Pharm quizzes Spring
A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? Sedation Increased appetite White coating in the mouth Dry oral mucous membranes
White coating in the mouth Fluticasone/salmeterol is an inhaled glucocorticoid and long acting beta adrenergic agonist combination inhalation medication that is used for daily management of asthma. It is not a rescue medication. An adverse effect of the medication is oropharyngeal candidiasis. The nurse should instruct the client to gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue to the provider.
A nurse is teaching a client who plans to take St. John's wort to treat her depression. Which of the following information should the nurse include in the teaching? -You should avoid driving while taking St. John's wort because it can cause doziness -You may experience vivid dreams while taking St. John's wort. -St. John's wort increases your risk of developing oxalate kidney stones -St. John's wort may cause gastrointestinal irritation.
You my experience vivid dreams while taking St. John's wort. (The nurse should include in the teaching that St. John's Wort can cause the client to have vivid dreams due to the CNS effects)
A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching? -"I should expect to feel better 24hrs after starting this medication" -"I should not take this medicine with grapefruit juice." -" I'll take this medicine with food" -" I'll take this medicine first thing in the morning"
" I'll take this medicine first thing in the morning" (The client should take fluoxetine in the morning to reduce the risk for insomnia.)
A nurse 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 understanding of the teaching: - "I will report any loss of appetite" -" Increased flatulence is an indication of toxicity" -" Vomiting is an indication of toxicity" -" I will call my provider if I experience any headaches"
" Vomiting is an indication of toxicity" (Since vomiting and diarrhea are early signs of lithium toxicity, the client should omit the next dose of lithium and call the provider.)
A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching? -"Do not take antihistamines with this medication." -"Take the Medication on an empty stomach." -"Stop taking the medication immediately for a headache." -"Expect to develop diarrhea initially."
"Do not take antihistamines with this medication." (The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen.)
A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority? -"He takes a 2-hr nap every day after school." -" He says he feels sick to his stomach after taking this medication." -"He has so many new bruises on his body." -"He says his mouth is always dry."
"He has so many new bruises on his body." (When using the urgent vs non-urgent approach to client care, the nurse determines that the priority concern is frequent bruising because this is a manifestation of carbamazepine toxicity. Carbamazepine toxicity can cause bone marrow depression, including leukopenia, anemia, and thrombocytopenia. The parent should monitor the client for bruising, bleeding, and sore throat and have periodic blood work drawn to monitor for myelosuppression.)
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? "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." "A pharmacist is the person to answer that question." "Heparin does not dissolve clots. It stops new clots from forming." "The oral medication you will take after this IV will dissolve the clot."
"Heparin does not dissolve clots. It stops new clots from forming." This statement accurately answers the client's question.
A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? "I have started taking ginger root to treat my joint stiffness." "I take this medication at the same time each day." "I eat a green salad every night with dinner." "I had my INR checked three weeks ago."
"I have started taking ginger root to treat my joint stiffness." Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching.
A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? -"If I get a rash from this medication, I will take my usual antihistamine." -"I need to increase my fluid intake while taking this medication." -"I should take this medication on an empty stomach." -"If I get a fever while taking this medication, I will take some aspirin."
"I need to increase my fluid intake while taking this medication." (Clients who have gout should increase their fluid intake to 2 to 3L per day to prevent toxicity of allopurinol and decrease uric acid levels.)
A nurse is discussing the treatment of depressive disorders with a client who has major depression. Which of the following client statements indicates an understanding of the teaching? -"I need to make a voluntary choice to stop feeling depressed." -" I can cure my depression by thinking positive thoughts." -"I will attend psychotherapy to help manage my depression." -"I will plan on antidepressant taking three to five days to be effective."
"I will attend psychotherapy to help manage my depression." (Psychotherapy is an effective treatment for the long-term management of depressive disorders.)
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? "If my breathing begins to feel tight, I will use the cromolyn immediately." "I will be sure to take the albuterol before taking the cromolyn." "I will use both medications immediately after exercising." "I will administer the medications 10 minutes apart."
"I will be sure to take the albuterol before taking the cromolyn." The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client's lungs
A nurse is teaching a client who has a new diagnosis of Hepatitis C, which of the following statements indicate a need for further teaching? -"I will need to take medication to treat Hepatitis C for the rest of my life" -"If left untreated hepatitis C can lead to liver cancer" -"If I Continue risky behavior after treatment, I can become re-infected with the virus" -" I am at a higher risk of developing insulin resistance and diabetes mellitus."
"I will need to take medication to treat Hepatitis C for the rest of my life" (Treatment goal is a sustained viral load for 6 months, this is usually accomplished by 8-24 weeks of therapy.)
A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching? -"I will notify my doctor before taking any other medications.: -"I have made an appointment to see my dentist nest week." -"I know that I cannot switch brands of this medication." -"I'll be glad when I can stop taking this medicine."
"I'll be glad when I can stop taking this medicine." (Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.)
A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? "Limit your fluid intake to meal times." "Do not take this medication on an empty stomach." "Increase your daily intake of dietary fiber." "You can expect swelling of the ankles while taking this medication."
"Increase your daily intake of dietary fiber." The nurse should instruct the client to increase his daily intake of dietary fiber to reduce the risk of constipation associated with verapamil.
A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for alprazolam 0.25mg PO Q8 for anxiety. Which of the following client statements should the nurse consider administering alprazolam? -"I see purple bugs crawling on the wall" -The client tells the nurse that he is too tired to attend the group meeting. -The client tells the nurse that he is a government agent. -"My heart is pounding out of my chest"
"My heart is pounding out of my chest" (Alprazolam is a benzodiazepine and is used to treat anxiety. The medication works in the central nervous system to decrease the severity of panic attacks, decrease anxiety and insomnia, and promote relaxation of muscles. Physiological symptoms of anxiety as it reaches the panic level often include tension, impatience, apprehension, increased heart and respiratory rates, confusion, feelings of impending doom, and extreme fright and horror. Expected adverse effects of alprazolam are dizziness, lightheadedness, and drowsiness. The nurse should closely monitor the client and assist the client with ambulation and self-care needs.)
A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include? -"Sit upright or stand for at least 30min after taking this medication." -" Take this medication with food." -"Take this medication with orange juice." -"Chew or suck on the tablet."
"Sit upright or stand for at least 30min after taking this medication." (The nurse should instruct the client to sit or stand for 30 minutes after administration of this medication to reduce prolonged contact of the medication with the esophageal mucosa that can cause esophagitis.)
A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching? -"Syncope episodes may occur when taking this medication." -"This medication may cause tachycardia." -"You should administer the medication each morning." -"You will need to monitor for constipation."
"Syncope episodes may occur when taking this medication." (The nurse should inform the family to monitor for syncope, which places the client at risk for falling.)
A nurse is teaching the parents of a child who is to start using a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching? "The spacer increases the amount of medication delivered to the oropharynx." "The spacer increases the amount of medication delivered to the lungs." "Inhale rapidly using the spacer with the MDI." "Cover exhalation slots of the spacer with lips when inhaling."
"The spacer increases the amount of medication delivered to the lungs." The client uses a spacer to increase the amount of medication that reaches the lungs.
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? "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." "I will call the provider to get a prescription for discontinuing the IV heparin today." "Both heparin and warfarin work together to dissolve the clots." "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." Heparin and warfarin are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood vessels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued.
A nurse is providing discharge teaching to a female client who has neuropathy and a new prescription for gabapentin. Which of the following statements should the nurse include in the teaching? -"Take this medication with an antacid to reduce gastric irritation." -"You may experience drowsiness while taking this medication." -"You should take this medication with meals." -"You may continue to breastfeed while taking this medication."
"You may experience drowsiness while taking this medication." (The nurse should instruct the client that drowsiness can occur while taking this medication and to exercise caution while performing activities that require alertness.)
A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include? "Take this medication with food." "You might have to stop taking this medication 5 days before any planned surgeries." "Take this medication three times daily." "Expect to have black-colored stools while taking this medication."
"You might have to stop taking this medication 5 days before any planned surgeries." Clopidogrel inhibits platelet aggregation and can cause bleeding. The client should report taking this medication to providers to determine whether to discontinue the medication prior to elective procedures to reduce the risk for bleeding
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? -"take this medication with food if nausea develops." -"monitor for muscle pain." -"expect to have increased bruising." -"increase our intake of grapefruit juice."
"monitor for muscle pain." (This medication can cause rhabdomyolysis. The client should monitor and report muscle pain.)
A nurse is providing teaching to client who has schizophrenia and is to begin taking haloperidol. Which of the following information should the nurse include in the teaching? -"you may experience dizziness upon standing while taking this medication." -" this medication will decreased your symptoms of OCD." -"this medication may cause excessive salivation." -"you can stop taking this medication if the adverse effects are bothersome.
"you may experience dizziness upon standing while taking this medication." (Haloperidol may cause orthostatic hypotension; therefore, the client should be instructed to change positions slowly.)
A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? -tinnitus -constipation -hyperkalemia -weight gain
- Tinnitus (Tinnitus and hearing loss are adverse effects of cisplatin.)
A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? -"I won't pass gas as often now that I'm taking this medication." -"I will take this medication each morning with my breakfast/" -" I have an increased risk of getting pneumonia while taking this medication." -"I will need to take a daily stool softener while taking this medication."
-" I have an increased risk of getting pneumonia while taking this medication." (The client taking esomeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur.)
A nurse is 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 information should the nurse include? -"to prevent dehydration, drink an additional liter of fluid during preparation time." -"Expect bowel movements to begin 3 hr following completion of solution." -"Abdominal bloating may occur." -"Drink 400mL every our until bowel movements are clear."
-"Abdominal bloating may occur." (While PEG is well-tolerated, adverse effects include nausea, bloating, and abdominal discomfort.)
A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make? -"irregular bowel movements are an indication of poor intestinal health." -"Excessive laxative use may cause an electrolyte imbalance." -Chronic use of laxatives can lead to a tear in the rectal mucosa." -" Decrease your intake of foods high in fiber."
-"Excessive laxative use may cause an electrolyte imbalance." (Bisacodyl is a stimulant laxative that acts by stimulating intestinal motility and increasing the amount of water and electrolytes within the intestines; therefore, chronic use of laxatives can lead to fluid and electrolyte imbalance.)
A nurse is teaching a client about the side effects of chemotherapy medication. Which of the following statement should the nurse include in the teaching? -"Most clients do not experience nausea." -"Hair loss is common and includes eyebrows and eyelashes." -" Most clients start to gain weight during their treatment." -"Client's lose their hair, but it usually grows back nice and thick."
-"Hair loss is common and includes eyebrows and eyelashes." (This nursing statement is correct, because alopecia occurs as a whole-body hair loss for most clients administered chemotherapy.)
A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching? -" I will take the antiemetic as soon as the chemotherapy is complete." -"I will run my toothbrush in the dishwasher every month" -"I will call my Dr if I notice any unusual menstrual bleeding." -" I will avoid crowds to keep from infecting others."
-"I will call my Dr if I notice any unusual menstrual bleeding." (Clients should be taught bleeding precautions and to report bruising or excessive bleeding.)
A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching. -"I will take this medication as needed to reduce pain." -"I will reduce my fluid intake with this medication." -" I will take this medication with an antacid." -"I will take this medication 1 hour before meals and at bedtime."
-"I will take this medication 1 hour before meals and at bedtime." (The client should take sucralfate on an empty stomach, 1 hr before each meal and at bedtime to create a protective coating over the ulcer.)
A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching? -"It might take up to 3 days for the medication to work" -"I will take the medication for diarrhea." -" I should drink 4oz of water when I take this medication." -" I can take this medication along with mineral oil."
-"It might take up to 3 days for the medication to work" (The client understands docusate sodium is a stool softener and the therapeutic effect might take up to 3 days to achieve.)
A nurse is instructing a client who is newly diagnosed with pulmonary TB about the use of antitubercular medications. Which of the following information should the nurse include in the teaching? -Medications will need to be taken for the rest of the client's life, even if the client feels better. -Medications will need to be taken until the Mantoux test is negative. -A typical course of treatment involves 6-9 months of consistent medication use. -The client's family will also need to take medications to prevent infection.
-A typical course of treatment involves 6-9 months of consistent medication use. (Pulmonary TB is a contagious bacterial infection caused by Mycobacterium tuberculosis. Active TB is usually treated with the simultaneous administration of a combination of medications to which the organisms are susceptible. Such therapy is continued until the disease is controlled. A 6- to 9-month regimen consisting of two, and often four, different medications is used. The client should not drink alcohol during this time.)
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 verified the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? -an excess amount of doxorubicin can lead to myelosuppression -exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. -An excess amount of doxorubicin can lead to cardiomyopathy. -exceeding the lifetime cumulative dose limit of doxorubicin might produce red-tinged urine and sweat.
-An excess amount of doxorubicin can lead to cardiomyopathy. (Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m2 or 450 mg/m2 with a history of radiation to the mediastinum.)
A nurse is caring for a client who has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication? -Sodium 140 mEq/L -Potassium 4.5mEq/L -BUN 55 mg/dL -Glucose 120 mg/dL
-BUN 55 mg/dL (This BUN level is above the expected reference range (10-20 mg/dL). Amphotericin B is nephrotoxic and is contraindicated if BUN is > 40mg/dL. The nurse should report this laboratory value to the provider before initiating the medication.)
A nurse is completing a medication history for a client who reports using over the counter calcium carbonate antacid. Which of the following recommendations should the nurse make about this medication? -Decrease bulk in the diet to counteract the adverse effect of diarrhea -Take this medication with dairy products to increase absorption -Reduce sodium intake -Drink a glass of water after taking this medication.
-Drink a glass of water after taking this medication. (Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness.)
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy induced nausea. For which of the following adverse effects should the nurse monitor? -Headache -dependent edema -polyuria -photosensitivity
-Headache (Headache is a common adverse effect of ondansetron. Analgesic relief is often required.)
A nurse is caring for a client who has prostate cancer. The nurse should expect the provider to prescribe which of the following medications for this client? -Leuprolide -Cyclophosphamide -Finasteride -Tamoxifen
-Leuprolide (Leuprolide treats cancer of the prostate hormonally. It antagonizes the androgens that androgen-dependent neoplasms require.)
A nurse is planning care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care? -Insert and indwelling catheter to monitor sediment in the urine. -Take the client's temperature once per shift. -Provide the client with fresh fruit to avoid constipation. -Limit the number of heath care workers entering the room
-Limit the number of heath care workers entering the room (The nurse should limit the number of health care workers entering the client's room to prevent possible overexposure to microorganisms that can lead to an infection.)
A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? -Liver function tests -Gallbladder studies -Thyroid Function studies -Blood Glucose Levels
-Liver function tests (Pyrazinamide and rifampin can both cause hepatotoxicity, thus the provider will monitor liver function regularly.)
A nurse is teaching about adverse effects of anastrozole with a client who has advanced breast cancer and is postmenopausal. Which of the following adverse effects should the nurse recommend the the client report to the provider? -Weight Gain -Stomatitis -Cough -Musculoskeletal Pain
-Musculoskeletal Pain (The client who is experiencing musculoskeletal pain should notify the provider. Musculoskeletal pain is a common adverse effect that affects 50% of clients that is possibly caused from estrogen deprivation.)
A nurse in a clinic is collecting a history from a client who reports that a member of his family just received a diagnosis of pulmonary TB. The nurse should expect the provider will prescribe which of the following diagnostic tests first? -Sputum culture for acid-fact bacillus (AFB) -Nucleic acid amplification test (NAAT) -CT Scan -Chest X-ray
-Nucleic acid amplification test (NAAT) (The CDC recommends that the NAAT test replace other diagnostic screening tests for tuberculosis. The test is performed on a client's sputum.)
A nurse is preparing for the admission of a client who has suspected active tuberculosis. Which of the following precautions should the nurse plan to implement to safely care for this client? -have staff and visitors wear gowns, masks, and gloves while in the room. -Place the client in a private room with a special ventilation system. -Assign the client to a room with other clients who require droplet precautions -modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room.
-Place the client in a private room with a special ventilation system. (Clients who have active tuberculosis should be assigned to private rooms with negative-pressure airflow via HEPA filtration systems. In these rooms, the air is not returned to the inside ventilation system but is filtered and exhausted directly to the outside.)
A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? -WBC 2300/mm3 -RBC 5 million/mm3 -Hgb 12g/dL -Plt 155,000/mm3
-WBC 2300/mm3 ( This WBC finding is below the expected reference range. Chemotherapy treatment can cause leukopenia; the nurse should report this finding to the provider and implement precautions to protect the client from infection.)
A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take? -tell the client to expect dark stools following chemotherapy. -have the client floss 4 times daily -have the client swish with commercial mouthwash before therapy -administer an antiemetic prior to the procedure.
-administer an antiemetic prior to the procedure. (The nurse can help prevent nausea and vomiting by administering an antiemetic prior to chemotherapy, and to tell the client to continue taking medication until nausea and vomiting resolve.)
A nurse is reviewing the medical record of a client who has a peptic ulcer. which of the following should the nurse recognize as a risk factor for this condition. -history of bulimia -history of NSAID use -drinks green tea -has a glass of wine with dinner each day
-history of NSAID use (The nurse should recognize that long-term use of NSAIDs is a risk factor for peptic ulcer disease. NSAIDs break down the mucosal barrier and cause production of prostaglandins to decrease, which results in local gastric mucosal injury.)
A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include that which of the following is an adverse effect of this medication. -hot flashes -insomnia -increased appetite -constipation
-hot flashes (Hot flashes are a common adverse effect of tamoxifen. Other adverse effects include fluid retention and vaginal discharge. The nurse should advise the client these effects should subside when therapy is discontinued.)
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alpha. The nurse should instruct the client to increase dietary intake of which of the following substances? -iron -protein -potassium -sodium
-iron (Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates the bone marrow to produce red blood cells. Increased iron is needed for the production of hemoglobin and red blood cells by the bone marrow.)
A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm3. Which of the following interventions should the nurse include in the plan of care? -check the IV site for bleeding every 8hrs -limit IM injections -Obtain a rectal temperature every 8 hrs -Check the client for proteinuria
-limit IM injections (The nurse should plan to limit IM injections or venipunctures to prevent harm to the client. If venipuncture is necessary, the nurse should hold pressure to the site for 10 min afterward.)
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? -monitor for dizziness -observe for diarrhea -administer 24hr before effects are desired -expect an increase in salivation
-monitor for dizziness (The client should monitor for dizziness and avoid activities that require alertness because dimenhydrinate can cause dizziness and drowsiness.)
A nurse is caring for a client who has active pulmonary TB and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication. -constipation -black-colored stools -staining of teeth -red-colored urine
-red-colored urine (Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown.)
A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications -senna -ibuprofen -omeprazole -zolpidem
-senna (Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort.)
A nurse is preparing to administer phenytoin IV to a client who has seizure disorder. Which of the following actions should the nurse plan to take? -Administer the medication at 100mg/min. -Administer a saline solution after the injection. -Hold the injection if seizure activity is present -Dilute the medication with dextrose 5% in water.
Administer a saline solution after the injection. (The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation.)
A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? Administer a short-acting ß2 -agonist (SABA). Obtain a peak flow reading. Administer an inhaled glucocorticoid. Determine the cause of the acute exacerbation.
Administer a short-acting ß2 -agonist (SABA). When using the urgent versus non-urgent approach to client care, the nurse should determine that the priority action is to administer a nebulized high-dose SABA to relieve bronchoconstriction and improve ventilation.
A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication? Give the medication in the morning daily. Administer the medication 2 hr before exercise. Give the medication at the onset of wheezing. Administer the granules mixed with 20 oz of water.
Administer the medication 2 hr before exercise. Montelukast should be given daily during the evening, except when being used for exercise-induced bronchospasm. It should then be given 2 hr before exercise, and not given again for 24 hr
A nurse in an emergency department is preparing to administer alteplase accelerated therapy to a client who is having a myocardial infarction. Which of the following actions should the nurse plan to take? (Select all that apply.) Administer the medication within 30 min of the client's arrival to the department. Reconstitute the medication with sterile water. Administer a 15 mg IV bolus. Tell the client that the purpose of the medication is to keep a new clot from forming. Assess the client for back pain.
Administer the medication within 30 min of the client's arrival to the department. Reconstitute the medication with sterile water. Administer a 15 mg IV bolus. Assess the client for back pain.
A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? Hyperglycemia Adrenocortical insufficiency Severe dehydration Rebound pulmonary congestion
Adrenocortical insufficiency Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insuciency.
A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide? -Phenytoin turns urine blue -Alcohol increases the chance of phenytoin toxicity -Avoid flossing the teeth to prevent gum irritation -Take an antacid with the medication if indigestion occurs
Alcohol increases the chance of phenytoin toxicity (The nurse should include in the home instructions that alcohol alters the blood level of phenytoin.)
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 adverse effects of this medication? -Cardiac Dysrhythmia -Metabolic Alkalosis -Renal Failure -Aplastic Anemia
Aplastic Anemia (Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.)
A nurse 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? Asthma Glaucoma Depression Migraines
Asthma Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation.
A nurse is reviewing the medication history of a client who has a new prescription for colchicine. Which of the following medications increases the client's risk when used in combination with colchicine for developing rhabdomyolysis? -Atorvastatin -Omeprazole -Carvedilol -Hydrochlorothiazide
Atorvastatin (Atorvastatin can cause rhabdomyolysis. When the client takes both of these medications, the risk of developing this adverse effect is increased.)
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? Consume a high-protein diet. Administer the medication with food. Avoid caffeine while taking this medication. Increase fluids to 1L/per day.
Avoid caffeine while taking this medication. The nurse should instruct the client that caffeine should be avoided while taking theophylline, as it can increase central nervous system stimulation
A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the following information should the nurse include in the teaching? -Discontinue medication if nausea occurs. -Expect urine to turn orange. -Monitor for increased muscle spasms. -Avoid driving until the effects are known.
Avoid driving until the effects are known. (Cyclobenzaprine can cause drowsiness and dizziness. Instruct the client to avoid driving if these effects occur.)
A nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following menu items requires intervention by the nurse? -Glass of whole milk -Celery sticks -Bologna Sandwich -Sliced Apple
Bologna Sandwich (Clients who are receiving an MAOI should avoid foods containing a high tyramine content. Bologna has a high tyramine content and should be avoided.)
A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority? -Positive Western Blot Test -CD4-T-Cell count 180 cells/mm3 -Platelets 150,000/mm3 -WBC 5,000/mm3
CD4-T-Cell count 180 cells/mm3 (A CD4-T-cell count of less than 180 cells/mm3 indicates that the client is severely immunocompromised and is at high risk for infection. Therefore, this value is the priority for the nurse to report to the provider.)
A nurse is caring for a client who is receiving a continuous IV infusion of heparin. Which of the following actions should the nurse take? Administer 50,000 units of heparin by IV bolus every 12 hr. Check the activated partial thromboplastin time (aPTT) every 4 hr. Have vitamin K available on the nursing unit. Use IV tubing specific for heparin sodium when administering the infusion.
Check the activated partial thromboplastin time (aPTT) every 4 hr. Heparin is an anticoagulant. The activated partial thromboplastin time (aPTT) should be monitored every 4 hr and the infusion rate should be adjusted accordingly until the eective dose has been determined.
A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client. -constipation -metallic taste -headache -muscle spasms
Constipation (Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed.)
A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority? Defibrillation Airway management Epinephrine administration Amiodarone administration
Defibrillation The greatest risk to the client is death from a lack of cardiac output. Ventricular defibrillation is a lethal rhythm in which the ventricles are in a quivering pattern and there is no atrial activity. Defibrillation is essential to resolve ventricular defibrillation promptly and convert the rhythm to restore cardiac output. The nurse should follow defibrillation with cardiopulmonary resuscitation and repeated defibrillation, if necessary, to convert the ventricular defibrillation into a sustainable rhythm
A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider? Blurred vision Palpitations Constipation Depression
Depression Montelukast can cause neuropsychiatric effects such as depression, behavior changes, hallucinations, and suicide ideation. The nurse should instruct the client to report such adverse effects. A change in medication might be prescribed.
A nurse is reinforcing teaching with a client who has a new prescription for colchicine orally to treat gout. The nurse should inform the client that which of the following findings is an adverse effect of colchicine? -Increased appetite -Urinary retention -Diarrhea -Sore Throat
Diarrhea (The nurse should inform the client that gastrointestinal effects, including diarrhea, are an adverse effect of colchicine and are an indication of toxicity due to the medication. The nurse should instruct the client to discontinue the medication if these gastrointestinal effects occur.)
A nurse is caring for a client who is exhibiting signs of alcohol withdrawal. Which of the following medication should the nurse plan to administer? -Methadone -Disulfiram -Diazepam -Buprenorphine
Diazepam (Diazepam is prescribed to treat the symptoms and prevent complications of alcohol withdrawal.)
A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? -Take an antiemetic 1 hr following administration -Drink 2-3L of water per day -Take the medication with an NSAID -Rinse mouth 2 times per day with an alcohol based mouthwash.
Drink 2-3L of water per day (Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per day to promote excretion of the medication.)
A client with a new diagnosis of rheumatoid arthritis is beginning DMARD therapy and states that they take echinacea as needed when they have the common cold. -They should take echinacea for the anti-inflammatory properties -Echinacea must be used long-term to see benefits -Echinacea should be avoided in patients with autoimmune diseases -Echinacea has been shown to reduce the length of illness with the common cold.
Echinacea should be avoided in patients with autoimmune diseases (Because the effects of echinacea on the immune system are not widely known, clients with autoimmune diseases should avoid this supplement.)
A nurse in a community health clinic is administering an inactive influenzas vaccine. Before administering it, the nurse mist confirm that the client is not allergic to which of the following? -Shellfish -Eggs -Gelatin -Yeast
Eggs (The nurse should assess the client for allergies to eggs. The seasonal influenza vaccine contains small amounts of egg protein and can induce a severe allergic reaction in clients who are hypersensitive.)
A nurse is teaching a client who takes aspirin daily for coronary artery disease about herbal supplements. The nurse should instruct the client that which of the following herbal supplements may interact adversely with aspirin? Cranberry juice Aloe vera Feverfew Flaxseed
Feverfew The nurse should instruct the client to avoid taking feverfew with aspirin because it suppresses platelet aggregation and places the client at risk for bleeding when taken with aspirin
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? Hyperthermia Hypotension Ototoxicity Muscle pain
Hypotension Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator and antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood pressure and pulse must be monitored before and during parenteral administration.
A nurse is evaluating teaching for a client who has newly diagnosed depression and a new prescription for bupropion. Which of the following statements indicates an understanding of the teaching? -I my develop a slow heartrate while taking this medication -I can drink one glass of wine with dinner each day while taking this medication -I may not notice a lifting of my mood for at least two weeks -I should watch for increased salivation and drooling while taking this medication.
I may not notice a lifting of my mood for at least two weeks (Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI). As with other antidepressants, it can take 2 to 4 weeks for therapeutic effects to occur when taking bupropion.)
A nurse is providing teaching to a client who has schizophrenia and is receiving chlorpromazine. Which of the following client statements indicates an understanding of the teaching? -I will contact my provider if I have difficulty urinating -I am less likely to get an infection while taking this medication -weight loss is a sign that my dose is too high -I may need to take this medication with an antiacid due to stomach upset.
I will contact my provider if I have difficulty urinating (Chlorpromazine is a first-generation, or typical, antipsychotic medication. The client should be instructed to monitor for increased anticholinergic adverse effects, such as dry mouth and urinary retention. Difficulty urinating could be a sign of urinary retention and should be reported to the provider for further evaluation.)
A nurse is providing teaching for a client who has schizophrenia and a new prescription for risperidone. Which of the following should the nurse include in the teaching? -Increase your fluid and fiber intake to prevent constipation -have your blood pressure checked frequently for hypertension -expect to have your blood checked weekly for serum electrolyte imbalances -increase caloric intake to prevent weight loss.
Increase your fluid and fiber intake to prevent constipation (Constipation is a common adverse effect of risperidone and the client should be taught strategies to prevent constipation, such as increasing the amount of fiber in the diet.)
A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take? Infuse the medication with an IV pump. Cover the IV container with dark paper. Administer a test dose first. Infuse the medication at 35 mg/min.
Infuse the medication with an IV pump. Theophylline should be administered slowly on an infusion pump. Rapid administration may cause hypotension and death.
A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor for which of the following adverse effects of this medication? -Insomnia -Bradycardia -Hearing Loss -Hypertension
Insomnia (The nurse should monitor the client for paradoxical effects such as insomnia and excitation. If these occur, the medication should be withdrawn.)
A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? Restrict the client's fluid intake to less than 2 L/day. Provide the client with a low-protein diet. Have the client use the early-morning hours for exercise and activity. Instruct the client to use pursed-lip breathing
Instruct the client to use pursed-lip breathing. Pursed-lip breathing lengthens the expiratory phase of respiration and also increases the pressure in the airway during exhalation. This action reduces airway resistance and decreases trapped air for clients who have COPD
A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (SATA) ~Tinnitus ~Jaw Pain ~Blurred Vision ~Drowsiness ~Dysphagia
Jaw pain (Alendronate can cause osteonecrosis of the jaw, so the client should report this adverse effect to the provider.) Blurred Vision (Alendronate can cause ocular inflammation, so the client should report vision problems to the provider.) Dysphagia (Alendronate can cause esophagitis, so the client should report any difficulty or pain with swallowing.)
A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client? -Piperacillin/tazobactam -Levothyroxine -Levodopa/carbidopa -Carbamazepine
Levodopa/carbidopa (Levodopa/carbidopa is the cornerstone of Parkinson's treatment. The nurse should prepare to instruct the client on the use of this medication.)
A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations? -metabolic Acidosis -metabolic alkalosis -respiratory acidosis -respiratory alkalosis
Metabolic Alkalosis (Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.)
A nurse is teaching the family of a client who has a new diagnosis of epilepsy about actions to take if the client experiences a seizure. Which of the following instructions should the nurse include in the teaching? -"insert a padded tongue blade into the client's mouth." -"Restrain the client." -"Place the client on his back." -"Move objects away from the client."
Move objects away from the client." (The nurse should instruct the family to move objects away from the client to reduce the risk of injury to the client.)
A nurse is assessing a client who is receiving treatment with multiple antipsychotic medication and who suddenly became ill. Findings include blood pressure changes, hyperpyrexia, and diaphoresis. The nurse should recognize that which of the following adverse effects may be occurring? -Tardive Dyskinesia -Neuroleptic Malignant Syndrome -Acute Dystonia -Pseudoparkinsonism
Neuroleptic Malignant Syndrome (Acute dystonia is characterized by acute muscle spasms of the head and neck. It occurs during the first few days of antipsychotic medication administration and does not include blood pressure changes, hyperpyrexia, or diaphoresis.)
A nurse is providing teaching for a client who has a recent diagnosis of depression. Which of the following should the nurse identify as a primary risk factor for this disorder? -Recent history of stressful, positive life events. -Past history of childhood trauma. -Being an only child. -Having elevated levels of serotonin.
Past history of childhood trauma. (A history of trauma in childhood is a primary risk factor for depression.)
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? Prevents dysrhythmias Slows intestinal motility Dissolves blood clots Relieves pain
Prevents dysrhythmias Lidocaine is an antidysrhythmic medication that delays the conduction in the heart and reduces the automaticity of heart tissue
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? Vitamin K Protamine sulfate Acetylcysteine Deferasirox
Protamine sulfate Protamine sulfate reverses the effects of heparin by binding with heparin to form a heparin-protamine complex that has no anticoagulant properties.
A nurse is caring for a client who has HIV. Which of the following laboratory tests should the nurse monitor to assess the effectiveness of therapy? -Quantitative RNA Assay -Platelet Count -Enzyme Immunoassay test (EIA) -Western Blot
Quantitative RNA Assay (A quantitative RNA assay measures the viral load and is useful in monitoring HIV disease progression and treatment effectiveness.)
A nurse is teaching a client about medications that prevent osteoporosis. The nurse should instruct the client what which of the following medications is prescribed to prevent osteoporosis? -levothyroxine -Calcitonin -Raloxifene -Allopurinol
Raloxifene (Raloxifene is prescribed for the prevention and treatment of osteoporosis in postmenopausal women.)
A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse expect? -Hepatitis -Peptic Ulcer Fracture -Renal Stones -Pancreatitis
Renal Stones (Hypercalcemia due to calcium supplements can cause renal stones. Clients should increase their water intake while taking calcium supplements to hydrate the kidneys and should report any blood in the urine or flank pain.)
A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? Check the pulse after medication administration. Take the medication with meals. Rinse the mouth after administration. Limit caffeine intake.
Rinse the mouth after administration. Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication.
A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis? -Obesity -Sedentary lifestyle -Long-term use of diuretics -Prolonged stress
Sedentary lifestyle (A sedentary lifestyle places the client at risk for osteoporosis. Regular, weight-bearing exercises help to build bone tissue.)
A nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication? -Metallic taste -Diarrhea -Skin Rash -Anxiety
Skin Rash (Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.)
A nurse is teaching a client who is to start taking warfarin about herbal supplements. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin? Valerian Black cohosh Echinacea St. John's wort
St. John's wort The nurse should instruct the client that St. John's wort can decrease anticoagulation when taking warfarin.
A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? Drowsiness Constipation Oliguria Tachycardia
Tachycardia Theophylline can increase cardiac stimulation and cause tachycardia.
A nurse is caring for a client who has rheumatoid arthritis and a new RX for methotrexate. The client tells the nurse that she is planning a pregnancy. Which of the following response's should the nurse give the client? -Dietary modifications occur during pregnancy while taking this medication -The medication should be discontinued 3 months prior to a planned pregnancy -Dosage of this medication will be reduced during pregnancy -the client can breast feed when taking this medication.
The medication should be discontinued 3 months prior to a planned pregnancy (Methotrexate should be discontinued 3 months prior to planning a pregnancy because of the risk of birth defects.)
A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.) The medication will stimulate flow of mucus. The medication will prevent wheezing. The medication will open the airways. The medication will reduce inflammation. The medication will decrease coughing episodes.
The medication will prevent wheezing. The medication will open the airways. The medication will decrease coughing episodes.
A nurse is caring for a client who has a fractured ulna and a new prescription for cyclobenzaprine. Before administering, what of the following explanations should the nurse provide to explain the purpose of this medication? -The medication will kill microorganisms that can cause infection at the fracture site. -cyclobenzaprine will reduce itching that might occur as the fracture begins to heal. -The medication will relieve muscle spasms that might occur with a fracture. -Cyclobenzaprine will relieve any nausea associated with the fracture.
The medication will relieve muscle spasms that might occur with a fracture. (The nurse should explain that the provider prescribed cyclobenzaprine to relieve muscle spasms that can accompany the acute pain of fractures.)
A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take? Insert the needle at a 45º angle. Aspirate for a blood return before depressing the plunger. The nurse should not expel the air bubble in the prefilled syringe. Administer the medication 2.54 cm (1 in) from the umbilicus
The nurse should not expel the air bubble in the prefilled syringe. The nurse should not expel the air bubble that is in the prefilled syringe prior to administering the medication.
A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed. -Thyroid hormone assay -Liver Function tests -Erythrocyte sedimentation rate -Brain natriuretic peptide
Thyroid hormone assay (Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.)
A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following? To convert atrial fibrillation to sinus rhythm To dissolve clots in the bloodstream To slow the response of the ventricles to the fast atrial impulses To reduce the risk of stroke in clients who have atrial fibrillation
To reduce the risk of stroke in clients who have atrial fibrillation Clients who have atrial fibrillation are at an increased risk for thrombus formation and subsequent embolization to the brain. Anticoagulants, such as dabigatran, help prevent thrombus formation
A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)? -Shuffling gait -Constant tapping of feet when sitting -Sudden onset of high fever -Twisting tongue movements
Twisting tongue movements (Twisting tongue movement, tics, sudden involuntary jerking movements of the extremities, and other findings occur in TD. The nurse should notify the provider of these findings since treatment includes reducing dosage of antipsychotic medications or perhaps changing to a second-general antipsychotic medication.)
A nurse is teaching a client who has chronic tophaceous gout about his new prescription for allopurinol. The nurse should explain that the purpose of this medication is to reduce blood levels of what substances? -Uric Acid -Chloride -Interleukin 1 -Potassium
Uric Acid (Hyperuricemia is the underlying cause of gout. Clients who have chronic gout develop tophi. The purpose of allopurinol is to reduce the synthesis of uric acid.)
A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer? Epinephrine Atropine Protamine Vitamin K
Vitamin K Vitamin K reverses the effects of warfarin.
A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? -zolpidem -alprazolam -spironolactone -allopurinol
allopurinol (Allopurinol is a xanthene oxidase inhibitor that reduces uric acid synthesis. The medication is prescribed to treat gout.)
A nurse is modifying the diet of a client who has Parkinson's disease and is prescribed selegiline, an MAOI. Which of the following foods should the nurse eliminate? -fresh fish -cheddar cheese -cherries -chicken
cheddar cheese (The nurse should eliminate aged cheeses from the diet of a client who is prescribed selegiline. Cheddar cheese contains tyramine, which can cause a hypertensive crisis.)
A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25mg PO TID. Which of the following outcomes should the nurse expect to see? -delay in the disease progression -improved bladder function -relief of depression -decreased tremors
decreased tremors (Clients who have Parkinson's disease often experience trembling, muscle rigidity, difficulty walking, and problems with balance and coordination. Antihistamines, like diphenhydramine, have a mild anticholinergic effect and may be helpful in controlling tremors in the early stage of the disease.)
A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse should monitor for which of the following adverse effects of haloperidol? -extrapyramidal symptoms -fever -intractable hiccups -excessive salivation
extrapyramidal symptoms (Extrapyramidal symptoms include movement disorders and are associated with typical antipsychotic medications, such as haloperidol.)
A charge nurse is teaching a group of nurses about the antagonist action of medications. The nurse should include in the teaching that which of the following antagonist medication is used for benzodiazepines? -flumazenil -diphenhydramine -protamine -naloxone
flumazenil (The nurse should teach that flumazenil is an antagonist that reverses the effects of benzodiazepines by recognition site on the GABA/benzodiazepine receptor complex.)
A nurse is proving teaching for a client who has Schizophrenia and a new prescription for chlorpromazine. Which of the following information should the nurse provide? -A low-grade fever is expected with the first dose -sleepiness should subside within a week -this medication might turn your urine orange -stop this medication if hypotension occurs
sleepiness should subside within a week (The nurse should inform the client that chlorpromazine, like other first-generation antipsychotics, may cause sedation with early treatment, but should subside within a week or so.)
A nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. Which of the following adverse effects should the nurse report to the provider? -sweating -decreased appetite -discolored urine -hallucinations
sweating (Sweating is a manifestation of serotonin syndrome and should be reported to the provider.)
A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of rheumatoid arthritis. Which of the following information should the nurse include in the teaching? - this medication should be taking between meals -this medication can turn skin an orange color -wear sunglasses when out in bright sunshine -avoid crushing the medication
wear sunglasses when out in bright sunshine (The nurse should instruct the client to wear sunglasses to decrease photophobia when taking hydroxychloroquine. Clients should have an ophthalmologic examination before treatment because the medication can cause retinopathy.)
A nurse is reviewing the medical record of a client who has schizophrenia and is receiving olanzapine. Which of the following findings should the nurse identify as an adverse effect of olanzapine? -weight gain of 3lbs in 2 weeks -delusions of grandeur -HR of 60BMP -oral candidiasis
weight gain of 3lbs in 2 weeks (Weight gain is a common adverse effect of olanzapine.)
