new RN requires interventions by the charge nurse?

A: The RN initiates an infusion of 0.9% sodium chloride. B: The RN collects a urine specimen. C: The RN sends a blood specimen to the lab. D: The RN starts the transfusion of another unit of blood product. D

A RN is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the med, the RN should check to see that which of the following tests have been completed?

A: Thyroid hormone assay (Rationale: Long term use may lead to thyroid dysfunction) B: Liver functions tests C: ESR D: Bran natriuretic peptide A

A RN is caring for a 1-month old infant who weighs 3500 g and is prescribed a dose of cephazolin 50 mg/kg by intermittent IV bolus TID. How many mg should the RN administer per dose?

175 mg

a nurse is preparing to administer verapamil IV bolus to a client who is having cardiac dysrhythmias. for which of the following adverse effects should the nurse monitor when giving this med?

A. hyperthermia B. hypotension C. ototoxicity D. muscle pain B

A RN is preparing to administer dextrose 5% in water (D5W) 150 mL IV to infuse over 3 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The RN should set the manual IV infusion to deliver how many gtt/min?

8

a nurse is caring for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. which of the following medications should the nurse plan to administer?

A. albumin 25% B. dextran 70 C. hydroxyethyl glucose D. mannitol 25% D

a nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. prior to beginning the infusion, the nurse verifies the client's cumulative lifetime dose of the medication. for which of the following reasons is this verification necessary?

A. an excess amount of doxorubicin can lead to myelosuppression B. exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation C. an excess amount of doxorubicin can lead to cardiomyopathy D. exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat C

a nurse is caring for a client who has hypertension and asks the nurse about a prescription for propranolol. the nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

A. asthma B. glaucoma C. depression D. migraines A

a nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. the nurse should monitor the client for which of the following adverse effects of this medication?

A. cardiac dysrhythmia B. metabolic alkalosis C. renal failure D. aplastic anemia D

a nurse is caring for a client who has CHF and is taking digoxin daily. the client refused breakfast and is complaining of nausea and weakness. which of the following actions should the nurse take first?

A. check VS B. request dietician consult C. suggest that the client rests before eating the meal D. request an order for an antiemetic A

a nurse is assessing a client who is receiving a unit of packed RBC. which of the following findings is a manifestation of acute hemolytic reaction?

A. client report of low back pain B. client report of tinnitus C. a productive cough D. distended neck veins A

a nurse is caring for a client who has active pulmonary TB and is to be started on intravenous rifampin therapy. the nurse should instruct the client that this medication can cause which of the following adverse effects?

A. constipation B. black colored stools C. staining of teeth D. body secretions turning a red orange color D

a nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. which of the following instructions should the nurse provide?

A. consume a high protein diet B. administer the med with food C. avoid caffeine while taking this med D. increase fluids to 1L/per day C

a nurse is preparing a client for surgery. prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications?

A. controlling emesis B. diminishing anxiety C. reducing the amount of narcotics needed for pain relief D. preventing thrombus formation E. drying secretions A,B,C,E

a nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric coated aspirin PO once daily. the client asks if the medication can be crushed to make it easier to swallow. which of the following responses should the nurse provide?

A. crushing the medication might cause you to have a stomachache or indigestion B. crushing the medication is a good idea, and i can mix it in some ice cream for you C. crushing the medication would release the medication at once rather than over time D. crushing is unsafe as it destroys the ingredients in the medication A

a nurse is assessing a client who is receiving IV vancomycin. the nurse notes a flushing of the neck and tachycardia. which of the following actions should the nurse take?

A. document that the client experienced an anaphylactic reaction to the med B. change the IV infusion site C. decrease the infusion rate on the IV D. apply cold compresses to the neck area C

a nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. a peak and trough is required with the next dose. which of the following actions should the nurse take to obtain an accurate gentamicin serum level?

A. draw a trough level at 0900 and a peak level at 2100 B. draw peak level 90 min prior to administering the med and a trough level 90 min after the dose C. draw a trough level immediately prior to administering the med and a peak level 30 min after the dose D. draw a peak level at 0900 and a trough level at 2100 C

a nurse is assessing a client who is receiving a parental lipid infusion. which of the following findings is a manifestation of fat overload syndrome?

A. elevated temperature B. hypertension C. peripheral edema D. erythema at the insertion site A

a nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. the client states, "i dont need this med. i am not constipated." the nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?

A. glucose B. ammonia C. potassium D. bicarbonate B

a nurse is teaching a client who has a UTI and is taking ciprofloxacin. which of the following instructions should the nurse give the client?

A. if the med causes an upset stomach, take an antacid at the same time B. limit your daily fluid intake while taking this med C. this med can cause photophobia, so be sure to wear sunglasses outdoors D. you should report any tendon discomfort you experience while taking this medication D

a nurse is reviewing a client's admission record. the nurse notes that there a prescriptions for several medications. which of the following factors should the nurse recognize is of primary consideration when determining the schedule of administration?

A. institutional policies regarding routine medication administration times B. specific characteristics of the meds C. schedule of administration that the client follows at home D. time at which the medication can be available from the pharmacy B

a nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. the client asks the nurse how long it will take for the heparin to dissolve the clot. which of the following responses should the nurse give?

A. it usually takes heparin at least 2-3 days to reach a therapeutic blood level B. a pharmacist is the person to answer that question C. heparin does not dissolve clots. it stops new clots from forming D. the oral medication you will take after this IV will dissolve the clot C

a nurse is teaching a client who has a new prescription for dimenhydrinate. which of the following instructions should the nurse include in the teaching?

A. monitor for dizziness B. observe for diarrhea C. administer 24 hr before effects are desired D. expect an increase in salivation A

a nurse is caring for a 4 year old child who is resistant to taking medication. which of the following strategies should the nurse use to elicit the child's cooperation?

A. offer the child a choice of taking the med with juice or water B. tell the child is it candy C. hide the med in a large dish of ice cream D. tell the child he will have to have a shot instead A

a nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. the provider and nursing staff suspect the client is not adhering to his medication therapy. which of the following interventions should the staff use to encourage the client's adherence?

A. perform mouth checks following the administration of the med B. provide for once daily dosing C. use sustained release forms D. engage the client in conversation following medication administration E. rotate staff that administer the medications B, C, D

a nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. the client is receiving lidocaine IV at 2 mg/min. when the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

A. prevents dysrhythmias B. slows intestinal motility C. dissolves blood clots D. relieves pain A

a nurse is a critical care unit is caring for a client who is post op following a right pneumonectomy. after extubation from the ventilator, in which of the following positions should the client be placed?

A. prone B. on the nonoperative side C. sims D. semi fowlers D

a nurse is planning to administer butorphanol to a client who is in labor. which of the following medications should the nurse plan to have available to reverse the action of this medication?

A. protamine B. diphenhydramine C. atropine D. naloxone D

a nurse is reviewing the medication list for a client who has a new diagnosis of type 2 DM. the nurse should recognize which of the following meds can cause glucose intolerance?

A. ranitidine B. guaifenesin C. prednisone D. atorvastatin C

a nurse is caring for a client who is receiving mydriatic eye drops. which of the following manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect?

A. seizures B. bradycardia C. constipation D. hypothermia C

a nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. which of the following actions should the nurse plan to take?

A. spread the cream over the lateral surface of both arms B. apply to intact skin C. apply the med an hour before the procedure begins D. cleanse the skin prior to procedure E. use a visual pain rating scale to evaluate effectiveness of the treatment B,C,D,E

a nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G intermittent IV bolus. 10 minutes into the infusion of the third dose., the client reports that the IV site itches and that he feels dizzy and SOB. which of the following actions should the nurse take first?

A. stop the infusion B. call the provider C. elevate HOB D. auscultate the breath sounds A

a nurse is teaching a client who has a new prescription for colchicine to treat gout. which of the following instructions should the nurse include?

A. take this med with food if nausea develops B. monitor for muscle pain C. expect to have increased bruising D. increase your intake of grapefruit juice B

a nurse is caring for a client who is at 6 weeks gestation and has pneumonia. while the nurse is obtaining the client's history, the client tells the nurse that she takes the herb feverfew for migraines. which of the following actions should the nurse take?

A. tell the client that she should take an OTC analgesic instead B. explain to the client that she should not take this herb while she is pregnant C. ask the client why she would take an herb during pregnancy D. suggest that the client ask her herbalist within the next few weeks about taking it while pregnant B

a nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. the client reports having discontinued the medication after experiencing severe N/V. which of the following reasons should the nurse suspect to be a likely cause of the client's distress?

A. the client demonstrated an allergic response to the med B. the client experienced a common side effect C. the client consumed alcohol while taking the med D. the client took an overdose of the med C

a nurse is caring for a client who is taking montelukast. which of the following outcomes indicates a therapeutic effect of the medication?

A. the client experiences less muscle pain B. the client's seizure threshold is reduced C. the client experiences and increased ease of breathing D. the client's platelet count in increased C

a hospice nurse is caring for a client who has terminal cancer and take PO morphine for pain relief. the client reports that he had to increase the dose of morphine this week to obtain pain relief. which of the following scenarios should the nurse document as the explanation for this situation?

A. the client not been taking the med properly B. the client is experiencing episodes of confusion C. the client has become addicted to the medication D. the client developed a tolerance D

a nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. which of the following instructions should the nurse provide?

A. the medication is to be applied when the client is experiencing pain B. the med will be used until the client's intraocular pressure returns to normal C. the med should be applied on a regular schedule for the rest of the client's life D. the med is to be used for approximately 10 days, followed by a gradual tapering off C

a nurse is providing teaching for a client who has schizophrenia and a new prescription for fluphenazine. which of the following information should the nurse provide?

A. this med might turn urine orange B. sleepiness should subside within a week C. stop the medication if hypotension occurs D. a low grade fever is expected with first doses B

a nurse is providing instructions about bowel cleansing with polyethylene glycol electrolyte solution (PEG) for a client who is going to have a colonoscopy. which of the following info should the nurse include?

A. to prevent dehydration, drink an additional liter of fluid during preparation time B. expect bowel movements to begin 3 hr following completion of the solution C. abdominal bloating might occur D. drink 400 mL every hour until bowel movements are clear C

a nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. which of the following medications should the nurse have available to reverse heparin's effects?

A. vitamin K B. protamine sulfate C. acetylcysteine D. deferasirox B

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?

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

a nurse is teaching an adolescent about medication therapy with oral acetylcysteine. which of the following information should the nurse include in the teaching?

A. you should avoid eating eggs B. your mouth will become dry C. it is necessary to monitor your serum electrolyte levels D. this med has a very unusual odor D

A RN is caring for four clients whom she has to administer oral meds in the morning. The Rn should administer which of the following meds before breakfast?

A: Alendronate B: Digoxin C: Mycostatin mouthwash D: Divalproex A

A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the RN include?

A: Avoid activities that require alertness such as driving. B: Increase caffeine intake. C: Take this med before bedtime. D: Reduce calorie intake. A

A Rn 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 TID. For which of the following adverse effects should the RN inform the client?

A: Constipation B: Metallic taste C: Headache D: Muscle spasms A

A RN is caring for a client who has ARDS, and requires mechanical ventilation. The client receives a prescription for pancuronium. The RN recognizes that this medication is for which of the following purposes?

A: Decrease chest wall compliance B: Suppress respiratory effort C: Induce sedation D: Decrease respiratory secretions. B

A Rn is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The RN should tell the client that this med might cause which of the following adverse effects?

A: Drowsiness B: Constipation C: Oliguria D: Tachycardia D

A RN in a provider's clinic is assessing a client who has cancer and a precsription for methotrexate PO. Which of the following actions should the RN take when the client reports bleeding gums?

A: Explain to the client that this is an expected adverse effect. B: Check the value of the client's current platelet count. C: Instruct the client to use an electric toothbrush D: Have the client make an appointment to see the dentist. B

A Rn is teaching a group of young women about the use of oral contraceptives. The RN should teach that taking which of the following herbal preparations reduces the effectiveness of this birth control method?

A: Ginseng B: Ginko biloba C: St. Johns wort D: Saw palmetto C

A RN is caring for a client who has HF and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the med?

A: I can walk a mile a day. B: I've had a backache for several days. C: I am urinating more frequently. D: I feel nauseated and have no appetite. D. (Anorexia, N/V and abdominal discomfort are early signs of digoxin toxicity.)

A RN is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understand of the teachings?

A: I will report any loss of appetite. B: Increased flatulence is an indication of toxicity. C: Vomiting is an indication of toxicity. D: I will call my provider if i experience any headaches. C

A Rn is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both nebulizer. Which of the following statements by the client indicates an understanding of the teaching?

A: If my breathing begins to feel tight, i will use cromolyn immediately. B: I will be sure to take the albuterol before taking the cromolyn. C: I will use both meds immediately after exercising. (Rationale: should be before exercise) D: I will administer the meds 10 minutes apart. (Rationale: Inhalants of different meds should be administered 2-5 min apart. ) B

Before giving morphine, what is a priority to check in your client other than pain level?

Respirations. (If 12 or below, do not give)

What education would you give to a client who is receiving eye medications?

You may experience blurry vision, especially at night. Night lights are a good idea. Have someone drive you at night time.

a nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. which of the following instructions should the nurse provide?

a. administer the meds by touching the tip of the dropper to the sclera of the eyes b. hold pressure on the conjunctiva sac for 2 min following application of drops c.. administer the meds 5 mins apart d. it is not necessary to remove contact lenses before administering medications C