Pharm Final NCLEX Questions (based on medlist)
Answer: A Rationale: Aspirin is an antiplatelet medication. A client taking both aspirin and Lovenox could cause excessive bleeding.
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."
b. enoxaparin and low-dose heparin given 6-12 hours preoperatively reduce the incidence of DVT and pulmonary emboli by 60% in clients who are at risk for DVT, such as those who are placed in the lithotomy position.
A client is to receive enoxaparin (Lovenox) 6 hours before the scheduled time of laparoscopic hysterectomy. Which of the following effects does the nurse recognize as an intended therapeutic action of the enoxaparin? a. increase in red blood cell production b. reduction of postoperative thrombi c. decrease in postoperative bleeding d. promotion of tissue healing
kayexalate causes potassium to be exchanged for sodium in the intestines and excreted through bowel movements. If client does not have stools, the drug cannot work properly. Blood pressure and urine output are not of primary importance. The nurse would already expect changes in t waves with hyperkalemia. Normal serum potassium is 3.5 to 5.3 meq/l.
A client with a potassium level of 5.5 mEq/L is to receive Kayexalate. After administering the drug, the priority nursing action is to monitor Urine output. Blood pressure. Bowel movements. ECG for tall, peaked T waves. Bowel movements.
ANSWER: b.) RATIONALE: Nitroglycerin is a vasodilator that will lower blood pressure. The client is having chest pain, and the ST elevation indicates an injury to the myocardium, which may benefit from nitroglycerin. The potassium and heart rate are WNL.
A client with chest pain is prescribed intravenous nitroglycerin. Which assessment is of greatest concern for the nurse initiating the nitroglycerin drip? a.) serum potassium is 3.5 mEq/L (3.5 mmol/L) b.) blood pressure is 88/46 mmHg c.) ST elevation is present on the electrocardiogram d.) heart rate is 61 bpm
D (Pain is what the patient says it is. The nurse should notify the surgeon of the inability to control the patient's pain. People who are narcotic tolerant often require additional opioids to manage the pain associated with surgery. Distraction should not be used to avoid administration of medication in patients in pain.)
A man has an order for morphine sulfate 2 mg intravenously every 2 hours following a cholecystectomy. the patient has a history of IV drug abuse. He reports that his pain is 7 out of 10 (with 10 being the worst) and requests the morphine every hour. what is the nurse's appropriate response? a. to instruct him about possible adverse effects b. to tell him that you can administer the drug only every 2 hours c. to use distraction techniques to help him forget his pain d. to notify the surgeon of his request
B (Naloxone displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, hypertension, and analgesia opiates cause.)
(1) A nurse is caring for a client who has been in the PACU for more than 1 hour and is difficult to arouse. The nurse should anticipate which of the following medication prescriptions? A. Pentazocine (Talwin) B. Naloxone (narcan) C. Naltrexone (Trexan) D. Butorphanol (Stadol)
A (Restlessness is a common side effect of bronchodilators because of central nervous system stimulation.)
(2) A nurse is preparing to administer a bronchodilator to a client who has asthma. Which of the following is a common side effect of these drugs for which the nurse should monitor? A. Restless B. Nystagmus C. Ataxia D. Gingival hyperplasia
C (Descriptive scales are a more objective means of measuring pain intensity. A. Asking the client what precipitates the pain does not assess intensity, but rather is an assessment of the pain pattern. B. Asking the client about the location of pain does not assess the intensity of the client's pain. D. To determine the quality of the client's pain, the nurse may ask open-ended questions to find out about the sensation experienced.)
1.) When assessing the intensity of the pain, the nurse should: A) Ask about what precipitates the pain B) Question the client about the location of the pain C) Offer the client a pain scale to objectify the information D) Use open-ended questions to find out about the sensation
D (Clozapine is associated with agranulocytosis. Therefore, the nurse must instruct the client about the need for weekly blood tests to monitor for this adverse effect.)
1.) When preparing the teaching plan for a client who is to start clozapine, which information is correct to include? a.) description of akathisia and drug-induced parkinsonism b.) measures to relieve episodes of diarrhea c.) the importance of reporting insomnia d.) an emphasis on the need for weekly blood tests
ANSWER; B- Rationale: Iron must be present in order for this medication to be effective. This medication specifically stimulates the growth of RBC's which again it is essential for iron to be present in order for them to grow.
10. The nurse is about to administer Epoetin alfa (epogen) for a patient who has anemia. What is the nurses number one priority when monitoring the patient prior to administering this medication? A. Blood pressure B. Iron levels C. Heart rate D. Neutrophils (ANC)
A (because if this person doesn't get adequate treatment they will get under treated and possibly start using drug seeking behaviors and may also go into withdrawals)
1) how should a nurse manage pain in a client with a history of drug abuse? A)Provide adequate pain relief B)Provide half the pain medication ordered C)Give extra pain medication because this patient will have a increased tolerance D)Don't provide medication because they will become addicted
D (corticosteroid have a side effect of causing hyperglycemia)
1. A client is ordered to receive a high dose of a corticosteroid IV. Which action should the nurse anticipate to include in the client's plan of care? A. Observe the client for hypotension. B. Increase the client's oral fluid intake. C. Restrict the client's potassium intake. D. Monitor the client for hyperglycemia.
Correct answer: 4 Rationale: When administered too quickly through an IV, vancomycin is known to cause red man syndrome. Red man syndrome is characterized by flushing, hypotension, and rash on face, neck, back, and arm
A nurse is administering IV vancomycin to a patient. The nurse knows a side effect that is unique to vancomycin is: 1. Retinal toxicity 2. Neurotoxicity 3. Respiration depression 4. Red man syndrome
D (Due to the risk for fatal agranulocytosis, weekly monitoring of the client's WBC count is recommended. It is not appropriate to increase carbohydrate intake due to increased risk of developing DM. Clozapine has a low risk for hand tremors and it does not cause temporary numbing of the mouth.)
1. A nurse is providing discharge teaching to a client who has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching? a. "You should have a high-carbohydrate snack between meals and at bedtime." b. "You are likely to develop hand tremors if you take this medication for a long period of time." c. "You may experience temporary numbness of your mouth after each dose." d. "You should have your white blood cell count monitored every week."
correct answer is B. Rational... Propranolol inhibits beta-2 receptors in the lungs, leading to bronchospasm and bronchoconstriction. asthma places the patient at an increased risk for bronchospasm and constriction. hypoglycemia, alopecia and insomnia are all side effects associated with beta blockers, but this patient is not at an increased risk.
1. A patient with HTN and Asthma is taking propranolol, which of the following side effects is the patient most at risk to develop? A Alopecia B Bronchospasm C hypoglycemia D insomnia
B
A patient has the flu and is concerned about their fever of 103 degrees F. Which medication would be appropriate to reduce the fever? a. aspirin b. acetaminophen c. indomethacin d. naproxen
(A, B, C, D) (cough, hoarseness, dry mouth, and a risk of developing oral candidiasis are all known side effects of corticosteroids. Corticosteroids are not known to cause fatigue.)
1. A patiënt with emphysema is prescribed a corticosteroid. Which of the following side effects should the nurse instruct the patient about in the discharge instructions? SELECT ALL THAT APPLY A. Cough B. Oral candidiasis C. Hoarseness D. Dry mouth E. Fatigue
c (Respiratory rate is too low)
1. Which of the following situations will cause the nurse to fill an incident report. (a)administering morphine sulfate to a postoperative patient who rates pain of 7 on a pain scale of 0-10 (b)administering acetylcysteine to a patient admitted with acetaminophen overdose (c)administering morphine sulfate to a patient whose respiratory rate is 8 breaths per minute (d)monitoring oxygen saturation on patient on patient controlled analgesics (PCA) pump
a, d, e (Dizziness, tachycardia, and tremors are side effects the nurse should be watching for on this patient.)
A patient in severe respiratory distress is prescribed continuous albuterol nebulizers. Which of the following side effects should the nurse expect? Select all that apply. a) Dizziness b) Urticaria c) Hyperkalemia d) Tachycardia e) Tremors
ANSWER: a. eggs Rationale: A patient that is allergic to eggs or soy should not receive Propofol. The nurse should communicate this to the anesthesia provider
A patient is admitted for a routine colonoscopy and Propofol is the drug of choice for sedation. Which of the following allergies should nurse report to the anesthesia provider? a. eggs b. peanuts c. shrimp d. strawberries
Answer: A & D Levothyroxine should be taken early in the morning to avoid interfering with sleep (side effects: insomnia, anxiety and nervousness) Levothyroxine should not be taken with food to increase absorption. Also, levothyroxine should not be taken within 4hrs of using multivitamins, antacids or iron supplements. It is chelated with certain elements.
A patient recently diagnosed with hypothyroidism is prescribed levothyroxine. The nurse should include which of the following in his teaching plan? select all that apply. A. Do not take with antacid. B. Take at bedtime. C. Take at meal time. D Take early in the morning on an empty stomach.
2 (When a patient is being switched from an oral to an inhaled corticosteroid, the inhaled drug should be started during the tapering of the oral drug. Approximately 1-2 before discontinuing or reaching the lowest anticipated dose of the oral drug)
A patient with a diagnosis of asthma has responded well to treatment with oral corticosteroids and a switch to inhaled corticosteroids is planned. What strategy for managing this change in treatment should be implemented? 1 The inhaled drug should begin 3-4 weeks before starting to taper the oral drug 2 The inhaled drug should be started during tapering of the oral drug 3 The two drugs should be taken simultaneously for 10-12 weeks 4 The patient should stop taking the oral drug approximately 1 week prior to starting the inhaled drug.
A, C, D, E ( Common side effects of beclomethasone and other inhaled corticosteroids include dry mouth, cough, hoarseness, sore throat, nausea, and upset stomach. Local immunosuppression can cause oral candidiasis)
A patient with emphysema is prescribed beclomethasone. Which of the following side effects should the nurse instruct the patient about in the discharge instructions? (select all that apply) A. Cough B. Fatigue C. Dry mouth D. Oral candidiasis E. Hoarseness
Answer: D Rationale:Before giving this medication, the patients INR, aPTT and platelet baseline should be established (and checked again, 2-3 hours after administration). There is a serious risk for brain hemorrhage with this drug; the patients pupils, LOC and signs of IICP should be monitored. This medication is administered IV only. Signs and symptoms of HIT (Heparin Induced Thrombocytopenia) are associated with Heparin.
After administering Activase to a patient, the nurse knows to monitor the patient for: A.) Skin irritation B.) Signs and symptoms of HIT C.) Tachycardia D.) Decreased LOC, dilated pupils
B (Constipation Opioid analgesics commonly cause constipation, especially in the elderly. Bed rest and NPO are also contributing factors for constipation. Nausea is a side effect, but this can be medicated. The nurse would be most concerned about addressing the side effects of constipation, then nausea. Opioids can cause nausea and dizziness, but hypertension is not a side effect.)
An alert and oriented elderly patient is prescribed oral morphine sulphate for acute pain management. The patient is on bed rest and is NPO except for meds. The nurse is MOST concerned about which side effect of oral morphine sulfate? A) Dizziness B) Constipation C) Nausea D) Hypertension
Answer: D Rationale: Ciprofloxacin and other fluoroquinolone antibiotics have a black box warning for the increased risk for tendon rupture. Patients usually experience pain and edema around tendons that may eventually lead to rupture. Patients should be instructed to rest if they experience tendon pain or edema while taking antibiotics in this class.
An elderly patient is prescribed ciprofloxacin for the treatment of a Urinary Tract Infection (UTI). The nurse should inform the patient of which potential most serious side effect? A) Atrial Fibrillation B) Constipation C) Ototoxicity D) Tendon Rupture
d (After administering naloxone, the nurse should monitor the client's respiratory statues carefully because the drug is short acting and respiratory depression may reoccur after its effects wear off. Cerebral edema, kidney failure, and seizure activity are not directly related to opioid overdose or naloxone therapy.)
NCLEX Questions Exam #3 After administering naloxone (Narcan), an opioid antagonist, the nurse should monitor the client carefully for which of the following? A Cerebral edema B Kidney failure C Seizure activity D Respiratory depression
B (The chance of excessive cns and cardiac simulations goes up with asthma medications if the patient drinks caffeine.)
Nurse if providing teaching about the asthma medication that has been prescribed. What statement by the patient indicates the need for more teaching? A "I'll take montelukast (singulair) pill before I work out so I can worry less about an asthma attack while working out B "Since I'm quitting smoking, I'm glad I'll have my coffee to look forward to every morning" C "I'll keep my albuterol with me at all time, and only use it if I have an asthma attack" D "I'm glad I changed from a beta-blocker to an arb!"
4 ( Corticosteroids are contraindicated in fungal infections)
Patients taking corticosteroid medication should be asked about any recent history of? 1 Antidepressant use 2 Cognitive disorders 3 Urinary incontinence 4 Infections
Answer: B (Fluoxetine should not have been prescribed for this patient because he has a history of attempted suicides. Although drinking alcohol can enhance sedation, it is still okay to drink alcohol as long as it is in moderation. Explaining that the medication takes 2 weeks to take effect is a true statement, but his is not the best choice.)
Question 2: You are working with a 23-year-old patient who has a history of suicide attempts and depression. He was prescribed Fluoxetine (Prozac) a week ago and is back at the clinic. During the assessment he explains that his depression has not changed, and that he has started drinking lately (in moderation) to help cope. How should the nurse respond? A Explain to the patient that he cannot drink alcohol with Fluoxetine (even in moderation) because it can cause serious side effects. B Call the provider and recommend discontinuing this medication. C Explain to the patient that the medication takes up to 2 weeks to take effect. D Explain the risks of drinking alcohol with this medication and that the medication takes 2 weeks to take effect.
1 (lithium has a therapeutic lag time of 1-2weeks. Haloperidol is prescribed temporarily to produce a neuroleptic effect and discontinued when the lithium starts to take effect. )
The client with acute mania is prescribed 500mg lithium PO three times a day. The healthcare provider also prescribes 5mg of haloperidol PO for bedtime. Which action should the nurse take? 1. Administer the medications as prescribed 2. Question the Healthcare provider about the prescription 3. Administer the haloperidol but not the lithium 4. Consult with the nursing supervisor before administering the medications
2 ( The presence of dizziness could indicate orthostatic hypotension which may place the patient at risk for falls)
The healthcare provider prescribes fluoxetine to a 72 year old patient with depression. Which transient adverse effect requires immediate attention by the nurse? 1. Nausea 2. Dizziness 3. Sedation 4. Dry mouth
The answer is B. Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia.
The most dangerous metabolic side effect of general anesthesia that can occur during surgery is: a. hyperglycemia b. hyperthermia c. hypoglycemia d. hypothermia
Answer is A. It is essential to monitor patients receiving calcium intravenously for cardiac dysrhythmias
The nurse is administering a continuous IV infusion of calcium properly diluted in a compatible IV fluid. Which one of the following would it be most important for the nurse to monitor? A. cardiac rhythm B. urine output C. hearing changes D. musculoskeletal pain
a, d (The client should shake the inhaler and hold it upright when administering the drug. The head should be tilted back slightly. The client should wait about 1-2 minutes between puffs. The mouth should be rinsed following the use of a corticosteroid MDI to decrease the likelihood of developing an oral infection. The client does not need to lie supine; instead, the client will likely be able to breathe more freely if sitting upright.)
The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a corticosteroid. Which of the following indicates that the client is using the MDI correctly? Select all that apply. A The inhaler is held upright B The head is tilted down while inhaling the medicine C The client waits 5 minutes between puffs D The client rinses the mouth with water following administration E The client lies supine for 15 minutes following administration
d (Decreased ammonia levels Rationale: Hepatic encephalopathy is a complication of liver failure and is associated with elevated serum ammonia levels. Lactulose traps ammonia in the intestinal tract and also has a laxative effect that helps remove it from the body as stool. This lowers ammonia levels in the body and can reduce symptoms of hepatic encephalopathy)
The provider orders lactulose for a patient with hepatic encephalopathy. Which of the following assessment findings indicates to the nurse that this medication has been effective? a Relief of abdominal pain b Relief of constipation c Decreased liver enzymes d Decreased ammonia levels
1, 3, 4 (AST, Bilirubin, and PT are all tests that measure liver function. ESR is a test to measure inflammation. A1C is a test to measure long-term glucose levels.)
What are some labs the nurse should watch for when giving acetaminophen to an alcoholic with severe liver damage? Select all that apply. 1 AST 2 ESR 3 Bilirubin 4 PT 5 A1C
A. Alteplase (Activase) can cause bleeding as well as reperfusion dysrhythmias. Alteplase does not directly affect liver enzymes. Vitamin K will not reverse the effects of Activase. Vital sign changes can alert the nurse to complications; however, a blood pressure below 110 systolic is not, in itself, cause for alarm.
What nursing intervention is essential for the client receiving alteplase [thombolytic]? A) a. Assess for reperfusion dysrhythmias. B) b. Monitor liver enzymes. C) c. Administer vitamin K if bruising is observed. D) d. Monitor blood pressure and stop the medication if blood pressure drops below 110 systolic.
Answer C is correct. Lasix is a non-potassium-sparing diuretic. This drug can potentiate fluid volume deficit. Answer A is incorrect because insulin will force fluid back into the cell and will not increase fluid volume deficit. Answer B is incorrect because Inderal (propanolol) is a beta blocker used for the treatment of hypertension and cardiac disease. Inderal does not potentiate diuresis. Answer D is incorrect because is a phenothiazine used as an anti-anxiety medication. This drug does not potentiate fluid volume deficit.
Which medication can potentiate a fluid volume deficit? A. Insulin B. Inderal (propanolol) C. Lasix (furosemide) D. Valium (diazepam)
Answer: D) It is large and negatively charged and cannot cross the membrane to be absorbed
Why can't Heparin be administered orally? A) It is large B) It contains too much magnesium C) It is negatively charged D) A and C E) All of the above
Answer 2: Propranolol blocks beta-adrenergic receptors in various organs and thereby controls symptoms of hyperthyroidism from excessive stimulation of the SNS. These symptoms include tachycardia, palpitations, excessive sweating, tremors, and nervousness.
Why would a patient be taking propranolol with hyperthyroidism? Increases T4 conversion to T3 in the hypothalamus Controls symptoms of hyperthyroidism due to excessive stimulation of SNS Enhances acidity buffer in the jejunum Decreases metabolic rate and increases O2 consumption by the CNS
B. (Loss of salt leads to an increased risk of adverse effects while taking lithium carbonate so a low sodium diet would not be advised. Maintaining adequate hydration, avoiding excessive sweating to avoid salt loss, and use of birth control while are all appropriate while taking lithium carbonate.)
You are caring for a client with bipolar disorder you know they need further education in regards to use of lithium carbonate when... A.They state they will be sure to drink 8 to 12 glasses of water per day. B. Will cut back their sodium intake. C. Will avoid using the sauna when they swim at the gym. D. Will use birth control
Answer: C. assessing the patients legs for sensation rational: A. apart of the routine assessment, but not the highest priority B. dressing should be assessed every 4 hours D. the patient does not need to be on a flat bed rest and may ambulate, also not a assessment.
he nurse is assessing a patient receiving epidural analgesia after a total knee replacement. Which of the following is the priority assessment? A. assessing peripheral pulses B. assessing the epidural dressing every shift C. Assessing the patient's legs for sensation D. keeping the patient supine on bed rest
CORRECT: A - Propofol (Diprivan) is the only anesthetic that does not trigger malignant hyperthermia reactions.
he nurse is assisting with the preparation of a surgical patient with a history of malignant hyperthermia. Which of the following anesthetic's does the nurse advocate the use for? A. Propofol (Diprivan) B. Vecuronium C. Succinycholine D. Isoflurane (Forane)
answer: 2- this is the correct time line for therapeutic effects and you are giving the family factual information while asking them to be patient 1-this is not true 3-this is not needed 4- this may be true, but does not address the daughter's concern about the drug or give her more useful information
he patient's daughter is concerned that the newly prescribed Levodopa has not improved her 89 year old father's shuffling gait after 4 days. What is the nurses' best response? 1. "A shuffling gait is inevitable at his age." 2. "Signs of improvement may take 2-3 weeks, possibly up to 6 months to appear." 3. "Let me call the provider to get the order changed." 4. "Parkinson's is very hard to treat."
A (is correct: The client who is taking lithium needs an adequate intake of sodium and fluid to prevent the development of lithium toxicity.)
which of the following findings is a factor in the development of lithium toxicity? A. Hyponatremia B. Hypercalcemia C. Hypocalcaemia D. Hypernatremia
A (Restlessness is a common side effect of bronchodilators because of central nervous system stimulation.)
A nurse is preparing to to administer a bronchodilator to a client who has asthma. Which of the following is a common side effect of these drugs for which the nurse should monitor? A Restlessness B Ataxia C Nystagmus
Answer: D Rationale: Hypokalemia heightens sensitivity to digoxin, predisposing the client to digoxin toxicity. The other imbalances are usually not related to or found in clients receiving digoxin unless there is another underlying cause.
11. A client is receiving digoxin (Lanoxin) 0.25 mg PO daily. The nurse should assess this client for which electrolyte imbalance? A. Hyponatremia B. Hypernatremia C. Hyperkalemia D. Hypokalemia
Answer: D. 2.0 is outside the normal limits for creatinine, and is an indicator of renal insufficiency. However, atenolol is well tolerated in patients with renal impairment.
12. A patient us to receive atenolol for his angina.. The nurse gets labs back that included a creatinine score of 2.0. The nurse also noted that the BP was 100/60 and a heart rate of 64. Because of this, the nurse will: A) Withhold the medication because the BP was too low. B) Withhold the medication because the HR was too low. C) Question the provider about the dose due to the creatinine score. D) Administer the medication as ordered.
ANSWER; C. is the most accurate, as well as therapeutic answer.
13. While Providing care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. The best response is: A. As you urinate more you will need less medication to control fluid. B. You will have to take this medication for about a year. C. The medication must be continued so the fluid problem is controlled. D. Please talk to your physician about medications and treatments.
Correct answer: B Rationale: Propranolol is used to slow the ventricular rate in atrial fibrillation -Atropine may be administered for bradycardia or in AV block -Epinephrine is administered to treat bronchospasm, cardiac arrest, and heart block -Phenytoin (dilantin) is used to treat digoxin-induced ventricular dysrhythmias
15. A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering for atrial fibrillation A. Atropine B. Propranolol (inderal) C. Epinephrine D. phenytoin (dilantin)
Answer: A When two medications are used to treat HTN, each medication should be from different drug classifications. Atenolol and metroprolol are both beta-adrenergic blockers and would essentially have the same mechanism of action. Metolazone is a thiazde-like diuretic, and valsartan is an angiotensin II receptor blocker (ARB). Captopril is an angiotensin converting enzyme (ACE) inhibitor, and furosemide is a loop diuretic. Bumetanide is a loop diuretic, and diltiazem is a calcium channel blocker. **Recall that beta blockers end in "LOL". Use this as a cue to identify the two medications that are within the same drug classification and would be inappropriately prescribed.
19. A health care provider (HCP) adds a second medication for blood pressure control for a client whose blood pressure has not been well-controlled with one antihypertensive medication. If the HCP orders the following medication combinations, which combination should the nurse question? A. Atenolol (Tenormin) and metoprolol (Lopressor) B. Metolazone (Zaroxolyn) and valsartan (Diovan) C. Captopril (Capoten) and furosemide (Lasix) D. Bumetanide (Bumex) and diltiazem (Cardizem)
A
2) Frequent use of bronchodilators may cause all the following side effects except: a. blurred vision b. increased heart rate c. nervousness d. tremors
A,C,D (with this drug there is a increase in suicidal ideations in children adolescents and young adults. serotonin syndrome is a side effect of this drug characterized by hypertensive crisis.)
2) when a nurse is administering fluoxetine (Prozac) for the treatment of depression what should the nurse assess for? (select all that apply) A)increased suicidal ideations in young adults? B)respiratory depression C)serotonin syndrome D)Hypertensive crisis E)Monitor ECG
C (clozapine has been known to cause agranulocytosis)
2. A client with chronic schizophrenia is receiving clozapine. Which of the following should a nurse be most concerned with monitoring? A. Sodium B. Potassium C. White blood cell count D. Hemoglobin and hematocrit
(A Acetylcysteine is the correct antidote for Acetaminophen overdose. Narcan is for opioid overdose, Flumazenil is for Diazepam overdose and Dantrium is for Malignant Hyperthermia.)
2. A nurse is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? a. Acetylcysteine b. Narcan c. Flumazenil d. Dantrium (Dantrolene Sodium)
D (Pain management of a burn patient should be through the use of IV opioids, typically morphine. )
2. A nurse is caring for a critical burn patient. The patient is suffering from intense pain and requires medication. The nurse should expect the physician to prescribe which of the following? A. Fentanyl patch B. Hydromorphone, intranasal C. Oxycodone via nasogastric tube D. Morphine sulfate, IV
B (When a client is prescribed an inhaled beta 2-agonist (such as albuterol) and an inhaled glucocorticoid (such as betomethasone) the client should take the beta 2-agonist first, it promotes bronchodilation and enhances absorption of the glucocorticoid.)
2. A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. which of the following instructions should the nurse include in the teaching? a.) Take the albuterol at the same time each day. b.) Administer the albuterol inhaler prior to using the beclomethasone inhaler. c.) Use beclomethasone if experiencing an acute episode. d.) Avoid shaking the beclomethasone before use.
C (Lithium should be taken with meals, Tylenol is generally safe for use with lithium, and the effects of lithium begin in 5-7 days, and full therapeutic affects may take 2-3 weeks to develop. C is correct because the nurse should encourage the client to maintain adequate dietary intake of sodium because decreased levels can result in lithium toxicity.)
2. A nurse is reinforcing teaching with a client prescribed lithium (Eskalith). Which of the following statements indicates a need for further teaching? A. "I should take my medication with meals" B. "I can take Tylenol for headaches" C. "I need to limit my salt intake with this medication" D. "I should feel better in about 2-3 weeks"
C (Naloxone (Narcan) is an opioid antagonist (blocks receptors. It counteracts the overdose. However, in conditions of extreme pain, Narcan should be given in small increments to avoid a complete loss of pain control. )
2. For an overdose of morphine sulfate, which drug should the nurse have on hand as an antidote? A. phenytoin (Dilantin) B. tramadol (Ultram) C. naloxone (Narcan) D. atropine sulfate (Atropine)
ANSWER: C. Take this medication with food. A. Protein-rich food should be avoided as they decrease the therapeutic effects of the drug. B. Muscle twitching can indicate toxicity. Monitor & report. D. Relief may take several weeks.
A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich food B. Expect muscle twitching to occur C. Take this medication with food D. Anticipate relief of manifestations in 24 hours.
B (Acetaminophen is extensively metabolized by pathways in the liver. Toxic doses of acetaminophen deplete hepatic glutathione, resulting in accumulation of the intermediate agent, quinine, which leads to hepatic necrosis. Prolonged use of acetaminophen may result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.)
2. Walter, teenage patient is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs? a. Lungs b. Liver c. Kidney d. Adrenal Glands
A (It is recommended that systemic corticosteroid medications be administered on alternate days. The dose administered is two times the normal daily dose)
2. When administering long-term systemic corticosteroid medications, which of the following dosing schedules is recommended? a. alternate-day therapy b. once daily at noon c. weekly therapy d. nightly therapy .
C (Corticosteroids have an ant-inflammatory effect and act to decrease edema in the bronchial airways and decrease mucus secretion. Corticosteroids do not have a bronchodilator effect, act as expectorants, or prevent respiratory infections.)
2.) A client with acute asthma is prescribed short-term corticosteroid therapy. Which is the expected outcome for the use of steroids in clients with asthma? a.) promote bronchodilation b.) act as an expectorant c.) have an anti-inflammatory effect d.) prevent development of respiratory infections
Answer: C Epoetin alfa (Epogen) is the prototype recombinant form of human erythropoietin that helps the body make more RBCs.
21. The expected outcome of administering Epogen to a patient with chronic renal failure is? A. decreased bleeding B. increased white blood cell production C. increased red blood cell production D. improved renal function
Answer: B Rationale: Steroids can cause hyperglycemia because of their effects on carbohydrate metabolism, making diabetic control more difficult. Aspirin is not known to affect glucose metabolism. Sulfonylureas are oral hypoglycemic agents used in the treatment of diabetes mellitus. ACE inhibitors are not known to affect glucose metabolism.
22. The nurse is assessing the client's understanding of the use of medications. Which medication may cause a complication with the treatment plan of a client with diabetes? A. Aspirin B. Corticosteroids C. Sulfonylureas D. Angiotensin-Converting Enzyme (ACE) Inhibitors
Answer: B, D, E Diaphoresis is a sympathetic nervous system response to hypoglycemia. Palpitations and a bounding heart rate are manifestations of stimulation of the sympathetic nervous system. Shakiness is due to stimulation of the sympathetic nervous system in response to hypoglycemia. In hypoglycemia, tachycardia and an increase in BP are expected due to stimulation of the sympathetic nervous system.
23. A nurse is planning to educate a client who has diabetes mellitus about adverse effects of insulin. Which of the following are associated with hypoglycemia? (select all that apply.) A. Bradycardia B. Diaphoresis C. Lowered blood pressure D. Palpitations E. Shakiness
c Hypersensitivity to sulfa is a no no for Glyburide (DiaBeta)
25. A nurse is providing care for a patient who was recently diagnosed with type 2 diabetes. He notices from the patient's charts that she is allergic to sulfa and is now questioning the order of a newly prescribed oral antidiabetic. Which medication is he questioning? a.) Metformin (Glucophage) b.) Sitagliptin (Januvia) c.) Glyburide (DiaBeta) d.) Rosiglitazone (Avandia)
ANSWER: A and D Rationale: ACE inhibitors have potent effects on the renin angiotensin-aldosterone system (RAAS) which regulates water and sodium reabsorption and has an indirect effect on blood pressure. ACE inhibitors have cardiovascular and renal benefits and are often first-line agents for treating hypertension. ACE inhibitors block the action of angiotensin-converting enzyme and prevent the production of angiotensin II, which then inhibits the secretion of aldosterone and leads to the excretion of sodium and water (diuresis). Aldosterone is responsible for sodium and water retention in the kidneys. It is stimulated by angiotensin II-a potent vasoconstrictor. Blocking both through inhibition of the angiotensin-converting enzyme, leads to decreased systematic vascular resistance (SVR), decreased cardiac after load, and lower blood pressure.
26. The patient has been prescribed enalapril for hypertension. The patient asks the nurse how the medication lowers blood pressure. The nurse understands that ACE inhibitors lower blood pressure by...(select all that apply). a) Decreasing systematic vascular resistance b) Decreasing heart rate c) Inhibiting epinephrine d) Preventing sodium resorption e) Increasing vasoconstriction
Answer: C Rationale: Digoxin should be held for pulse less than 60; the goal of therapy for atrial fibrillation is to eliminate a pulse deficit. Digoxin should be given with food to avoid GI upset, nausea and vomiting. The Apical pulse should be counted for 1 full minute at the point of maximal impulse (PMI). The same brand should be administered if possible because different brands have different concentrations and bioavailability.
4. The nurse should do the following before administering Digoxin via IV Push, to a 65-year-old patient with atrial fibrillation EXCEPT: A.) Give with food B.) Count the Apical pulse for 1 full minute C.) Increase the dose if pulse is less than 60 BPM D) Determine the brand the patient was taking at home
Answer: D- An increase in three areas: thirst, intake of fluids, and hunger RATIONAL The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger).
5. When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation? a. Excessive intake of calories, rapid weight gain, and difficulty losing weight b. Poor circulation, wound healing, and leg ulcers, c. Lack of energy, weight gain, and depression d. An increase in three areas: thirst, intake of fluids, and hunger
Answer and Rationale: B - Isotretinoin is a metabolite of Vitamin A and can result in additive toxicity with concurrent use of Vitamin A supplements or a diet rich in Vitamin A foods. The client should be advised to discontinue use of Vitamin A supplements and limit Vit A rich foods (sweet potato, carrots, broccoli), which taking Accutane.
7. A 20 year old female college student with severe acne was prescribed isotretinoin (Accutane) by her physician in the clinic. Which statement by the client indicates a further need for teaching by the nurse? A. "I will come to the clinic monthly for evaluation, counseling, and education according to the iPLEDGE program while taking Accutane." B. "I should continue using my oral Vitamin A supplements to improve the effectiveness of Accutane." C. "Accutane can cause photosensitivity reactions so I should apply sunscreen daily." D. "I should contact the clinic if I begin experiencing depression or suicidal thoughts."
Answer: A Rationale: Propranolol hydrochloride is a beta-adrenergic blocking agent. Actions of propranolol hydrochloride include reducing heart rate, decreasing myocardial contractility, and slowing conduction.
8. When teaching a client about propranolol hydrochloride, the nurse should base the information on the knowledge that propranolol hydrochloride: A) Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction. B) Increases norepinephrine secretion and thus decreases blood pressure and heart rate. C) Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure. D) Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II.
ANSWER; B- Rationale: (Hyperkalemia) can be effectivley treated with insulin and 50% dextrose, insulin will shift K+ from the ECF to the ICF and the dextrose will prevent hypoglycemia.
9. The physician orders 10 units of regular insulin IV and 50 ml dextrose 50% STAT. Which of the following is the physician most likely attempting to correct? A: Hyperglycemia B: Hyperkalemia C: Hypokalemia D: Hyponatremia
C( Albuterol is contraindicated with the presence of an abnormal heart beat because it increases the heart rate.)
A 24 year old man with asthma has just been prescribed an albuterol inhaler as needed. The nurse reviewing the chart is concerned about this prescription noting the patient has a diagnosis of what condition? a. Cushing's b. Hypotension c. cardiac dysrhythmia d. sleep apnea
C (Rationale: Similar to an antibiotic, it is a common mistake for people to think that once the symptoms go away the medication does not need to be taken anymore. However, for a full therapeutic effect, medications should be taken for the entire duration that they are prescribed.)
A 25-year-old female was recently diagnosed with Bipolar disorder. Which of the following statements would indicate to the nurse that the patient needs more education? a. "The doctor is going to prescribe me a low dose of Lithium first, and may increase the dose if he feels it's needed" b. "I will need to have my lithium levels checked periodically to make sure my levels don't get too high." c. "I only have to take Lithium for a few weeks until my symptoms subside" d. "Lithium is going to help treat my manic episodes."
Answer: D The main use of a Thrombolytic agents is for management of acute, severe thromboembolic disease, such as myocardial infarction or pulmonary embolism.
A 73-year-old man has been admitted to the emergency department with severe chest pain. Onset of symptoms is within the last 60 minutes. What medication would you expect the physician to order for his acute disorder? A) Anticoagulant drugs B) Direct thrombin inhibitor drugs C) Antiplatelet drugs D) Thrombolytic drugs
B
A manic patient has been taking lithium for 9 months. When the patient's serum laboratory results are complete, the nurse should compare the patient's lithium levels to what therapeutic range? A. 0.2-0.8 mEq/L B. 0.6-1.2 mEq/L C. 1.2-2 mEq/L D. 2.4-3.2 mEq/L
Answer: A,B,D Rationale: Propofol infusion syndrome (PRIS) is a rare but extremely dangerous complication associated with prolonged, high-dose infusions. Manifestations have a sudden onset and include severe metabolic acidosis, cardiac arrhythmias, hyperkalemia, lipemia, hepatomegaly, and acute kidney injury.
A nurse caring for a mechanically ventilated patient who is sedated for a prolonged time with a high dose of propofol knows to monitor for what adverse effect(s)? Select all that apply. A. Arrhythmias B. Hyperkalemia C. Hypokalemia D. Metabolic acidosis E. Respiratory acidosis
Answer 3. The nurse should hold the med if resting HR is above 100 because it increases the body's metabolic rate which would just increase the HR more
A nurse is administering Levothyroxine (Syndthroid) to a patient with hypothyroidism. When should the nurse not administer this medication? 1. If the patient is dehydrated 2. If the patient has a BP of 100/50 3. If the patients resting heart rate is more than 100 bpm 4. none of the above
A. Acetylcysteine (Acetylcysteine is the antidote for acetaminophen. Narcan is the antidote for opioids. Flumazenil is the antidote for diazepam. Naltrexone is used to treat symptoms of alcohol and opiate withdrawal.)
A nurse is admitting a toddler to the hospital after an acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? A Acetylcysteine B Narcan C Flumazenil D Naltrexone
2. (This is the most correct answer out of the choices because lactulose is a laxative that will help reduce constipation. However, what's unique about this specific laxative is that it also can decrease ammonia levels. This is super important for a patient with cirrhosis who is showing signs of decreased cognition because they could be experiencing hepatic encepalopathy which happens from increased ammonia levels. Incorrect answers: Mylanta is used for GERD, and the other laxatives do not have the capability of decreasing ammonia and therefore it's in the patients best interest to use a medication that can treat both symptoms. )
A nurse is caring for a an older adult who has been admitted for cirrhosis, with signs of decreased cognition and now has developed constipation due to immobility. Which GI medication would be most effective in treating this patient with these conditions? 1. Pysyllium (Metamucil) 2. Lactulose 3. Saline cahartics (Miralax) 4. Mylanta
A ( The patient reports taking less than the recommended total daily dose for Acetaminophen (< 4000 mg), but it is necessary to find out if they may be taking other OTC medications that may contain further Acetaminophen. Further information is needed before action can be taken.)
A nurse is performing medication reconciliation with a patient. The client complains of a severe headache and states that they have been taking 600-800 mg of Acetaminophen every 6 hours for the past 3 days. What is the first thing the nurse should do? A. Ask the patient what other OTC medications they have been taking. B. Stop and assess the patient for adverse symptoms from taking more than the recommended daily limit for this medication. C. Consult with the provider about ordering a prescription medication to help control the patients pain D. Educate the patient about the complications associated with taking too much Acetaminophen.
A (The client needs specific information about the effects of the drug, specifically its effect on the blood. The statement about weekly blood tests to determine safe dosage and monitoring for effects on the blood gives the client specific information to ensure follow up with the required protocol for Clorazil therapy. Lack of accurate knowledge can lead to noncompliance with necessary follow-up procedures and noncompliance with medication. It is also true that the medication is given out only in a one week supply and the provider will want to know how well the patient is progressing, but the correct response is one that will help the client understand and thereby follow through with appointments.)
A nurse is teaching a patient with severe schizophrenia about Clozaril (clozapine). The patient questions why he needs to return in 1 weeks time for blood work. Which of the following is the most appropriate nursing response? A) "Weekly blood test are necessary to determine safe dosage and to monitor the effect of the medication on the blood." B) "Your physician will want to know how well you are progressing with the medication therapy." C) "Everyone taking Clozapine has to go through the same procedure because it is required by the drug company." D) "Weekly blood tests are done so that you can receive another week's supply of the medication."
c. Protamine Sulfate Rationale: The antidote for Heparin is Protamine Sulfate
A patient being treated for a DVT is receiving IV Heparin and they begin to vomit blood. After stopping the IV Heparin, the nurse knows to administer which of the following medications? a. Vitamin K b. Atropine c. Protamine Sulfate d. Calcium Guconate
Correct answer D Rationale: Patients on Heparin are at an increased risk for bleeding and tarry stools is a sign of bleeding.
A patient diagnosed with a pulmonary embolism is receiving an IV Heparin infusion. Which of the following indicates a complication of therapy for which the nurse should monitor? Lethargy Shortness of breath Hyperglycemia Tarry stools
4 ( Usually you need to avoid certain meds for 14 days before taking a MAO Inhibitor. While most SSRIs only need 14 days, fluoxetine needs 5 weeks to be cleared before you can take a MAO inhibitor. for number 2, if the patient ate certain cheeses that contained tyramine, that would cause concern, but since he does not, it's not a concern.)
A patient has received a prescription for a MAO Inhibitor. The nurse is reviewing the patient's medical history. Which finding made the nurse question the provider on the oder. 1) Patient stopped taking albuterol 3 weeks ago 2) Patient is lactose intolerant, and he specifically avoids cheese 3) Patient stopped taking lithium 3 weeks ago 4) Patient stopped taking fluoxetine 3 weeks ago.
a) in the morning to prevent insomnia Levothyroxine (Synthroid) is a synthetic thyroid hormone that increases cellular metabolism. Levothyroxine should be given in the morning in a single dose to prevent insomnia and should be given at the same time each day to maintain an adequate drug level. Therefore, options B, C, and D are incorrect.
A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to administer this medication: a) in the morning to prevent insomnia b) only when the client complains of fatigue and cold intolerance c) at various times during the day to prevent tolerance from occurring d) three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels
C ( the client should wait 5-10 mins after using albuterol to allow for it to open the constricted airways so the corticosteroid inhaler can be effective.)
A woman begins using an albuterol inhaler and a beclomethasone inhaler for her asthma. Which statement by the client indicates further teaching is necessary? A) I use the albuterol inhaler first. After 5-10 minutes I use my beclomethasone inhaler. B) I should rinse my mouth with warm tap water after using my inhalers. C) I use my albuterol inhaler first then immediately use my beclomethasone inhaler. D) I can only use my albuterol inhaler when I am having an acute asthma attack.
Answer: 1 Ciprofloxacin is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided. Bismuth subsalicylate also decreases the absorption of ciprofloxacin and should be avoided. Extended release ciprofloxacin significantly reduces the frequency of nausea and diarrhea. Fennel will decrease the absorption of the ciprofloxacin. Dietary calcium can be taken at any ttime; it is unaffected by ciprofloxacin.
Ciprofloxacin is prescribed for a client to treat a urinary tract infection. Which point should a nurse stress when teaching the client about the medication? 1. Avoid taking ciprofloxacin with milk or yogurt 2. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate 3. Avoid fennel because it will increase the absorption of the ciprofloxacin 4. Take dietary calcium tablets 1 hour before or 2 hours after ciprofloxacin
2. (Instruct the client to stop taking the SSRI Serotonin syndrome is a serious complication of SSRIs that produces mental changes (confusion, anxiety, and restlessness), hypertension, tremors, sweating, hyperpyrexia (elevated temperature), and ataxia. Conservation treatment includes stopping the SSRI and supportive treatment. If untreated, ESE can lead to death)
The client with a major depressive disorder taking the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling confused and restless and having an elevated temperature. Which action should the psychiatric nurse take? 1. Determine if the client has flulike symptoms 2. Instruct the client to stop taking the SSRI 3. Recommend the client take the medication at night. 4. Explain that these are expected side effects
1
The client with deep vein thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following? 1. Activated partial thromboplastin time (aPTT) 2. Prothrombin time (PT) 3. Platelet counts 4. International normalized ratio (INR)
b (Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later.)
The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later. c. Administer each inhaler at 30-minute intervals. d. Administer beclomethasone first, wait 2 minutes, and administer ipratropium bromide, followed by the albuterol several minutes later.
C (pH testing is used to evaluate the quantity, frequency and duration of acid-reflux episodes. The minimal acceptable pH with antacid therapy is 3.5.)
The nurse is caring for a patient who is taking Mylanta to treat GERD and requires pH testing. The minimal acceptable gastric pH level is A. 1.5 B. 4.0 C. 3.5 D. 3.0
Answers: A, C, D Rationale: A is correct because calcium is irritating to tissue and needs to be diluted prior to administration to prevent tissue damage B is incorrect because calcium should be taken with food, and there is no need to restrict food after C is correct because calcium increases the risk for Digoxin toxicity D is correct because hypercalcemia can cause dysrhythmias
The nurse is preparing to administer calcium to a patient experiencing hypocalcemia. Which of the following actions should the nurse take? Select all that apply. A.) Ensure the calcium IV solution is diluted B.) Advise the patient they are unable to eat solid food for 12 hours after administration C.) Advise the provider the patient is taking Digoxin prior to administration D.) Prepare to monitor the patient's heart rate and ECG after administration
2 (The most common side effects related to this medication include CNS and GI system dysfunction. Fluoxetine affects the GI system by causing nausea and vomiting, cramping, and diarrhea. CV symptoms, dry mouth, and excessive sweating are not side effects associated with this medication.)
The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side/adverse effects of the medication? 1. Cardiovascular symptoms 2. GI symptoms 3. Problems with mouth dryness 4. Problems with excessive sweating
B (Rationale: the nurse should hold the 1700 hours dose of lithium because a level of 1.8 mEq can cause adverse reactions. the nurse should report this lithium level to the health care provider and monitor the patient for signs of lithium toxicity.)
The nurse is reviewing the laboratory report with the client's lithium level prior to administrating the 1700 hours dose. The lithium level is 1.8mEq/L. The nurse should: A. administer the 1700 hours dose of lithium B. hold the 1700 hours dose of lithium C. give the client 240 mL of water with the lithium D. give the lithium after the client's supper
B (Rationale: the nurse should hold the 1700 hours dose of lithium because a level of 1.8 mEq can cause adverse reactions. the nurse should report this lithium level to the health care provider and monitor the patient for signs of lithium toxicity.)
The nurse is reviewing the laboratory report with the client's lithium level prior to administrating the 1700 hours dose. The lithium level is 1.8mEq/L. The nurse should: A. administer the 1700 hours dose of lithium B. hold the 1700 hours dose of lithium C. give the client 240 mL of water with the lithium D. give the lithium after the client's supper
Answer: A & B, both is derived from porcine
The nurse understands that a patient with a coagulant disorder is strongly against the consumption of pork. which of these medications will the nurse not recommend? A. Heparin b. Lovenox c. Coumadin d. Argatroban
Answer: D Rationale: Lepirudin (Refludan) is used with acute coronary syndrome and HIT only. It does not use for all patients needing anticoagulant therapy. This drug and other DTIs are less suitable for long-term treatment because administration by injection only, therapeutic drug monitoring is not widely available, and no pharmacologic antidote to reverse the effects is available.
The patient is newly admitted with acute coronary syndrome and he has history of HIT. What treatment will the nurse expect the order from the provider? A. Heparin B. Levenox C. Coumadin D. Lipirudin
C (Rationale: The nurse should monitor the clients respirations closely for 4 to 6 hours because naloxone has a shorter duration of action than opioids. The client may need repeated doses of naloxone to prevent or treat a recurrence of the respiratory depression. Naloxone is usually effective in a few minutes; however, its effects last only 1 to 2 hours and ongoing monitoring of the clients respiration's is necessary. )
The physician ordered I.V. naloxone (Narcan) to reverse the respiratory depression from morphine administration. After administration of the naloxone the nurse should: A) Check Respirations in 5 minutes because naloxone is immediately effective in relieving respiratory depression. B) Check respirations in 30 minutes because the effects of morphine will have worn off by then. C) Monitor respirations frequently for 4 to 6 hours because the client may need repeated doses of naloxone D) Monitor respirations each time the client receives morphine sulfate 10 mg I.M.
2. (periodic laboratory monitoring of renal and thyroid function Two major long-term risks of lithium therapy are hypothyroidism and impairment of the kidney's ability to concentrate urine; therefore, a person receiving lithium therapy must have periodic follow-ups to assess thyroid and renal function. Weight gain and fine tremors are common side effects associated with this medication, but the patient should continue taking the medication. Sodium intake for clients who take lithium is not restricted.)
The plan of care for a patient who takes lithium (Lithobid) should include: 1. dietary teaching to restrict daily sodium intake 2. periodic laboratory monitoring of renal and thyroid function 3. the requirement for laboratory tests to monitor serum potassium level 4. the importance of discontinuing the medication if fine hand tremor occurs
