Pharm (Questions) (Non-psych)

B (is an anticholinergic) (decreasing spasms - decreased pain)

A client with cholecystitis is taking propantheline bromide. What should the nurse tell the client to expect as a result of taking this drug? a) increased bile production b) decreased biliary spasm c) absence of infection d) relief from nausea

B

A client with chronic alcohol use is admitted to the hospital for detoxification. Later that day, the client's blood pressure increases and the client is given lorazepam to prevent: a) stroke. b) seizure. c) fainting. d) anxiety reaction.

A (to eliminate barium)

A client with colon cancer is having a barium enema. The nurse should instruct the client to take which type of medication after the procedure is completed? a) laxative b) demulcent c) anticholinergic d) antacid

D (A - Fe can cause constipation, not diarrhea. B is normal. C does not occur with Fe)

A client with iron-deficiency anemia is prescribed liquid iron supplements. The nurse evaluates the client's understanding of how to take this drug. Which statement indicates the client has adequate knowledge? a) "I can use antidiarrheal drugs if I develop diarrhea." b) "I will report any black stools to the health care provider." c) "I will check my gums for any bleeding." d) "I will dilute the medication and drink it with a straw."

A

A client at 33 weeks' gestation is leaking amniotic fluid. She is placed on an external fetal monitor. The monitor indicates uterine irritability, and contractions are occurring every 4 to 6 minutes. The provider orders nifedipine 20 mg po now and every 8 hours until birth or contractions cease. What is the most important information for the nurse to teach this client concerning nifedipine? a) "You may experience nausea and some dizziness." b) "This medicine will ensure that you do not deliver early." c) "You will usually feel a fluttering or tight sensation in your chest." d) "This will dry your mouth and make you feel thirsty."

B

A client develops atrial fibrillation following an acute myocardial infarction. The physician orders digoxin, 0.125 mg I.M. daily. The nurse clarifies the order with the physician because I.M. administration of digoxin leads to a) a decreased serum CK level. b) an increased serum creatine kinase (CK) level. c) a decreased serum digoxin level. d) an increased serum creatinine level.

C

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? a) GI absorption rate b) therapeutic index c) creatinine clearance d) liver function studies

D

A client diagnosed with idiopathic thrombocytopenia purpura needs a peripherally inserted central catheter (PICC) placed. When explaining the catheter to the client, the nurse explains that one advantage of a catheter is that it can be used a) in clients with infections in the blood. b) to administer only blood products and I.V. fluids. c) for 2 weeks without being replaced. d) to provide long-term access to central veins.

A (RF folic acid def)

A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication? a) green, leafy vegetables b) eggs c) citrus fruits d) milk products

D

A client has had sucralfate prescribed as treatment for peptic ulcer disease. Which statement indicates that the client understands how to take the medication? a) "I should avoid milk products while taking this drug." b) "I should take the sucralfate every evening at bedtime." c) "I should have my hemoglobin checked monthly while taking sucralfate." d) "It's important that I take this drug on an empty stomach."

D (this med is only used with normal saline. Used with seizure pv)

A client with a subarachnoid hemorrhage is prescribed a 1,000 mg loading dose of I.V. phenytoin. What information is most important when administering this dose? a) Phenytoin should be administered through an I.V. catheter in the client's hand. b) Phenytoin should be mixed in dextrose in water before administration. c) Therapeutic drug levels should be maintained between 20 and 30 mg/ml. d) Rapid phenytoin administration can cause cardiac arrhythmias.

B (most serious SE = leukopenia and agranulocytosis - most often occurs within the first 3 mo of tx)

Propylthiouracil (PTU) is prescribed for a client with Graves' disease. Which symptom should the nurse teach the client to report? a) constipation b) sore throat c) increased urine output d) excessive menstruation

D (Bismuth salts suppress H. Pylori and help heal the mucosa)

The client with a peptic ulcer is prescribed antibiotics and bismuth salts. The nurse explains that this combination of medications will: a) prevent future ulcers from forming. b) prevent bleeding from the ulcer. c) prepare his bowel for surgery. d) eradicate the Helicobacter pylori bacteria.

D (all others = s/s of MI - indicate need for heparin)

The client is admitted for a myocardial infarction and has a heparin drip infusing. Which signs and symptoms would prompt the nurse to stop the infusion and notify the prescribing health care provider? a) Pain and stiffness to left shoulder b) Report of upset stomach and nausea c) Unrelieved chest pain d) New onset bleeding from client's rectum

D (nitroglycerin causes vasodilation which increases intraocular pressure... can trigger an attack and cause pain and loss of vision since have glaucoma)

The health care provider (HCP) has prescribed nitroglycerin to a client with angina. The client also has closed-angle glaucoma. The nurse should contact the HCP to discuss the potential for which drug interaction? a) decreased intraocular pressure b) hypotension c) hypertension d) increased intraocular pressure

D (pv crystalluria and stone formation) (normal for A to happen) (is an anti-infl sulfa med)

The health care provider prescribes sulfasalazine for the client with ulcerative colitis. Which instruction should the nurse give the client about taking this medication? a) Stop taking it if urine turns orange-yellow. b) Take the total dose at bedtime. c) Avoid taking it with food. d) Take it with a full glass (240 mL) of water.

D (do not rub or massage the ointment into the skin - allow the ointment to be absorbed slowly)

The nurse is teaching a client how to apply nitroglycerin topical ointment. Which statement indicates that the client needs additional clarification of the instructions? a) "It's important that I rotate the application sites to avoid skin irritation." b) "I should remove any remaining old ointment with a tissue before applying a new dose." c) "I'll use the applicator paper to measure the amount of ointment I should use." d) "I'll carefully massage the ointment into the skin."

D (b/c pituitary would normally release growth hormone w/in first 45-90 min of sleep)

The nurse is teaching the parents of a child with growth hormone deficiency how to administer growth hormone to their child. At what time should the nurse suggest administration of this medication? a) first thing in the morning b) in the middle of the day c) after dinner d) at bedtime

Kidney Damage

What can happen if metformin is not withheld 48 hours before undergoing a CT scan?

B (is an antibiotic- Flagyl)

What is the most important information for the nurse to include when teaching a client about metronidazole? a) Urine may develop a greenish tinge while the client is taking this drug. b) Mixing this drug with alcohol causes severe nausea and vomiting. c) Heart palpitations may occur and should be immediately reported. d) Breathlessness and cough are common adverse effects.

D (pv renal problems like stone formation and crystalluria)

Which instruction should the nurse give to a client with prostatitis who is receiving double strength co-trimoxazole? a) use a sunscreen of at least SPF-15 with para-aminobenzoic acid (PABA) b) don't expect improvement of symptoms for 7 to 10 days c) if a sore mouth or throat develops, take the medication with milk or an antacid d) drink six to eight glasses of fluid daily while taking this medication

C (prolongs bleeding time)

Which medication prescription to help relieve pain in a child with leukemia should the nurse question? a) acetaminophen with codeine b) hydrocodone c) ibuprofen d) hydromorphone

D (result of hypocalcemia) (B = laxative)

Which medication should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy? a) sodium bicarbonate b) sodium phosphate c) echothiophate iodide d) calcium gluconate

B (decreases intraocular pressure by decreasing secretion of aqueous humor)

Which medication would the nurse anticipate for a client having an episode of acute angle-closure glaucoma? a) atropine b) acetazolamide c) furosemide d) urokinase

Hearing Loss (ototoxic)

ASA can cause what?

D

A physician orders chlorzoxazone, 500 mg P.O. t.i.d for a client. The nurse knows that chlorzoxazone, a centrally acting skeletal muscle relaxant, is commonly used to treat a) chronic musculoskeletal disorder. b) muscle spasm caused by cerebral palsy. c) lower extremity spasticity. d) severe muscle spasm.

C

A physician orders spironolactone, 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect? a) blood pH of 7.25 b) serum potassium level of 3.5 mEq/L c) loss of 2.2 lb (1 kg) in 24 hours d) serum sodium level of 135 mEq/L

D (replaces lost Na+, corrects metabolic acidosis)

A team of nurses is preparing a trauma room for the arrival of a child with partial-thickness burns to both lower extremities and portions of the trunk. Which intravenous fluid should the nurse be prepared to administer to this client? a) albumin b) normal saline with 2 mEq KCl/100 ml c) dextrose 5% and half-normal saline d) lactated Ringer's solution

C

The nurse prepares to administer digoxin to a client. For which reason should the nurse question the prescribed dose? a) The client has chronic constipation. b) The client has eczema. c) The client has chronic kidney disease (CKD). d) The client has chronic obstructive pulmonary disease (COPD).

C (local anesthetic - so just by fingers. A is wrong even tho local b/c would lose gag reflex. General and IV conscious sedation = need to assess ability to swallow after)

The postoperative nursing assessment of a client's ability to swallow fluids before providing oral fluids is based on the type of anesthesia given. Which client would not have delayed fluid restrictions? The client who had: a) undergone a bronchoscopy under local anesthesia. b) a transurethral resection of a bladder tumor under general anesthesia. c) a repair of carpal tunnel syndrome under local anesthesia. d) an inguinal herniorrhaphy with spinal and intravenous conscious sedation.

A

A nurse explains to a client that the nurse will administer the client's first insulin dose in the client's abdomen. How does absorption at the abdominal site compare with absorption at other sites? a) Insulin is absorbed more rapidly at abdominal injection sites than at other sites. b) Insulin is absorbed rapidly regardless of the injection site. c) Insulin is absorbed unpredictably at all injection sites. d) Insulin is absorbed more slowly at abdominal injection sites than at other sites.

B

A definitive diagnosis of pulmonary embolism has been made for a client. Which medication would the nurse anticipate for this client? a) acyclovir b) heparin c) streptokinase d) warfarin

C

A newly admitted client diagnosed with delirium has a history of hypertension and anxiety. The client had been taking digoxin, furosemide, and diazepam. The nurse suspects that this client's impairment may be the result of: a) opportunistic infection. b) metabolic acidosis. c) drug intoxication. d) hepatic encephalopathy.

C (b/c want to maintain level of Ab in bloodstream)

A client with a urinary tract infection is to take nitrofurantoin four times each day. The client asks the nurse, "What should I do if I forget a dose?" What should the nurse tell the client? a) "You can wait and take the next dose when it's due." b) "Double the amount prescribed with your next dose." c) "Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose." d) "Tell your health care provider (HCP), who can then adjust your prescribed dose."

C

A client with joint pain, tenderness and swelling has been admitted to the hospital. A disease modifying anti-rheumatic drug (DMARD) is prescribed by the healthcare provider. Which medication should the nurse expect to administer? a) ferrous sulfate b) prednisone c) methotrexate d) aspirin

D (will help with hypercalcemia) (A is for hyperkalemia)

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of [12.0 mg/dl (3.0 mmol/L)], a serum potassium level of [3.9 mEq/L (3.9 mmol/L)], a serum chloride level of [101 mEq/L (11 mmol/L)], and a serum sodium level of [140 mEq/L (140 mmol/L)]. Based on this information, the nurse determines that the client will likely need which intervention? a) sodium polystyrene sulfonate b) calcium gluconate 10% at 10 ml slow I.V. push c) potassium chloride 10 mEq/100ml I.V. infusion d) mithramycin 25 mcg/kg/day

B (used to tx inflammation)

A nurse is reviewing the healthcare provider's orders for a client admitted with systemic lupus erythematosus (SLE). Which medication would the nurse expect to find in this client's plan of care? a) morphine b) hydroxychloroquine c) dimenhydrinate d) ketoconazole

D (early s/s of toxicity)

A toddler with a ventricular septal defect is receiving digoxin to treat heart failure. Which assessment finding should be the nurse's priority concern? a) hyperactivity b) hypertension c) tachycardia d) bradycardia

B (pv thrush)

The nurse is performing discharge teaching for a school-aged child who experienced an asthma attack. What is the most important information the nurse can provide this client about the prescription for budesonide? a) There is no need to use a spacer when taking this medication. b) Rinse the mouth after using this medication. c) This medication is used for acute asthma attacks. d) Use the medication before using a bronchodilator.

C

Every morning, a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain? a) 70% regular insulin and 30% NPH insulin b) 70 units of regular insulin and 30 units of NPH insulin c) 70% NPH insulin and 30% regular insulin d) 70 units of neutral protamine Hagedorn (NPH) insulin and 30 units of regular insulin

A

The nurse instructs a client with coronary artery disease in the proper use of nitroglycerin. The client has had 2 previous episodes of coronary artery disease. At the onset of chest pain, what should the client do? a) Call 911 when three nitroglycerin tablets taken every 5 minutes are not effective. b) Call 911 when five nitroglycerin tablets taken every 5 minutes are not effective. c) Take one tablet and then immediately call 911. d) Go to the emergency department if two nitroglycerin tablets taken 5 minutes apart are not effective.

B (tocolytics used to stop labor contractions. Most common SE is pulmon edema)

The nurse is caring for a client prescribed a tocolytic agent. The nurse takes immediate action based on what assessment finding? a) maternal heart rate of 114 beats/min b) bilateral crackles on lung auscultation c) peripheral pulse strength of +2 d) blood glucose of 170 mg/dL (9.4 mmol/L)

D

The nurse is caring for a client with toxic epidermal necrolysis. When reviewing the client's medical record, the nurse would suspect which medication to be a probable cause of this disorder? a) furosemide b) levothyroxine c) morphine sulfate d) phenytoin

A

The nurse is caring for a newborn with unrepaired transposition of the great vessels. Which medication should the nurse anticipate giving first for treatment of this defect? a) prostaglandin E1 b) furosemide c) enalapril d) digoxin

C

The nurse is discussing discharge instructions with a client with myasthenia gravis who is taking pyridostigmine. What should the nurse instruct the client to do? a) Administer artificial tears. b) Avoid contact with crowds. c) Take pyridostigmine in the afternoon. d) Decrease protein in the diet.

D

The nurse is teaching a female client about taking folic acid supplements for folic acid deficiency anemia. What information should be included in the teaching plan? a) It will take several months to notice an improvement. b) Folic acid should be taken on an empty stomach. c) Iron supplements are contraindicated with folic acid supplementation. d) Oral contraceptive use, pregnancy, and lactation increase daily requirements.

A (decreases preload + afterload + myocardial O2 demand)

The nurse makes initial rounds for the clients. Five medications are scheduled for administration at the same time to five different clients. Which medication should the nurse administer first after initial rounds? a) morphine sulfate to a client with a myocardial infarction reporting chest pain b) ondansetron to a diabetic client reporting nausea c) a maintenance dose of digoxin to the client with congestive heart failure d) naproxen to the client with rheumatoid arthritis

A (Vit D enhances absorption of Ca from GI tract... so if not taking this then Ca remains low)

The serum calcium level remains low in a client with hypoparathyroidism despite taking calcium supplements. What should the nurse ask the client related to these findings? a) "Have you been taking vitamin D along with your calcium supplements?" b) "Have you been taking your levothyroxine as prescribed in addition to calcium?" "c) Are you prescribed a thiazide diuretic along with the calcium supplements?" d) "Are you eating a diet that contains calcium-rich foods such as dairy products?"

C (Bicalutamide = antiandrogen, leuprolide decreases testosterone production)

Which assessment finding is expected in a client receiving bicalutamide and leuprolide for advanced prostate cancer? a) acromegaly b) abdominal distention c) hot flashes d) colicky pain