pharm test 2 Endocrine

It cannot be mixed with any other type of insulin

Which statement is correct regarding glargine insulin? -It is absorbed rapidly. -It cannot be mixed with any other type of insulin. -It is given twice daily. -Its peak action occurs in 2 to 3 hours.

Colace

Which of the following laxatives should be used by a cardiac patient who should avoid straining? -Milk of Magnesia -Mineral oil -Dulcolax -Colace

Desmopressin (DDAVP)

Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance? -Thiazide diuretics -Ibuprofen -Desmopressin (DDAVP) -Diabinese

Spironolactone (Aldactone)

Gynecomastia is a common side effect of which of the following diuretics? -Vasopressin (Pitressin) -Spironolactone (Aldactone) -Furosemide (Lasix) -Nitroglycerin (IV)

adrenal insufficiency

A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid: -menstrual irregularities. -adrenal insufficiency. -hypokalemia. -gastrointestinal problems.

Osteoporosis

Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease? -Cryptorchism -Bronchoconstriction -Osteoporosis -Swelling in the brain and spinal cord

Intermediate-acting

NPH is an example of which type of insulin? -Long-acting -Rapid-acting -Short-acting -Intermediate-acting

myxedema

caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism

Laxative

A 74-year-old client is on the hospital unit where you practice nursing. She will be undergoing rhinoplasty and you are completing her admission assessment and paperwork. She reports medications she uses on a daily basis, which you record for her chart. Which of her daily medications will result in constipation? -NSAIDs -Multivitamin without iron -Acetaminophen -Laxative

Use effective contraceptive measures

A 23-year-old female client is prescribed misoprostol (Cytotec). Which client teaching intervention is most important? -Report postmenopausal bleeding -Use effective contraceptive measures -Supplement therapy with magnesium antacids -Administer the drug one time per day

Blurred vision

A nurse is caring for a 48-year-old woman who has been hospitalized after injecting the wrong type of insulin. Which sign of hypoglycemia will the nurse be careful to observe for? -Blurred vision -Flushing of the face -Dry skin -Fruity breath

thyroid hormones/levothyroxine

A nurse is teaching a client about a prescribed thyroid supplement and describes a drug that is relatively inexpensive, requires once-a-day dosing, and has a more uniform potency than do other thyroid hormone replacement drugs. Which drug is the nurse describing? -antithyroid agent/propylthiouracil -thyroid hormones/levothyroxine

Blood pressure 145/87

The nurse knows that which assessment finding suggests hyperthyroidism? -Heart rate 55 beats per minute -Blood pressure 145/87 -Cool, dry skin -Hard, thick nails

basal insulin

NPH is considered this type of insulin

-Weight gain -Round or "moon face" appearance -Feeling of well-being -Fragile skin

Patients who are taking corticosteroids would be expected to report which of the following? -Weight gain -Round or "moon face" appearance -Feeling of well-being -Weight loss -Excessive hair growth -Fragile skin

heart rate

What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine? -oxygen saturation level -respiratory rate -level of consciousness and orientation -heart rate

decreases production of gastric secretions

What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection? -protects ulcer craters -decreases pepsin production -assists in eliminating the bacteria -decreases production of gastric secretions

When there is an increase in calcium, the phosphate is decreased

Which statement reflects the relationship between calcium and phosphate? -When there is an increase in calcium, the phosphate is elevated. -When there is a decrease in calcium, the phosphate is decreased. -When there is an increase in calcium, the phosphate is decreased. -There is no relationship with calcium and phosphate.

Lispro

Which type of insulin acts most quickly? -Glargine -NPH -Lispro -Regular

basal insulin

type of insulin that controls glucose production between meals and overnight, is about 50% of daily needs, nearly constant levels

on an empty stomach, 1 hour before or 2 hours after meals and at bedtime

how would the nurse educate a pt. on taking their GI protectant/sucralfate

Proton pump inhibitors

suppress the secretion of hydrochloric acid into the lumen of the stomach

3 hours

the nurse is administering the initial dose of rapid acting insulin to a client with type 1 diabetes. the nurse should assess the client for hypoglycemia within: -1/2 an hour -1 hour -2 hours -3 hours

Take the drug before breakfast

A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug? -Take the drug before breakfast. -Take the drug before bedtime. -Take the drug just before dinner. -Take the drug after lunch.

swallow tablets or capsules whole.

A nurse taking care of a patient who is receiving a proton pump inhibitor should teach the patient to -take the drug after every meal. -chew or crush tablets to increase their absorption. -swallow tablets or capsules whole. -stop taking the drug after 3 weeks of therapy.

Glarginet (Lantus)

Which of the following insulins are used for basal dosage? -Glarginet (Lantus) -NPH (Humulin N) -Lispro (Humalog) -Aspart (Novolog)

Proton pump inhibitors

are the strongest inhibitors of acid secretions

Pink to red brown urine

A client has been prescribed a phenothiazine for chemotherapy related nausea and vomiting. Which urinary side effect should the nurse include when educating the client on this medication? -Temporary urinary burning -Urinary frequency -Urinary urgency -Pink to red brown urine

Nystatin

A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about? -Fluocinolone acetonide oral base gel -Acyclovir -Nystatin -Cephalexin

Black

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color? -Dark brown -Black -Red -Green

Metformin does not cause hypoglycemia

A client has refused a scheduled dose of metformin, stating that he/she is worried about inducing hypoglycemia because his/her blood glucose level is currently 66 mg/dL (3.66 mmol/L). The nurse should convey what teaching points to the client? -Overuse of metformin creates a risk for hyperglycemia, not hypoglycemia. -If the client has been taking metformin for more than 3 to 4 weeks, there is no risk for hypoglycemia. -Hypoglycemia is only a risk in clients with type 1 diabetes. -Metformin does not cause hypoglycemia.

Abdominal cramping

A client is being sent home with orders for a laxative PRN. The nurse is conducting client teaching on the use of a laxative. What will the nurse inform the client is one of the most common adverse effects of a laxative? -Headache -Weakness -Dizziness -Abdominal cramping

Nervousness and tachycardia

A client is brought to the emergency department after taking an overdose of levothyroxine [thyroid hormone]. When assessing this client, what adverse effects would the nurse expect to find? -Slow speech and mental dullness -Drowsiness and bradycardia -Nervousness and tachycardia -Skin rash and itching

Proton pump inhibitors

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication? -H2RAs -Proton pump inhibitors -Antacids -Sucralfate

1 to 2 weeks

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms most likely be resolved? -6 weeks -1 month -4 weeks -1 to 2 weeks

"Have your calcium levels checked periodically."

A client is prescribed calcitriol [antihypocalcemic agents]. Which instruction would be most important for the nurse to include in the teaching plan? -"Take the drug with a magnesium antacid." -"Have your calcium levels checked periodically." -"Limit your intake of dairy products." -"Take the drug with food if gastrointestinal issues occur."

"Be sure to wear sunscreen while taking this medicine."

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? -"Take the medication with milk." -"Expect a metallic taste when taking this medicine, which is normal." -"Be sure to wear sunscreen while taking this medicine." -"Do not drive when taking this medication."

Central nervous system effects

A client is receiving a phenothiazine antiemetic. The nurse instructs the client to use the call light if he needs to get out of bed to go to the bathroom based on the understanding that this group of drugs is associated with: -Urinary abnormalities -Endocrine effects -Central nervous system effects -Gastrointestinal overstimulation

Offering carbonated drinks

A client is receiving an antiemetic. Which of the following would be most appropriate to facilitate the client's comfort? -Distracting the client with activities -Offering mouth care every 4 to 6 hours -Encouraging rapid, shallow breaths -Offering carbonated drinks

30 minutes

A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame? -15 minutes -30 minutes -60 minutes -45 minutes

polyethylene glycol-electrolyte solution

A client is scheduled for a colonoscopy in the morning. The nurse will provide information concerning which laxative? -polyethylene glycol-electrolyte solution -castor oil -lactulose -psyllium

PPIs suppress acid more strongly and for a longer time

A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA? -PPIs suppress acid more strongly and for a shorter time. -PPIs suppress acid more strongly and for a longer time. -PPIs are less expensive. -PPIs suppress acid more gently and for a longer time.

pork

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to -ragweed. -pollen. -pork. -shellfish.

Abdomen

A client learning to self-administer desmopressin subcutaneously should be taught to administer the injection at which site? -Deltoid -Abdomen -Ventrogluteal -Forearm

"It's true, that hydrocortisone can affect nearly every body system, but your health care team will monitor you thoroughly for indications of adverse reactions."

A client, prescribed hydrocortisone, states, "I know quite a few different people who have had unpleasant side effects of steroids." How should the nurse best respond to the client's concern? -"Most often, when people experience side effects of hydrocortisone it's because they've not following the instructions closely." -"There are indeed quite a few diverse side effects of hydrocortisone, but they're mostly very minor." -"In the past, this was often the case, but modern corticosteroids are largely free of side effects." -"It's true, that hydrocortisone can affect nearly every body system, but your health care team will monitor you thoroughly for indications of adverse reactions."

Laxatives should not be routinely taken due to destruction of nerve endings in the colon

A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? -Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first. -Laxatives should not be routinely taken due to destruction of nerve endings in the colon. -When taking the laxatives, plenty of fluid should be taken as well. -The laxatives should be taken no more than 3 times a week or laxative addiction will result.

A decrease in urine output

A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience? -A decrease in blood pressure -A decrease in blood glucose levels -A decrease in urine output -A decrease in appetite

-Dry mouth -Urine color change -Photosensitivity -Drowsiness

A patient is prescribed prochlorperazine. The nurse would teach the patient about which possible adverse effects? (Select all that apply.) -Drowsiness -Dry mouth -Photosensitivity -Irritability -Urine color change

10 to 20 minutes

A patient receives prochlorperazine by IM injection. The nurse would expect the drug to begin acting within which time frame? -40 to 50 minutes -10 to 20 minutes -30 to 40 minutes -20 to 30 minutes

Famotidine

Which medication is classified as a histamine-2 receptor antagonist? -Lansoprazole -Esomeprazole -Metronidazole -Famotidine

"I need to drink 8 ounces of water before eating."

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? -"I need to chew my food slowly and thoroughly." -"I need to drink 8 ounces of water before eating." -"A total serving should amount to be less than one cup." -"I should pick cereals with less than 2 g of fiber per serving.

"I should eat a high-fiber diet."

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful? -"I may need something to control diarrhea." -"I need to avoid sugarless lozenges." -"I should eat a high-fiber diet." -"I need to limit my fluid intake."

Loperamide

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent? -Bismuth subsalicylate -Kaolin and pectin -Loperamide -Bisacodyl

Subcutaneous injection

After teaching a group of students about the various methods for the delivery of insulin, the instructor determines that the teaching was successful when the students identify which method as most commonly used for administration? -Subcutaneous injection -Insulin pen -Implantable infusion pump -Jet injector

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine? -"Famotidine and omeprazole are both histamine-2 antagonists and could be used interchangeably." -"Famotidine is more expensive than omeprazole." -"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population." -"Omeprazole is taken at bedtime making it easier to remember."

Lubricates and softens fecal matter

As part of the management of constipation, the client is instructed to take 30 mL of mineral oil orally. How does mineral oil facilitate bowel evacuation? -Increases the volume of intestinal contents -Decreases water retention of stool -Lubricates and softens fecal matter -Irritates nerve endings in the intestinal mucosa

Headache

The health care provider has prescribed ranitidine (H2 antagonists) for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client? -Tremor -Anxiety -Headache -Visual disturbances

Abdominal distention

The nurse is teaching a client who is receiving prednisone about possible adverse effects. The client demonstrates understanding of the teaching when the client identifies what possible effect? -Abdominal distention -Anorexia -Weight loss -Hypoglycemia

Vasopressin

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? -Nitroglycerin -Spironolactone -Vasopressin -Cimetidine

Have a colleague confirm the dosage

Before administering a prescribed 20 units of NPH insulin to a client, the nurse should implement which intervention? -Assess the client's urine for the presence of glucose. -Have a colleague confirm the dosage. -Massage the chosen injection site. -Assess the client's understanding of diabetes.

Sympathetic

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? -Respiratory effects -Parasympathetic -Sympathetic -Gastrointestinal effects

Bismuth salts, antibiotics, and proton pump inhibitors

The health care provider prescribes a combination of three drugs to treat peptic ulcer disease. The nurse, preparing to review the drug actions and side effects with the patient, understands that the triple combination should be in which order? -Proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts -Prostaglandin E1 analogs, antibiotics, and proton pump inhibitors -Antibiotics, prostaglandin E1 analogs, and bismuth salts -Bismuth salts, antibiotics, and proton pump inhibitors

Abdominal pain and fever

The nurse is assessing a client who reports constipation. The use of a medication to treat this problem is contraindicated if the client reports what symptom? -Abdominal pain and fever -Lack of urge to defecate -Lack of bowel movement for 5 days -Frequent episodes of flatulence

-Throat burning -Metallic taste -Sore teeth

The nurse is assessing a patient receiving strong iodide solution. Which would alert the nurse to the possible development of iodism? (Select all that apply.) -Constipation -Throat burning -Metallic taste -Salivary gland swelling -Sore teeth

motion sickness

Different medications are used to treat the differing causes of nausea and vomiting. Antihistamines may be effective in the treatment of nausea and vomiting created by: -drugs. -radiation therapy. -surgery. -motion sickness.

Motion sickness

Different medications are used to treat the differing causes of nausea and vomiting. Phenothiazines, although effective against many causes, are usually ineffective in the treatment of nausea and vomiting created by: -Motion sickness. -Radiation therapy. -Surgery. -Drugs.

iodine solution

Diluting the drug with fruit juice or using a straw are appropriate instructions for a client taking

-Increase blood volume -Cause the release of glucose for energy -Block the effects of the inflammatory and immune systems -Block protein production to save energy

Corticosteroid hormones are released during a sympathetic stress reaction. They would act to do which of the following? -Increase blood volume -Cause the release of glucose for energy -Increase the rate of protein production -Block the effects of the inflammatory and immune systems -Store glucose to preserve energy -Block protein production to save energy

Decreasing intestinal motility

Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action? -Absorbing toxins -Decreasing intestinal motility -Inhibiting cellular division in causative bacteria -Binding with fecal material to increase bulk

Vital signs

The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client? -Pain -Skin -Vital signs -Vision

Vital signs

The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client? -Vital signs -Vision -Pain -Skin

Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol. What information from the nurse would be most accurate about misoprostol? -Increases the speed of gastric emptying -Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) -Works best when taken on an empty stomach -Decreases mucus production

reduce urine output to 2 to 3 L/24 hours.

DDAVP and lypressin (Diapid) do what

movements and reflexes in the gastrointestinal tract

Defecation is normally stimulated by what physiologic trigger? -synthesis and release of digestive enzymes -stimulation from the medulla oblongata -changes in the osmolarity of bowel contents -movements and reflexes in the gastrointestinal tract

-Elevated body temperature -Weight loss -Tachycardia -Insomnia

During initial therapy with levothyroxine (Synthroid), what are some of the most common reactions a nurse might observe in a client? (Select all that apply.) -Insomnia -Hypotension -Tachycardia -Elevated body temperature -Weight loss

-Decreases the tone of its muscularis mucosa layer -Decreases the secretion of digestive enzymes -Decreases peristatalsis -Increases sphincter tone

During the "fight or flight response" the sympathetic nervous makes what alterations to the functioning of the gastrointestinal system? Select all that apply. -Decreases the tone of its muscularis mucosa layer -Decreases peristatalsis -Increases stimulation of the chemoreceptor trigger center -Decreases the secretion of digestive enzymes -Increases sphincter tone

To relax colonic musculature and reduce spasm

The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure? -To reduce air accumulation in the colon. -To relax colonic musculature and reduce spasm. -To relieve anxiety during the procedure for moderate sedation. -The client is probably hypoglycemic and requires the glucagon.

Increased motility of the stomach

Gastrin has which of the following effects on gastrointestinal (GI) motility? -Increased motility of the stomach -Contraction of the ileocecal sphincter -Relaxation of gastroesophageal sphincter -Relaxation of the colon

promote the preservation of energy through increased glucose levels, protein breakdown, and fat formation

Glucocorticoids are hormones that -are released in response to high glucose levels. -help to regulate electrolyte levels. -help to regulate water balance in the body. -promote the preservation of energy through increased glucose levels, protein breakdown, and fat formation.

Diabetes mellitus

Glucocorticoids should be used with caution in patients with what disease process? -Diabetes mellitus -Hepatic disease -Hypotension -Pneumonia

iodine deficiency

Goiter also commonly occurs with?

hyperthyroidism

Goiter, or enlargement of the thyroid gland, is usually associated with -hypothyroidism. -iodine deficiency. -hyperthyroidism. -underactive thyroid tissue.

in the heart, CNS, and stomach.

H2 receptors are found throughout the body, including -in the nasal passages, upper airways, and stomach. -in the CNS and upper airways. -in the respiratory tract and the heart. -in the heart, CNS, and stomach.

B12

H2 receptors can cause this vitamin deficiency

garlic

Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication? -basil -garlic -anise -oregano

Pentagastrin

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? -Atropine -Pentagastrin -Glycopyrronium bromide -Acetylcysteine

-increased body temperature. -thickening of the tongue. -loss of hair

Hypothyroidism is a very common and often missed disorder. Signs and symptoms of hypothyroidism include -increased body temperature. -thickening of the tongue. -bradycardia. -loss of hair. -excessive weight loss. -oily skin.

Pitressin (Vasopressin)

In actively bleeding patients with esophageal varices, the initial drug of therapy is usually: -Pitressin -Inderal -Sandostatin -Corgard

-urinary retention -tachycardia -dizziness

In the hours following the initial administration of prescribed diphenoxylate [antidiarrheals] with atropine, the nurse should plan to assess the client for what adverse reaction? Select all that apply. -urinary retention -tachycardia -dyspnea -dizziness -pruritus

Treatment of gastroesophageal reflux

In which of the following scenarios would the nurse question the order for ondansetron (5-HT3)? -Prevention of postoperative nausea or vomiting -Prevention of nausea and vomiting from chemotherapy -Treatment of gastroesophageal reflux -Treatment of nausea and vomiting as a result of chemotherapy

Entry of glucose into the cells

Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which action does this enable? -Interruption of glucose movement across the membrane -Release of glucagon from the cells -Entry of glucose into the cells -Storage of glucagon in the cells

Speed the passage of the intestinal contents through the GI tract.

Laxatives are drugs that are used to -increase the quantity of wastes excreted. -speed the passage of the intestinal contents through the GI tract. -increase digestion of intestinal contents. -increase the water content of the intestinal contents.

Rapid-acting

Lispro (Humalog) is an example of which type of insulin? -Short-acting -Rapid-acting -Intermediate-acting -Long-acting

routine liver function testing

Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up? -serial complete blood counts -routine liver function testing -daily nonfasting blood glucose testing -chest radiographs every 3 months

are always given in conjunction with appropriate glucocorticoids.

Mineralocorticoids are used to maintain electrolyte balance in situations of adrenal insufficiency. Mineralocorticoids -are usually given alone. -can be given only IV. -are always given in conjunction with appropriate glucocorticoids. -are separate in their function from the glucocorticoids.

electrolyte levels

Mineralocorticoids directly affect: -cholesterol levels. -electrolyte levels. -blood glucose levels. -blood gas values.

prevent NSAID-related gastric ulcers in patients at high risk.

Misoprostol (Cytotec) is a prostaglandin that is used to -prevent uterine contractions. -prevent NSAID-related gastric ulcers in patients at high risk. -decrease hyperacidity with meals and at bedtime. -relieve the burning associated with hiatal hernia at night.

are pregnant

Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who: -are hypertensive. -are pregnant. -have arthritis. -have diabetes.

It inhibits both daytime and nocturnal basal gastric acid secretions as well as gastric acid secretion

Mr. Palmer is scheduled to receive ranitidine at 9:00 am this morning. What is a correct explanation of the pharmacodynamics of ranitidine? -It affects pepsin secretion. -It has effects on fasting or postprandial serum gastrin secretion. -It inhibits both daytime and nocturnal basal gastric acid secretions as well as gastric acid secretion. -It has effects on prolactin levels, gonadotropins, thyroid-stimulating hormone, growth hormone, cortisol, aldosterone, androgen and estrogen levels, and sperm count.

liver enzymes

Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? -liver enzymes -D-dimer -creatinine -platelet count

albumin

Serum calcium levels are directly related to what blood components? -glucose -sodium -potassium -albumin

-digoxin -opioid analgesics -anticancer drugs-

Some medications are more likely to cause the adverse effects of nausea and vomiting than others. With which medications are nausea and vomiting especially associated? Select all that apply. -opioid analgesics -digoxin -selective serotonin reuptake inhibitors (SSRIs) -anticancer drugs -beta-adrenergic blockers

Nausea

The nurse is teaching a client about loperamide, which the health care provider has prescribed for treatment of chronic diarrhea. Which adverse effects should the nurse be sure to mention? -Disorientation -Flatulence -Nausea -Tremors

Activation of the sympathetic nervous system

The anatomy and physiology instructor is discussing reactions of the body to stress. According to the instructor, what is responsible for the release of cortisol (hydrocortisone) during times of stress? -Activation of the parasympathetic nervous system -Stimulation of the thyroid -Activation of the sympathetic nervous system -The negative feedback mechanism

Renal dysfunction

The client has Maalox (Magnesium-based antiacid) ordered for administration before meals. Which condition is contraindicated with the administration of Maalox? -Renal dysfunction -Stress ulcer -Heart rate of 68 -Hypertension

06:45

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? -06:45 -06:00 -06:20 -07:00

alendronate.

The drug of choice for the treatment of postmenopausal osteoporosis would be -risedronate. -alendronate. -zoledronic acid -calcitriol.

Hypoglycemia

The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client? -Bradycardia -Lipodystrophy -Hypoglycemia -Hypotension

-Reinforce teaching about dosage. -Encourage client to sip on clear fluids to prevent dehydration. -Do not drive while taking antinausea medicine.

The home care nurse is visiting a client who is receiving antiemetics. Which actions will the nurse perform to ensure safe and effective treatment for the client? (Select all that apply.) -Reinforce teaching about dosage. -Encourage the client to get up and walk after taking the medication. -Do not drive while taking antinausea medicine. -Encourage client to sip on clear fluids to prevent dehydration. -Take the medication approximately 5 minutes before taking the medication that makes you nauseated.

10:00 AM to 10:30 AM

The nurse administers metoclopramide [gastrointestinal stimulants] orally at 9:00 AM to a patient with GERD. The nurse would expect this drug to exert its maximum effectiveness at which time? -1:00 PM to 2:00 PM -10:00 AM to 10:30 AM -11:00 AM to 11:30 AM -12 noon to 12:30 PM

I will start this medication when I am feeling ill or tired.

The nurse has just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. What statement indicates the client requires further instruction? -I will call my health care provider if I develop a fever. -I need to minimize my exposure to anyone who may be ill. -I will report any weight gain above 5 pounds in 1 week to my health care provider. -I will start this medication when I am feeling ill or tired.

"I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."

The nurse has just finished client education with a client who is being discharged home on bulk-forming laxatives. The nurse knows the client understands discharge instructructions regarding these medications when which statement is made? -"I will mix the dry medication with applesauce." -"I will decrease the roughage in my diet while I am using this medication." -"I will use milk of magnesia in conjunction with this medication until I am having daily bowel movements." -"I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."

esophageal bleeding

The nurse has reinforced the correct administration technique for alendronate in the knowledge that incorrect administration is associated with what increased risk? -ischemic stroke -esophageal bleeding -decreased joint range of motion -coronary artery disease (CAD)

-Bradycardia -Feeding difficulties -Lethargy

The nurse in the newborn nursery is assessing an infant with suspected congenital hypothyroidism. What assessment findings support this diagnosis? (Select all that apply.) -Bradycardia -Feeding difficulties -Lethargy -Elevated temperature -Diarrhea

-Orange or other fruit juice -Glucose tablets -Hard candy

The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.) -Glucose tablets -Insulin glargine (Lantus) -Orange or other fruit juice -Hard candy -Insulin detemir (Levemir)

-Sodium iodide -Potassium iodide -Saturated solution of potassium iodide (SSKI)

The nurse recognizes that which of the following agents suppress release of thyroid hormones? Select all that apply. -Propylthiouracil (PTU) -Saturated solution of potassium iodide (SSKI) -Potassium iodide -Methimazole -Sodium iodide

Anterior neck

The nurse should assess for an enlarged thyroid by palpating which area? -Midsternum -Anterior neck -Submandibular -Supraclavicular

inhibiting the secretion of gastric acid

The nurse should be aware that ranitidine achieves a therapeutic effect by which means? -binding to proton pumps -raising the pH of gastric secretions -decreasing gastric motility -inhibiting the secretion of gastric acid

hemorrhage

The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction? -hemorrhage -venous thromboembolism -fluid volume excess -rebound gastroesophageal reflux disease (GERD)

2 days

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long? -7 days -2 days -1 day -12 hours

a dark tongue or dark stool

The nurse should inform the client planning to use an over-the-counter bismuth[antidiarrheals] product that there is a potential that the medication will cause what side effect? -hyperglycemia and a metallic taste -photosensitivity and visual "floaters" -yellowing of the sclerae and skin -a dark tongue or dark stool

Tachycardia

The nurse should monitor a client for which effect of a drug interaction in a client taking thyroid hormones and a beta blocker? -Visual changes -Tachycardia -Prolonged bleeding -Hypoglycemia

Constipation

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects? -Constipation -Diarrhea -Dehydration -Flatulence

Inhibition of production of thyroid hormone

The pharmacology instructor is providing education regarding antithyroid horomone/ propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication? -Inhibition of production of thyroid hormone -Suppression of the anterior pituitary gland's hormonal secretions -Sedation of the central nervous system and suppression of cardiac function -Destruction of part of the thyroid gland

Levothyroxine (Synthroid)

The preferred preparation for treating hypothyroidism includes which of the following? -Methimazole (Tapazole) -Levothyroxine (Synthroid) -Propylthiouracil (PTU) -Radioactive iodine

"In order to manage this condition, you'll need to take these for the rest of your life."

The results of a client's plasma corticotropin (ACTH) stimulation test have confirmed a diagnosis of Addison's disease. The nurse has consequently provided health education around the necessity of hormone replacement therapy. The client has asked the nurse, "How long am I going to have to take these medications?" How should the nurse best respond? -"In order to manage this condition, you'll need to take these for the rest of your life." -"You'll have to take these until you can pass the corticotropin stimulation test without them." -"You'll need to take these until your symptoms have been stable for at least 6 months." -"You'll have to take these until your kidneys regain their normal level of function."

iodine found in the diet.

The thyroid gland produces the thyroid hormones triiodothyronine (T3) and tetraiodothyronine (T4), which are dependent on the availability of -iodine produced in the liver. -iodine found in the diet. -iron absorbed from the GI tract. -PTH to promote iodine binding.

Lifelong exogenous insulin is required

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes? -it always starts in childhood. -Blood glucose level can be controlled with diet. -Lifelong exogenous insulin is required. -Oral agents can control the disease process.

A client seen in the emergency room for injuries associated with alcohol intoxication

The use of an antiemetic is not clinically safe for which client reporting nausea and vomiting? -A client seen in the emergency room for injuries associated with alcohol intoxication -A postoperative client who underwent a an internal fixation of the femur -A client receiving intensive chemotherapy of metastatic cancer -A client experiencing exacerbation of chronic intractable hiccups

myxedema.

Thyroid replacement therapy is indicated for the treatment of -obesity. -myxedema. -Graves' disease. -acute thyrotoxicosis.

-hyperglycemia -peptic ulcers -mood disorders -cataracts

What adverse effects should the nurse discuss with a client prescribed long-term systemic corticosteroid therapy? Select all that apply. -hyperglycemia -peptic ulcers -weight loss -mood disorders -cataracts

ondansetron [5-HT3]

What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting?

Neutralize the acid bolus

What best describes the action of sodium bicarbonate (antiacid)? -Neutralize the acid bolus -Facilitate swallowing -Breakdown of proteins -Stomach muscle contraction

Laxatives may reduce absorption of other drugs present in the GI tract

What is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications? -They often taste bad and clients are less likely to take other medications. -Often laxatives make the client nauseated, which interferes with the ability to take medications. -Because a laxative may stimulate a bowel movement, it can interfere with medication administration. -Laxatives may reduce absorption of other drugs present in the GI tract.

"They slowly increased the dose until I stopped vomiting."

Which statement, made by an older adult who is prescribed an antiemetic, demonstrates effective medication management by the healthcare provider? -"They gave me the medication in the form of a rectal suppository." -"I've never experienced any dizziness from the medication." -"The medication made me only a little sleep." -"They slowly increased the dose until I stopped vomiting."

Flushed, warm skin

Which would a nurse expect to assess in a client experiencing hyperthyroidism? -Bradycardia -Slow and deep tendon reflexes -Intolerance to cold -Flushed, warm skin

Massaging the site after removing the needle

Which would be least appropriate when administering insulin by subcutaneous injection? -Inserting the needle at a 45-degree angle -Injecting the insulin slowly -Using a 25 gauge 1/2-inch needle -Massaging the site after removing the needle

Taking the agent with a large amount of wate

Which would be most important to include when teaching a patient about using psyllium [bulk forming]? -Limiting the use of high fiber foods -Taking other prescribed drugs along with the psyllium -Taking the agent with a large amount of water -Taking the agent at bedtime

Muscle weakness

Which would the nurse expect to assess in a patient who is to start therapy with biphosphonates? -Muscle weakness -Paresthesias -Tetany -Hyperactive reflexes

Dystonia

a condition of abnormal muscle tone that causes the impairment of voluntary muscle movement

steroids

the nurse is assessing the client's understanding of the use of medications. which medicines may cause a complication with the treatment plan of a client with diabetes? -aspirin -steroids -sulfonylureas -ACE inhibitors

Adsorbents

All of the following are centrally acting antiemetics EXCEPT -Antihistamines -Phenothiazines -Serotonin (5-HT3) receptor blockers -Anticholinergics -Adsorbents

Agitation

An 86-year-old client has been prescribed ranitidine (Zantac). The nurse knows that an older adult who takes H2RAs may experience what adverse effect? -Hypertension -Hyperplasia -Lethargy -Agitation

dry mouth

An adult client being administered hydroxyzine [antihistamines] for nausea should be monitored for which adverse effect? -thrombocytopenia -palpitations -hypertonic muscle tone -dry mouth

use of a fiber supplement

A middle-aged client, frustrated by increasingly frequent episodes of constipation, is highly reluctant to take medications. What nonpharmacologic measure should the nurse recommend? -adoption of a low-fat diet -daily consumption of 6 to 8 L of fluids -use of a fiber supplement -use of a ginger or ginseng supplement

Coronary artery disease

A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history: -Diabetes -Coronary artery disease -Peptic ulcer disease -Use of lithium

2 tablets

A client has been prescribed 200 micrograms of misoprostol to be taken 4 times a day orally for the prevention of gastric ulcers. The drug is available in 100 microgram tablets. How many tablets should the nurse administer to the client each time? -Half a tablet -3 tablets -1 tablet -2 tablets

Polyethylene glycol-electrolyte solution (NuLYTELY)

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is: -Polyethylene glycol solution (MiraLAX) -Bisacodyl (Dulcolax) -Polyethylene glycol-electrolyte solution (NuLYTELY) -Psyllium (Metamucil)

hepatic disease

A client is taking cimetidine (H2 antagonist) for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition? -hepatic disease -diabetes mellitus -hypertension -cancer

30 to 60 minutes before the treatment

A client is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the client severe nausea and vomiting. The oncology nurse should normally administer antiemetics on what schedule? -simultaneous with radiation treatment -30 to 60 minutes before the treatment -the night before a scheduled radiation treatment -10 to 15 minutes before the treatment

Inspect the previous injection site for inflammation

A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose? -Check for symptoms of myalgia or malaise. -Do not administer insulin kept at room temperature. -Keep prefilled syringes horizontally. -Inspect the previous injection site for inflammation.

Insulin is needed because the beta cells of the pancreas are no longer functioning

A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client? -Insulin is needed because the beta cells of the pancreas are no longer functioning. -More insulin is needed than that which the client can produce naturally. -The client most likely does not exercise enough to control his glucose levels. -The insulin is more effective in establishing control of blood glucose levels initially.

"Have you been under an unusual amount of stress lately?"

A 38-year-old client has been living with Addison's disease for many years and has achieved adequate symptom control through lifestyle modifications and drug therapy. However, the client has now been admitted to the hospital in addisonian crisis. Which of the nurse's assessment question is most appropriate? -"How would you describe your diet over the last few days?" -"Have you been under an unusual amount of stress lately?" -"When was the last time that you drank any alcohol?" - "Has your urine output been typical for the past few days?"

"Sadly, this is an adverse effect seen in women. It should improve when you finish the medication."

A 45-year-old woman has been taking a corticosteroid and calls the clinic reporting the development of acne-like lesion on her face as well as facial hair. What is the nurse's best response? -"This is a permanent problem. You will need to schedule electrolysis treatments." -"Sadly, this is an adverse effect seen in women. It should improve when you finish the medication." -"If you shave it regularly, no one will notice." -"Stop taking the drug immediately."

Accumulation and hypoglycemia

A 54-year-old male client is diagnosed with chronic renal failure and hyperglycemia. He asks if he can be prescribed sulfonylurea because it works well for his friend. If he were to be given sulfonylurea, this client's renal impairment may lead to what effect? -Decreased absorption of the sulfonylurea -Accumulation and hyperglycemic reactions -Accumulation and hypoglycemia -Hypersensitivity to sulfonylurea

Smaller than the average prescribed dose

A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way? -No antacids, because they are contraindicated in the elderly -The same as the average prescribed dose -Larger than the average prescribed dose -Smaller than the average prescribed dose

subcutaneous

A black box warning alerts nurses that promethazine is contraindicated for this type of administration

"Children younger than 1 year of age should not be given this medication."

A caregiver of a 1-year-old asks the nurse if the caregiver can give the diphenoxylate [antidiarrheals] that was prescribed for an older sibling to the child. Which is the nurse's best response? -"Children younger than 1 year of age should not be given this medication." -"I will call the prescriber to find out if this is safe." -"There are over-the-counter medications that are better for the 1-year-old." -"The medication needs to be adjusted for the 1-year-old's weight."

delayed growth and development

A child has received a diagnosis of Addison's disease, and the nurse is providing health education to the child's family around hormone replacement therapy. When planning this child's care, the nurse should know that hormone replacement therapy constitutes a risk for what nursing diagnosis? -deficient fluid volume -latex allergic response -impaired gas exchange -delayed growth and development

Dystonia

A child is administered metoclopramide (nonphenothiazine) for nausea. What adverse effect is likely with this medication? -Dystonia -Thrombocytopenia -Malignant hyperthermia -Palpitations

Notify the primary health care provider

A client admitted to the hospital with hyperthyroidism treated with propylthiouracil [propylthiouracil] suddenly develops a skin rash. Which action would the nurse implement first? -Avoid using soap to cleanse affected areas. -Notify the primary health care provider. -Record weight and report weight gain or loss. -Provide soothing cream to affected areas.

osteopenia

A client diagnosed with excessive parathyroid production is prone to develop: -Alzheimer's disease. - hypertension. -osteopenia. -heart disease.

TSH

A client diagnosed with hypothyroidism is to start thyroid hormone replacement therapy. Which lab value should the nurse review to assist the health care provider in determining the dosage? -Glucose -CBC -Platelets -TSH

serum sodium 128 mEq/L (128 mmol/L)

A client has been admitted to the emergency department with a diverse constellation of signs and symptoms. What diagnostic finding is most consistent with a diagnosis of Addison's disease? -serum albumin 4.0 g/dL (40 g/L) -serum potassium 3.9 mEq/L (3.90 mmol/L) -blood glucose 75 mg/dL (4.16 mmol/L) -serum sodium 128 mEq/L (128 mmol/L)

Early morning

A client has been placed on daily glucocorticoid therapy. The nurse should teach the client to take the medication at which time of day? -Lunch time -Bedtime -Early morning -Afternoon

Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.

A client prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client? -Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias. -The metformin will be temporarily substituted for with insulin, to address the risk of potential kidney failure. -The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out the kidneys. -The client will be prescribed an extra dose of metformin due to address the contrast material's effect on the body.

Grapefruit juice

A client receiving cancer chemotherapy has been prescribed aprepitant [neurokinin 1 receptor antagonist] for nausea. The nurse should instruct the client to avoid which liquid? -Coffee -Orange juice -Whole milk -Grapefruit juice

Apply a soothing cream until the rash subside

A client taking methimazole develops a rash. What is the nurse's best recommendation to treat the rash? -Use an antibacterial soap when bathing. -Wear gloves to prevent scratching and subsequent skin damage. -Apply a soothing cream until the rash subsides. -Avoid topical lubricants.

Permit the client to drink only clear liquids.

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? -Instruct the client to have low-residue meals. -Provide saline gargles to the client. -Allow the client to ingest fat-free meal. -Permit the client to drink only clear liquids.

Assess the most recent hemoglobin A1C levels

A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? -Arrange to have the client's random blood glucose measured. -Review and discuss the data contained in the client's written blood glucose log. -Assess the most recent hemoglobin A1C levels. -Dialogue with the client about implemented management strategies.

Sore teeth

A client who is receiving a strong iodide solution, potassium iodide, develops iodism. What would the nurse expect to find? -Rash -Sweet taste in the mouth -Sore teeth -Constipation

Sympathetic stress reaction due to intense GI tract neurostimulation

A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following? -Direct stimulation of the nerve plexus in the abdominal wall -Formation of a slippery coat on the contents of the intestinal tract -Detergent action on the surface of the intestinal bolus -Sympathetic stress reaction due to intense GI tract neurostimulation

diarrhea

A client who is undergoing cancer treatment is being discharged home with a prescription for ondansetron. When providing medication education concerning ondansetron, the nurse should describe actions that the client can take to address what common adverse effect? -shortness of breath -dry cough -anorexia -diarrhea

"Avoid contact with other people who might have an infection."

A client with Crohn's disease is to receive prednisone as part of the treatment plan. Which of the following instructions would be appropriate? -"Avoid contact with other people who might have an infection." -"Make sure to increase your salt intake to compensate for the loss of fluid." -"Once your symptoms improve, you can stop taking the drug." -"Take the drug on an empty stomach to avoid upsetting your stomach."

"The medications will kill the bacteria and stop the acid production."

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen? -"My ulcer will heal because these medications will kill the bacteria." -"The medications will kill the bacteria and stop the acid production." -"I should take these medications only when I have pain from my ulcer." -"These medications will coat the ulcer and decrease the acid producation in my stomach."

Vitamin K

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? -Potassium -Oral bile acids -Vitamin K -Vitamin B

Increased thirst

A client with diabetes has started thyroid hormone replacement therapy. The nurse should monitor closely for which effects? -Increased thirst -Decreased appetite -Decreased oral fluid intake -Oliguria

the past 3 or 4 months

A client with diabetes is undergoing testing for glycosylated hemoglobin. The nurse instructs the client that this test measures average blood glucose over what time period? -the past 1 or 2 months -the past 3 or 4 months -the past 12 to 24 hours -the past 7 to 10 days

Vitamin A

A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client? -Vitamin A -Vitamin K -Thiamine -Riboflavin

Calcium gluconate

A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit? -Fludrocortisone -Sodium bicarbonate -Calcium gluconate -Methylprednisolone

urinary retention

A client, prescribed an antihistamine for nausea, should be monitored for which adverse effect of this classification of medication? -urinary retention -inverted T wave -prolonged QRS complex -diarrhea

metabolic alkalosis

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for: -metabolic acidosis. -hypocalcemia. -hypercholesterolemia. -metabolic alkalosis.

"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."

A client, who is 42 years old and newly diagnosed with type 2 diabetes, has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching? -"I don't like getting this diagnosis, but I know that treatment now can prevent future health consequences." -"People always tried to encourage me to lose weight, and I suppose they might have been right." -"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections." -"From what I've learned, I know that the basic problem is that my pancreas can't keep up with my insulin needs."

smoking effects on the healing of ulcers

A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment? -the connection between smoking and chronic pain -the importance of taking prescribed medication until symptoms subside -smoking effects on the healing of ulcers general health dangers research has proven to be associated with smoking

dependence

A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives? -abdominal pain -fecal incontinence -impaired absorption of water-soluble vitamins -dependence

-Assist the client in making menus that will meet the needs of both the client and the family. -Watch the client draw up and administer her insulin. -Reinforce instructions on dealing with hypoglycemia

A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.) -Encourage the client to check her blood glucose every hour. -Watch the client draw up and administer her insulin. -Instruct the client to go to the emergency department immediately if she develops a cold or upper respiratory infection. -Reinforce instructions on dealing with hypoglycemia. -Assist the client in making menus that will meet the needs of both the client and the family.

Rebound acidity

A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client? -Hyperactive gastric mucosa -Hypocalcemia -Gastric reflux -Rebound acidity

Client's average blood glucose is above normal.

A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding? -Client is in good glycemic control. -Client's blood glucose levels are not consistent. -Client's blood glucose demonstrates longstanding hypoglycemia. -Client's average blood glucose is above normal.

Use strict birth control methods

A female client with chronic hepatitis B has been prescribed recombinant interferon alfa-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client? -Maintain an exercise regimen. -Avoid hot water baths or soaks. -Use strict birth control methods. -Avoid calcium-rich foods.

"It may take three to four weeks for the effects of this medication to be seen."

A female client with hyperthyroidism reports nervousness and "racing" heart one week after starting antithyroid medication. How should the nurse respond to the client's report? -"I'll notify the primary care provider about increasing the dosage." -"Increase the dosage of medication each day until relief of symptoms is achieved." -"Have you counted your resting heart rate?" -"It may take three to four weeks for the effects of this medication to be seen."

Increase the fluid in the intestinal contents

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants? -Increase the fluid in the intestinal contents -Directly stimulate the nerve plexus in the intestinal wall -Allow formation of a slippery coat on the intestinal contents -Selectively antagonize opioid binding

At bedtime

A health care provider has written an order for ranitidine 300 mg once daily. The nurse schedules the medication for which time? -Before breakfast -After lunch -At bedtime -With supper

persistent tachycardia

A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug? -orthostatic hypotension -visual disturbances -persistent tachycardia -tinnitus

Use an alternative medication

A male client has been receiving promethazine for nausea that occurred following chemotherapy. Recently it has been discovered that this client has developed liver dysfunction. The nurse anticipates that the health care provider will do what to treat this client's nausea? -Use an alternative medication. -Decrease the dose of the medication. -Maintain the current dose of the medication. -Increase the dose of the medication.

Prednisone

A male client is diagnosed with Addison's disease. What daily medication would the nurse expect to be administered? -Hydrochlorothiazide -Warfarin -Apresoline -Prednisone

-Duodenal ulcers -Zollinger-Ellison syndrome -Gastric ulcers

A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for: -metabolic acidosis. -hypocalcemia. -hypercholesterolemia. -metabolic alkalosis.

general assessment of the skin

A nurse at a health care facility is caring for a client who has been prescribed insulin for the first time. Which preadministration assessments should the nurse perform before the first dose of insulin is given? -assess the dental health of the client -assess for hypoglycemic episodes -general assessment of the skin -assess the hearing ability of the client

signs of GI irritation

A nurse caring for a patient receiving pancreatic enzymes as replacement therapy should be assessing the patient for -hypertension. -cardiac arrhythmias. -excessive weight gain. -signs of GI irritation.

-Palpitation -Excessive diaphoresis -Significant weight changes -Chest pain

A nurse educating a client and their family about thyroid hormone/levothyroxine (Synthroid) for the treatment of hypothyroidism should advise the client to contact the health care provider if which occur? (Select all that apply.) -Constipation -Palpitation -Chest pain -Significant weight changes -Excessive diaphoresis

-Rebound hyperacidity -Headache -Confusion

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply: -Confusion -Anorexia -Headache -Rebound hyperacidity -Dehydration

"Excess glucose pulled more water through your kidneys and the increased urination caused thirst."

A nurse educator, explaining the pathophysiology of diabetes to a newly diagnosed client, should provide what explanation for the client's "constant, insatiable thirst"? -"Excess glucose pulled more water through your kidneys and the increased urination caused thirst." -"When your body cells are starved for useful glucose, they signal your body to increase food and fluid intake." -"Increased thirst is your body's attempt to dilute your blood because it contains too much glucose." -"The excess glucose in your blood accumulates in your blood vessels and neurons, including the neurons that control thirst."

Insulin is absorbed more rapidly at abdominal injection sites than at other sites

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

"The medication makes the client sleepy by blocking the action of the serotonin receptors."

A nurse is caring for a client admitted to the unit for nausea and vomiting who was treated with ondansteron. A friend visiting the client asks the nurse why the client is sleeping. Which is the nurse's best response? -"The medication makes the client sleepy by blocking the action of the serotonin receptors." -"I have been instructed to allow the client to sleep." -"The client is having anticholinergic effects from the medication." -"The drug blocks the postganglionic neurons to depress the vomiting center in the brain.

Call the prescriber about the laboratory tests

A nurse is caring for a client that has developed diarrhea after antibiotic administration. The client has a BUN of 35 and creatinine of 1.8. The provider has ordered diphenoxylate with atropine for the client. What action should the nurse implement? -Administer the medication as prescribed. -Hold the medication. -Call the prescriber about the laboratory tests. -Discuss the issues with another nurse on the unit.

history of taking anticoagulant drugs

A nurse is caring for a client who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for: -history of taking anticoagulant drugs. -the client's age. -hirsutism. -allergy to seafood.

edema

A nurse is caring for a client with adrenocortical deficiency. The health care provider has prescribed a fludrocortisone drug to the client. Which adverse reaction should the nurse monitor for in the client? -nasal congestion -sore throat -malaise -edema

Observe the patient for hypoglycemic episodes

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient? -Assess the skin for ulcers, cuts, and sores. -Document family medical history. -Monitor the patient for lipodystrophy. -Observe the patient for hypoglycemic episodes.

Decreased cardiac output

A nurse is caring for a patient with hypothyroidism. The nurse would know that the effects of hypothyroidism include: -Decreased cardiac output -Increased blood pressure -Nervousness and restlessness -Fever

Closely monitor the patient for confusion and dizziness

A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform? -Inform the PHCP if the patient exhibits tardive dyskinesia symptoms. -Closely monitor the patient for confusion and dizziness. -Monitor the patient for reports of pain or sour taste. -Monitor the patient for concentrated urine and restlessness.

insulin lispro

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer? -insulin detemir -insulin glargine -isophane insulin suspension -insulin lispro

measurement of blood pressure

A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment? -temperature measurement -assessment of pupillary response -chest auscultation for rales -measurement of blood pressure

apple juice

A nurse is preparing to administer dolasetron [5-HT3] orally to a child who is unable to swallow the tablet. The nurse would expect to mix the solution with: -apple juice. -cranberry juice. -orange juice. -grapefruit juice.

"This medication will help with the nausea by making you drowsy."

A nurse is preparing to administer hydroxyzine [antihistamine] to the nauseated client. Which is included in the teaching plan about the medication? -"I will mix this medication with applesauce to help you feel better." -"The medication may make you feel more alert, like coffee." -"This medication will help with the nausea by making you drowsy." -"The drug will aid in making you feel less nauseated by stimulating your intestines."

Order an additional calcium supplement

A nurse is reviewing the laboratory values of a client being treated for a diagnosis of hypocalcemia. The current serum calcium level is 8.1 mg/dL. What intervention does the nurse expect the prescriber to order? -Redraw the serum level of calcium. -Order an additional calcium supplement. -Prescribe potassium chloride infusion. -The prescriber will not order any intervention.

-Acetaminophen -Ketoconazole -Valproic acid

A nurse is taking health history data from a client. Use of which of the following medications would especially alert the nurse to an increased risk of hepatic dysfunction and disease in this client? Select all that apply. -Valproic acid -Ketoconazole -Insulin -Diazepam -Acetaminophen

"I need to swallow the drug whole."

A nurse is teaching a client about omeprazole [Proton Pump Inhbitors], which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug? -"I should crush the medication and mix it into apple sauce." -"It is important that I take the drug after each meal." -"I need to swallow the drug whole." -"I'll have to stop using antacids."

"As my stools decrease, I will discontinue this medication."

A nurse is teaching a client who is prescribed diphenoxylate[antidiarrheals] with atropine. Which statement by the client indicates the teaching was effective? -"I will add this medication to my daily medication schedule." -"As my stools decrease, I will discontinue this medication." -"I will start working out at the gym before my bowel habits become more normal." -"My urine should be dark and cloudy."

"I may stop taking this medication when I feel better."

A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching? -"I may stop taking this medication when I feel better." -"I will eat lots of chicken and dairy products." -"I will avoid friends and family members who are sick." -"I will see my ophthalmologist regularly for a check-up."

-consuming a high-fiber diet -engaging in frequent physical exercise -drinking 6 to 10 glasses of fluid each day

A nurse is teaching a group of older adults about strategies for preventing constipation that do not involve the use of medications. The nurse should recommend what intervention? Select all that apply. -consuming a high-fiber diet -drinking 6 to 10 glasses of fluid each day -engaging in frequent physical exercise -reserving at least 8 hours nightly to assure adequate sleep -introducing organic foods into the daily diet

Take an oral dose of some form of glucose as soon as possible

A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction? -Stay calm and still until the reaction subsides. -Take an oral dose of some form of glucose as soon as possible. -Inject a prescribed dose of insulin as soon as you suspect the reaction is occurring. -Notify your health care provider immediately.

Omeprazole (Prilosec)

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. -Ranitidine (Zantac) -Famotidine (Pepcid) -Cimetidine (Tagamet) -Omeprazole (Prilosec)

Proton pump inhibitors

A nurse practitioner, who is treating a patient with GERD, knows that responsiveness to this drug classification is validation of the disease. The drug classification is: -Proton pump inhibitors. -Antacids -Antispasmodics -H2-receptor antagonists.

infections

A nurse taking a medical history on a client prescribed a corticosteroid medication should focus on which condition? -cognitive impairment -urinary incontinence -depression -infections

This time mimics the normal peak diurnal concentration levels.

A nurse tells a patient to take a prescribed glucocorticoid in the morning based on the understanding that: -This time ensures that the patient will take the drug. -The drug is absorbed better in the morning. -The drug needs to suppress the hypothalamic pituitary axis. -This time mimics the normal peak diurnal concentration levels.

Administer a lower dose

A patient is administered metoclopramide (nonphenothiazine). The patient has an elevated creatinine level. Which of the following is important when administering metoclopramide to this patient? -Administer a higher dose -Hold the medication -Administer a lower dose Administer the routine dose

-to restrict fluids as much as possible. -to stay upright for at least 1/2 hour after taking the drug.

A patient who is receiving a bisphosphonate for the treatment of postmenopausal osteoporosis should be taught -to also take vitamin D, calcium, and hormone replacement. -to restrict fluids as much as possible. -to take the drug before any food for the day, with a full glass of water. -to stay upright for at least 1/2 hour after taking the drug. -to take the drug with meals to avoid GI upset. -to avoid exercise to prevent bone fractures.

Widespread changes in the blood vessels

A patient with type 1 diabetes has come to the clinic for a routine follow-up appointment. While assessing the patient's skin, the nurse observes brown spots on his lower legs. What might these spots indicate? -Infection -Widespread changes in the blood vessels -Impaired glucose tolerance -Poor insulin injection technique

level of consciousness (LOC)

A physician orders lactulose (Cephulac), 30 ml three times daily, when a client with cirrhosis develops an increased serum ammonia level. To evaluate the effectiveness of lactulose, the nurse should monitor: -level of consciousness (LOC). -urine output. -stool frequency. -abdominal girth.

Loss of 2.2 lb (1 kg) in 24 hours

A physician orders spironolactone (Aldactone), 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? -Serum sodium level of 135 mEq/L -Blood pH of 7.25 -Loss of 2.2 lb (1 kg) in 24 hours -Serum potassium level of 3.5 mEq/L

It absorbs toxins and water, decreasing fluidity of stools

A prescriber adds magnesium citrate to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of magnesium citrate? -It absorbs toxins and water, decreasing fluidity of stools. -It reduces exchange of proteins and mucus in the stools. -It causes bloating and swells the colon. -It binds and expels toxins into the stool.

Helps tissues use insulin more efficiently

A type 2 diabetic is ordered metformin (Glucophage) as part of the management regime. Which is the best nursing explanation for the action of this drug in controlling glucose levels? -Delays digestion of carbohydrates -Reduces the production of glucose by the liver -Helps tissues use insulin more efficiently -Stimulates insulin release

lowering gastric acid to an alkaline level stimulates the release of gastric acid.

Acid rebound is a condition that occurs when -lowering gastric acid to an alkaline level stimulates the release of gastric acid. -raising gastric acid levels causes heartburn. -combining protein, calcium, and smoking greatly elevates gastric acid levels. -eating citrus fruit neutralizes gastric acid.

the importance of gradually reducing rather than abruptly stopping the drug

An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize? -the need to supplement prednisone with high doses of vitamin D -the need to avoid drinking grapefruit juice for the duration of treatment -the importance of gradually reducing rather than abruptly stopping the drug -the importance of matching each day's dose to the severity of symptoms

"I've been using a lot of antacids lately because of my indigestion."

An older adult client has been using levothyroxine for several years on an outclient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine? -"My daughter and I have started the Atkin's diet to try to lose some weight." -"Overall, I'd say that I'm under a lot of stress lately." -"I've stopped taking aspirin for my arthritis and started using Tylenol." - "I've been using a lot of antacids lately because of my indigestion.

Protect from injury

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client? -Have the client void after administration. -Maintain IV access. -Encourage fluids with this client -Protect from injury.

risk for falls related to adverse effects of hydroxyzine

An older adult client with early-stage Alzheimer's disease has had hydroxyzine prescribed for nausea. When planning this client's care, the nurse should consequently identify what risk nursing diagnosis? -risk for impaired skin integrity related to adverse effects of hydroxyzine -risk for falls related to adverse effects of hydroxyzine -risk for infection related to adverse effects of hydroxyzine -risk for functional urinary incontinence related to adverse effects of hydroxyzin

decreased absorption of drugs and vitamin

An older adult has regularly drunk mineral oil to treat occasional episodes of constipation. The nurse should encourage the client to explore other treatments because the use of oral mineral oil can result in which adverse effect? -edema from changes in intestinal solute content -paralytic ileus -rebound constipation -decreased absorption of drugs and vitamin

Obesity

The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition? -GERD -Hypotension -Diabetes mellitus type 1 -Obesity

8 mg

The nurse is caring for a client with a hepatic impairment. The nurse knows that the dose of ondansetron should not exceed what amount? -8 mg -12 mg -6 mg - 10 mg

Spironolactone (Aldactone)

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? -Acetazolamide (Diamox) -Bumetanide (Bumex) -Furosemide (Lasix) -Spironolactone (Aldactone)

-Decreased level of consciousness -Decreased respirations -Decreased blood pressure

The nurse is caring for a client with severe hypothyroidism and knows to contact the health care provider if which symptoms of myxedema coma occur? (Select all that apply.) -Decreased blood pressure -Decreased respirations -Fever -High blood glucose level -Decreased level of consciousness

Urinary retention

The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea? -Polyuria -Hematuria -Urinary retention -Dysuri

Spironolactone (Aldactone)

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? -Acetazolamide (Diamox) -Spironolactone (Aldactone) -Bumetanide (Bumex) -Furosemide (Lasix

Colitis

The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition? -Colitis -Chronic constipation -Gastroesophageal reflux disease -Oral stomatitis

parathyroid glands

What organ provides the control over the amount of calcium in the blood? -parathyroid glands -thyroid gland -pituitary -kidneys

To reduce gastric and pancreatic secretions

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason? -To reduce gastric and pancreatic secretions -To depress the central nervous system and increase the pain threshold -To decrease metabolism -To relieve nausea and vomiting

Sulfonylureas

Which category of oral antidiabetic agents exerts the primary action by directly stimulating the pancreas to secrete insulin? -Thiazolidinediones -Sulfonylureas -Alpha-glucosidase inhibitors -Biguanides

Bisacodyl

Which drug is considered a stimulant laxative? -Magnesium hydroxide -Bisacodyl -Mineral oil -Psyllium hydrophilic mucilloid

Pituitary ACTH levels

Naturally occurring aldosterone is regulated by which mechanism? -Increased renal blood flow, promoting an increase in aldosterone levels -Pituitary ACTH levels -In the absence of potassium, aldosterone levels increase. -Intercellular sodium and potassium

liver enzymes

Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? -liver enzymes -platelet count -D-dimer -creatinine

Inhibit gastric acid secretions.

The client has been taking famotidine (Pepcid) at home. The nurse prepares a teaching plan for the client indicating that the medication acts primarily to achieve which of the following? -Neutralize acid in the stomach. -Shorten the time required for digestion in the stomach. -Improve the mixing of foods and gastric secretions. -Inhibit gastric acid secretions.

Watery diarrhea

The nurse is administering Cephulac (lactulose) to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose? -Watery diarrhea -Ringing in the ears -Vomiting -Asterixis

Propylthiouracil

The nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. The client is not a candidate for surgical intervention at this time. What medication should the nurse administer to the client? -Levothyroxine -Spironolactone -Propylthiouracil -Propranolol

Regular

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously? -Lispro -Regular -Lantus -NPH

Lactulose

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent? -Spironolactone -Cholestyramine -Lactulose -Kanamycin

Urging the client to report any fever or sore throat

The nurse is assisting with the preparation of a teaching plan for a client who is to receive methimazole (Tapazole). Which of the following would be most appropriate to include in this plan? -Advising the client to use a straw when taking the drug. -Telling the client to dilute the drug with fruit juice. -Urging the client to report any fever or sore throat. -Telling the client to take largest dose of the drug in the morning.

7:00 AM and 8:00 AM

The nurse is aware that the best time of day for the total large corticosteroid dose is between: -7:00 AM and 8:00 AM -4:00 PM and 6:00 PM -4:00 AM and 5:00 AM -8:00 PM and 9:00 PM

Fatal respiratory depression

The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2? -Fatal hypertension and subsequent cerebral vascular accident -Life-threatening cardiac dysrhythmias -Fatal hypovolemia secondary to hemorrhage -Fatal respiratory depression

Help the client rinse his mouth

The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting? -Help the client rinse his mouth. -Weigh the client. -Take vital signs. -Go prepare an IM injection of an antiemetic.

decreased absorption of the esomeprazole

The nurse is caring for a client who is prescribed esomeprazole. The client informs the nurse that he is also taking sucralfate. The nurse would anticipate which effect as a possibility when these two drugs are administered? -increased risk of hypertensive episode -decreased effectiveness of sucralfate -decreased absorption of the esomeprazole -increased risk of sedation

-Fever -Insomnia -Intolerance to heat

The nurse is caring for a client who is receiving levothyroxine and educates the client to what adverse effects of this medication? (Select all that apply.) -Fever -Weight gain -Intolerance to heat -Insomnia -Lethargy

The client has been prescribed phenothiazine for anxiety

The nurse is discussing the possible side effects of chemotherapy with a client. What information obtained during the client's admission assessment and interview will have a direct influence on the management of nausea and vomiting -The cancer has been identified at stage 2 -There is a history of cancer in the client's family -The client has been prescribed phenothiazine for anxiety -The client has identified several food allergies

-Abdominal cramping -Leakage of stool -Dizziness -Weakness

The nurse is preparing a teaching plan for a patient who is using mineral oil. Which would the nurse include as a possible adverse effect? (Select all that apply.) -Dizziness -Abdominal cramping -Chills -Leakage of stool -Decreased heart rate -Weakness

"Take the medication with a full glass of water."

The nurse is providing client teaching regarding the administration of levothyroxine (Synthroid). What is the nurse's priority teaching point? -"Take the medication before going to bed at night." -"Take the medication after breakfast." -"Remain in the upright position for 30 minutes after taking it" -"Take the medication with a full glass of water."

-Avoid drinking beer, wine, or liquor. -Use artificial sweeteners instead of sugar in tea and coffee. -Read food labels carefully to look for hidden sources of sugar.

The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet? (Select all that apply.) -Avoid drinking beer, wine, or liquor. -Lose 10-15 pounds. -Read food labels carefully to look for hidden sources of sugar. -Use artificial sweeteners instead of sugar in tea and coffee. -If you skip a meal, increase your next insulin dosage.

-Ketones in the urine -Flushed, dry skin

The nurse who has admited a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.) -Rectal pressure -Flushed, dry skin -Blood glucose 191 mg/dL -Ketones in the urine -Somnolence

cardiac arrhythmias

The nurse would monitor a patient receiving IV cimetidine (generic) for an acute ulcer problem for -GI upset. -gynecomastia. -cardiac arrhythmias. -constipation.

an hour before meals

The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered: -with an antacid. -immediately after each meal. -an hour before meals. -with meals.

2.5

The order for the patient reads: ondansetron (Zofran) 2 mg IV now. The vial of Zofran on the floor contains 4mg/5mL. How many mL should be administered?

Allergy to aspirin

The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has: -Allergy to aspirin - Urinary retention -Hypertension -Hypothyroidism

Adrenal

What endocrine gland produces corticosteroids? -Adrenal -Parathyroid -Pituitary -Thyroid

Whole grains are known to interfere with calcium absorption.

What is the rationale for a nurse to suggest avoiding whole grains to a client being treated for osteopenia? -Whole grains increase the client's risks of adverse effects when taking calcium supplements. -Whole grains interact with calcium and increase serum phosphate levels. -Whole grains contain insufficient amounts of needed calcium. -Whole grains are known to interfere with calcium absorption.

"Do you have any trouble swallowing?"

What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism? -"Have you discussed your cancer treatment plan with your provider?" -"Are you afraid of needles?" -"Do you have any trouble swallowing?" -"Does anyone ever have trouble finding your veins?"

Perform a blood sugar analysis.

What should be the nurse's initial response when a client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy? -Perform a blood sugar analysis. -Have the client drink a 4-ounce glass of orange juice. -Administer 1 ampule of 50% dextrose intravenously (IV). -Administer 10 units of regular insulin subcutaneously (sub-Q).

"Regular exercise makes your body better able to use the insulin it produces."

What statement would be appropriately included in the teaching concerning type 2 diabetes? -"Until you need to start insulin injections, you do not have to check your blood sugar." -"If you drink alcohol, it may be necessary for you to increase your oral antidiabetic medication." -"Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines." -"Regular exercise makes your body better able to use the insulin it produces."

-Increased appetite -Tachycardia -Goiter

What would expected findings during an assessment of a client with hyperthyroidism include? (Select all that apply.) -Tachycardia -Goiter -Puffiness in the face -Increased appetite Weight gain

-Hydrocodone -Alcohol -Diazepam -Codeine

What would increase the risk of sedation in a patient receiving meclizine? (Select all that apply.) -Hydrocodone -Alcohol -Caffeine -Diazepam -Codeine

Administer the laxative with a full glass of water or juice

When administering a bulk laxative to a client, which action is important for the nurse to take? -Administer an anti-diarrheal medication simultaneously. -Administer the laxative with a full glass of water or juice. -Other than standard safety measures, no additional actions are needed. -Immediately place the client on a bedpan or commode.

Insert the needle at a 45-degree angle for injection

When administering insulin, what would be most appropriate? -Insert the needle at a 45-degree angle for injection. -Firmly spread the skin of the area of the intended site of injection. -Massage the injection site firmly after removing the needle and syringe. -Shake the vial vigorously to ensure thorough mixing before drawing up the dose.

vasopressin

When caring for a client with diabetes insipidus, the nurse expects to administer: -10% dextrose. -furosemide. -vasopressin. -regular insulin.

C-III

When describing dronabinol to a group of students, the instructor emphasizes that this antiemetic is classified as which class of controlled substance? -C-II -C-III -C-I -C-IV

Alopecia

When describing the possible adverse effects associated with omeprazole [proton pump inhibitors] therapy, which of the following would the nurse identify as least common? -Headache -Cough -Alopecia -Dizziness

iodine.

When describing thyroid function, the nurse would emphasize the need for intake of: -vitamin B6. -calcium. -iodine. -sodium.

-Most antiemetic medications are better at preventing nausea than treating it. -Before taking any other medications be sure to consult your health care provider

When educating a patient about antiemetic medications, which of the following information should the nurse include? Select all that apply -Before taking any other medications be sure to consult your health care provider. -Tea and gelatins are usually not tolerated well after acute vomiting attacks. -During episodes of vomiting, it is best to continue taking antiemetic medications as prescribed. -Most antiemetic medications are better at preventing nausea than treating it. -Activity can help nausea and vomiting subside.

Shortness of breath

When monitoring a client who is receiving mineralocorticoid therapy, which assessment finding would be most important for the nurse to report? -Headache -Weakness -Shortness of breath -Slight pedal edema

"Rinse your mouth completely after using the inhaler."

When providing client education relative to an inhaled glucocorticoid, the nurse should include which instruction to prevent a common side effect of the medication? -"While using the inhaler, inhale as quickly as possible." -"Rinse your mouth completely after using the inhaler." -"Forcefully exhale after using the inhaler." -"Do not eat or drink anything for 20 minutes after using the inhaler."

RAI does not seriously affect other tissues

When providing teaching to a client with hyperthyroidism that is prescribed radioactive iodine (RAI) to destroy thyroid tissue, which of the following would the nurse include? -Radioactive iodine (RAI) has no adverse effects. -RAI does not seriously affect other tissues. -The process may take several weeks or more. -Its effect is not apparent until the gland has secreted excess thyroid hormone.

chemotherapy

When reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant [nurokinin 1 receptor antagonist]. The nurse is justified in suspecting that this client's medical history includes which therapy/treatment? -endoscopy -placement of a nasogastric tube -chemotherapy -radiation therapy

Coronary artery disease

When reviewing the medical record of a client who is to receive a chemical stimulant laxative, the nurse would monitor the client closely if he had which condition? -Ulcerative colitis -Appendicitis -Coronary artery disease -Diverticulitis

Gynecomastia

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? -Hypertension -Hypoxia -Seizures -Gynecomastia

Increased fracture risk

Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis? -Abdominal pain -Increased fracture risk -Diarrhea -Headache

History of chronic liver dysfunction

Which assessment datum serves to contraindicate the use of an antiemetic agent? -History of chronic liver dysfunction -History of lung cancer -Currently receiving radiation therapy -Demonstrated signs/symptoms associated with menopause

The client is identified as a possible falls risk

Which intervention has priority when caring for an older adult client who has been prescribed a phenothiazine for reported nausea? -Assessing the client for pink tinged urine -The client is identified as a possible falls risk -Frequent oral care to manage oral dryness -Monitoring the client for signs of anorexia

Client rubbing eyes, reporting blurry vision

Which is a side effect a nurse should recognize after administration of hydroxyzine [atihistamine]? -Client is having 2 or 3 loose stools a day. -Client is having shortness of breath. -Client rubbing eyes, reporting blurry vision. -Client reporting nausea and vomiting.

It leaves a metallic taste in the mouth

Which is a true statement regarding the nursing considerations in administration of metronidazole? -The drug should be given before meals. -It leaves a metallic taste in the mouth. -It may cause weight gain. -Metronidazole decreases the effect of warfarin.

Promote absorption

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic? -Prevent muscle destruction. -Promote absorption. -Avoid infection. -Minimize discomfort.

Sodium 150 mEq/L

Which laboratory value monitored in a patient receiving fludrocortisone acetate requires immediate action by the nurse? -Potassium 4.5 mEq/L -Creatinine 1.1 mg/dL -Sodium 150 mEq/L -Hemoglobin 14 g/dL

Omeprazole

Which medication classification represents a proton (gastric acid) pump inhibitor? -Omeprazole -Metronidazole -Famotidine -Sucralfate

-Acupuncture -Acupressure wrist bands -Use of herbal supplements

Which nonpharmacologic interventions should the nurse teach the client who is currently reporting nausea and vomiting? Select all that apply. -Walking -Eating foods high in sodium and fiber -Use of herbal supplements -Acupressure wrist bands -Acupuncture

Acid secretion is reduced.

Which of the following is an outcome of histamine 2 (H2)-receptor antagonists blocking the action of histamine in the stomach? -Acid indigestion is relieved. -Symptoms of gastroesophageal reflux are relieved. -Acid secretion is reduced. -Blood phosphate levels are elevated.

Which of the following is considered a bulk-forming laxative? -Milk of Magnesia -Dulcolax -Mineral oil -Metamucil

Which of the following is considered a bulk-forming laxative? -Milk of Magnesia -Dulcolax -Mineral oil -Metamucil

Spironolactone (Aldactone)

Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension? -Lactulose (Cephulac) -Cyclosporine (Sandimmune) -Spironolactone (Aldactone) -Kanamycin (Kantrex)

Metoclopramide (Reglan)

Which of the following medications, used in the treatment of GERD, accelerate gastric emptying? -Famotidine (Pepcid) --Nizatidine (Axid) -Esomeprazole (Nexium) -Metoclopramide (Reglan)

Histamine-2 receptor antagonist

Which of the following would a nurse expect to administer if the goal of therapy is to block the release of hydrochloric acid in the stomach? -Histamine-2 receptor antagonist -Antacid -Proton pump inhibitor -Prostaglandin

They selectively block specific histamine receptor sites, leading to a reduction in gastric acid secretion.

Which of the following would a nurse include when describing the action of H2 antagonists to a patient? -They block the release of gastrin and pepsin, leading to a decrease in protein digestion. -They selectively block histamine receptors, reducing swelling and inflammation at numerous sites. -They selectively block specific histamine receptor sites, leading to a reduction in gastric acid secretion. -They are effective primarily for long-term use because of their slow onset of action.

"I may experience drowsiness with this medication."

Which statement indicates that the client has understood the teaching provided on hydroxyzine[antihistamines]? -"I will need to take potassium with this medication." -"I may experience drowsiness with this medication." -"I should eat before I take this medication." -"I will take repeated doses of this medication until my nausea resolves."

"Separate taking the two drugs by about a half hour."

While reviewing the medication history of a client receiving alendronate, the nurse notes that the client also takes a multivitamin. Which instruction would be most appropriate? -"Take the multivitamin just before the alendronate." -"Stop taking the multivitamin at once." -"Separate taking the two drugs by about a half hour." -"Take the alendronate with an antacid before the multivitamin."

-hypoglycemia may be experienced before dinnertime -the insulin should be administered at room temperature

a client is taking humulin NPH insulin and regular insulin every morning. the nurse should provide which instructions to the client? Select all that apply -hypoglycemia may be experienced before dinnertime -the insulin dose should be decreased if illness occurs -the insulin should be administered at room temperature -the insulin vial needs to be shaken vigorously to break up the precipitates -the NPH insulin should be drawn into the syringe first, then the regular insulin

one hour before meals and at bedtime

a client with gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. the nurse should schedule the medication for which times? -with meals and at bedtime -every 6 hours around the clock -one hour after meals and at bedtime -one hour before meals and at bedtime

-administer methimazole with food -assess the client for unexplained bruising or bleeding -instruct the client to report side and adverse effects such as sore throat, fever or headaches

a client with hyperthyroidism has been given methimazole. which nursing considerations are associated with this medication? select all that apply -administer methimazole with food -place the client on a low-calorie, low-protein diet -assess the client for unexplained bruising or bleeding -instruct the client to report side and adverse effects such as sore throat, fever or headaches -use special radioactive precautions when handling the client's urine for the first 24 hours after administration

contact the HCP and discuss the prescription of propranolol because of the client's history of having asthma

a client with hyperthyroidism is hospitalized to have a thyroidectomy. the HCP has prescribed propranolol. in reviewing the client's history the nurse notes that the client has asthma. the nurse should next -take the client's pulse and withold the propanolol if the pulse is <100 BPM -count the client's RR and withold the propranolol if the RR is <20 -contact the HCP and discuss the prescription of propranolol because of the client's history of having asthma -instruct the client to make position changes slowly

renal failure

angiotensin converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay development of: -COPD -pancreatic cancer -renal failure -cerebrovascular accident

10-80

normal ammonia level

0.6 to 1.2 milligrams

normal creatinine level

5-10

normal range for aluminum

prandial insulin

insulin secretion stimulated in response to meals

pork products

the nurse knows that a pt. prescribed digestive enzymes/pancrelipase cannot take them if they are allergic to this food product?

tremors

the nurse should tell the client who is taking levothyroxine, to notify the HCP if which problem occurs? -fatigue -tremors -cold intolerance -excessively dry skin

vasopressin

the antidiuretic hormone,

-i should sit up for at least 30 minutes after taking this medication -i should take this mediation first thing in the morning on an empty stomach

the client with hyperparathyroidism is taking alendronate. which statement by the client indicates understanding fo the proper way to take this medication. select all that apply -i should take this medication with food -i should take this medication at bed time -i should sit up for at least 30 minutes after taking this medication -i should take this mediation first thing in the morning on an empty stomach -i can pick a time to take this medication that best fits my lifestyle as long as i take it at the same time each day.

0100 while sleeping

the client with type 1 diabetes mellitus is taught to take isophane insulin suspension NPH at 1700 each day. the client should be instructed that the greatest risk of hypoglycemia will occur at about time? -1100 shortly before lunch -1300 shortly after lunch -1800 shortly after dinner -0100 while sleeping

refrigerate the insulin

the home care nurse visits a client recently diagnosed with diabetes mellitus who is taking humulin NPH insulin daily. the client asks the nurse how to store the unopened vials of insulin. the nurse should tell the client to take what action? -freeze the insulin -refrigerate the insulin -store the insulin in a dark, dry place -keep the insulin at room temperature

on the second or third day of their next menstrual cycle.

the nurse is educating a pt. taking prostaglandins/misoprostol about they should begin taking this drug. What would the nurse say?

-insomnia -weight loss -mild heat intolerance

the nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. which findings indicate the presence of a side effect associated with this medication? Select all that apply -insomnia -weight loss -bradycardia -constipation -mild heat intolerance

i need to constantly watch for signs of low blood sugar

the nurse is providing discharge teaching for a client newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin. which client statement indicates teh need for further teaching? -its is okay if i skip meals now and then -i need to constantly watch for signs of low blood sugar -i need to let my health care provider know if i get unusually tired -i will be sure to not drink alcohol excessively while on this medication

-i should decrease my oral fluids when i start this medication -i should report headache and drowsiness to my HCP since these symptoms could be related to my desmopressin

the nurse teaches the client who is newly diagnosed with DI about the prescribed intranasal desmopressin. which statements by the client indicate understanding? Select all that apply -this medication will turn my urine orange -i should decrease my oral fluids when i start this medication -the amount of urine i make should increase if this medicine is working -i need to follow a low-fat diet to avoid pancreatitis when taking this medication -i should report headache and drowsiness to my HCP since these symptoms could be related to my desmopressin

anticholinergic

this drug is effective in relieving nausea and vomiting associated with motion sickness and radiation therapy for cancer.

Vasopressin

this is administered in acute esophageal bleed because of its vasoconstrictive properties in the splanchnic, portal, and intrahepatic vessels

increases tubular reabsorption of water

vasopressin is administered to the client with diabetes insipidus because it: -decreases blood pressure -increases tubular reabsorption of water -increases release of insulin from the pain -decreases glucose production within the liver

-change site every 3 days -remember to connect it back after you take a shower -at risk for hypoglycemic and hyperglycemia

what do you need to educate your pt. about the insulin pump?

don't massage the site -same are for 7 days, 1/2-1 inch apart

what do you want to educate your pt. on about the administration of insulin

Aspart short-acting NPH

what insulins can you mix in one syringe

cloudy

what is different about NPH (intermediate) insulin?

you can not mix with any other insulins

what is different between all the other insulins and long- insulin?

only can be given IV

what is different between short-acting insulin and other insulins?

5-15 min 60-90 min 3-5hr

what is the: onset peak duration for our short-acting insulins

Prokinetic agents

which accelerate gastric emptying, used in the treatment of GERD?