Pharmacology assessment (B) 2019
A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? A) Cabamazepine B) Sumatriptan C) Atenolol D) Glipzide
A) Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.
A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
100gtt/min
A nurse is preparing to administer 0.9% sodium chloride (NaCl) 1,500 mL to infuse over 8 hr to a client who is postoperative. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
188mL/hr
A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
300mg
A nurse is preparing to administer to a client 0.9% sodium chloride 1,000 mL IV over 8 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
31gtt/min
A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
6.3mL
A nurse is teaching a client who is starting to take ketorolac. Which of the following information should the nurse include in the teaching? A) Check for bruising B) Take on empty stomach C) Can cause anxiety D) Inc iron intake
A) Check for bruising
A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? A) "I have tendonitis, so I haven't been able to exercise." B) "I take a stool softener for chronic constipation." C) "I take medicine for my thyroid." D) "I am allergic to sulfa."
A) "I have tendonitis, so I haven't been able to exercise." The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.
A nurse is precepting a newly licensed nurse who is caring for four clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse? A) Admin isosorbide mononitrate to client who has BP 82/60mmHg B) Admin digoxin to client who has HR 92bpm C) Admin reg insulin to client who has glucose of 250mg/dl D) Admin heparin to client who has aPTT of 70sec
A) Admin isosorbide mononitrate to client who has BP 82/60mmHg
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? A) Admin med outside the 5cm (2in) radius of umbilicus B) Aspirate for blood return before injecting C) Rub vigorously after injection to promote absorption D) Place pressure dressing on injection site to prevent bleeding
A) Admin med outside the 5cm (2in) radius of umbilicus
A nurse is caring for a client who is receiving haloperidol. The nurse should observe for which of the following findings as an adverse effect of the medication? A) Akanthisia B) Paresthesia C) Excess tear production D) Anxiety
A) Akanthisia
A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) A) Blood glucose levels will be monitored during therapy B) Avoid contact with people who have known infections C) Take med 1hr before breakfast D) Dec dietary intake of foods containing potassium E) Grapefruit juice can inc effects of med
A) Blood glucose levels will be monitored during therapy B) Avoid contact with people who have known infections E) Grapefruit juice can inc effects of med - The nurse should monitor the client for hyperglycemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. - The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. - The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body.
A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? A) Chest pressure B) White patches on the tongue C) Bruising D) Insomnia
A) Chest pressure
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium on a daily basis can minimize which of the following adverse effects of morphine? A) Constipation B) Drowsiness C) Facial flushing D) Itching
A) Constipation
A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? A) Creatinine kinase B) Erythrocyte sedimentation rate C) International normalized ratio D) Potassium
A) Creatinine kinase
A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? A) Cromolyn B) Beclomethasone C) Budesonide D) Tiotropium
A) Cromolyn
A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? (Select all that apply.) A) Dry mouth B) Tinnitus C) Blurred vision D) Bradycardia E) Dry eyes
A) Dry mouth C) Blurred vision E) Dry eyes anticholinergic that can: - due to an increase in intraocular pressure. - can cause dry eyes and mydriasis, or pupil dilation.
A nurse is teaching about neural tube defects to a client who is planning a pregnancy. Which of the following vitamins should the nurse instruct the client to start taking before becoming pregnant? A) Folic acid B) Thiamine C) Pyridoxine D) Riboflavin
A) Folic acid
A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) A) Glucose levels need to be monitored during therapy B) Avoid contact with persons with known infections C) Take med 1h before a meal D) Dec intake of foods containing potassium E) Grapefruit juice can inc blood levels of the med
A) Glucose levels need to be monitored during therapy B) Avoid contact with persons with known infections E) Grapefruit juice can inc blood levels of the med
A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (Select all that apply.) A) Hemoglobin 7g/dL B) Creatinine 1mg/dL C) RBC 4.7million.mm^3 D) Platelets 75,000/mm^3 E) Potassium 5.2 mEq/L
A) Hemoglobin 7g/dL D) Platelets 75,000/mm^3 E) Potassium 5.2 mEq/L
A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? A) Hot flashes B) Urinary retention C) Constipation D) Bradycardia
A) Hot flashes The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.
A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? A) Hyperventilation B) Heartburn C) Anorexia D) Swollen ankles
A) Hyperventilation
A nurse is caring for a client who is receiving oprelvekin. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? A) Inc platelet count B) Inc RBC count C) Dec prothrombin time D) Dec triglycerides
A) Inc platelet count
A nurse is reviewing the health history of a client who has diabetes mellitus and will begin taking insulin. Which of the following findings should the nurse identify as a factor that might cause the client to have difficulty safely self-administering insulin? A) Macular degeneration B) Right-sided HF C) Hyperlipidemia D) Stage II chronic kidney disease
A) Macular degeneration
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? A) Obtain BP B) Contact provider C) Inform charge nurse D) Complete incident report
A) Obtain BP
A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? A) Oral candidiasis B) Headache C) Joint pain D) Adrenal suppression
A) Oral candidiasis Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.
A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? A) Perform a capillary blood glucose test B) Provide client with protein rich snack C) Give client 120mL (4oz) OJ D) Schedule an early meal tray
A) Perform a capillary blood glucose test
A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) A) Report muscle pain B) Avoid grapefruit juice C) Take med in morning D) Expect flushing of skin E) Expect lifelong therapy
A) Report muscle pain B) Avoid grapefruit juice E) Expect lifelong therapy
A nurse is caring for a client who recently began taking oral amoxicillin/clavulanate and reports urticaria. Which of the following actions should the nurse take? A) Request a change in the type of the antibiotic B) Ask for a change in the route of the administration C) Check for pitting edema D) Check the client's WBC count
A) Request a change in the type of the antibiotic
A nurse is providing care for a client who is postoperative following an open cholecystectomy with the placement of a closed suction drain and is receiving morphine via patient-controlled analgesia for pain. Which of the following assessments is the nurse's priority? A) Respiratory rate B) Bowel sounds C) Drainage amounts D) Wound appearance
A) Respiratory rate
A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used to treat tuberculosis? (Select all that apply.) A) Rifampin B) Mirtazapine C) Temazepam D) Infliximab E) Isoniazid
A) Rifampin E) Isoniazid
A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication? A) Smoked sausage B) Cottage cheese C) Green beans D) Apple pie
A) Smoked sausage
A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication that she should complete an incident report? A) The client reports shortness of breath. B) The client is also taking lisinopril. C) The client's pulse rate is 60/min. D) The client's WBC count is 14,000/mm3.
A) The client reports shortness of breath
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? A) Tingling of fingers B) Constipation C) Weight gain D) Oliguria
A) Tingling of fingers The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.
A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? A) Turn client to a side laying position B) Disconnect the client's oxytocin from the maintenance IV C) Apply oxygen to the client by face mask D) Inc client's maintenance IV infusion rate
A) Turn client to a side laying position The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority action the nurse should take is to place the client in a lateral position.
A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? A) reduces the surface tension of the stools to change their consistency B) causes rectal contractions C) acts as a fiber agent, inc bulk in intestines D) stimulates motility of the intestines
A) reduces the surface tension of the stools to change their consistency
A nurse is caring for a client who is refusing to take their scheduled morning furosemide. Which of the following statements should the nurse make? A)By not taking your furosemide, you might retain fluid and develop swelling. B)you can double your dose of furosemide this evening if that would be better for you C)if you do not take your furosemide, we might get in trouble D)I'll go ahead and mix the furosemide into your breakfast cereal
A)By not taking your furosemide, you might retain fluid and develop swelling
A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? A) Vitamin E B) OJ C) Milk D) Antacids
B) OJ
A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? A) Birth B) 2m C) 6m D) 15m
B) 2m The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.
A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? A) Vit K B) Acetylcysteine C) Benztrophine D) Physostigmine
B) Acetylcysteine Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.
A nurse is teaching a client about warfarin. The client asks if she can take aspirin while taking the warfarin. Which of the following responses should the nurse make? A) It is safe to take an enteric-coated aspirin B) Aspirin will inc the risk of bleeding C) Acetaminophen may be sub for aspirin D) The INR lab work must be monitored more frequently if aspirin is taken
B) Aspirin will inc the risk of bleeding Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding.
A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol? A) Cholelithiasis B) Asthma C) Angina pectoris D) Tachycardia
B) Asthma
A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? A) vomiting B) Blood in urine C) Positive Chvostek's sign D) Ringing in the ears
B) Blood in urine
A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome? A) In seizure threshold B) Dec flexor and extensor spasticity C) Inc cognitive function D) Dec paralysis of extremities
B) Dec flexor and extensor spasticity
A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? A) Weigh the client weekly B) Determine apical pulse prior to admin C) Admin the med 30min prior to breakfast D) Monitor the client for jaundice
B) Determine apical pulse prior to admin Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.
A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? A) Administer epinephrine 0.5 mL via IV bolus. B) Discontinue the medication IV infusion. C) Elevate the client's legs above the level of the heart. D) Collect a blood specimen for ABGs.
B) Discontinue the medication IV infusion
A nurse is caring for a client who has heart failure and is prescribed enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? A) Bradycardia B) Hyperkalemia C) Loss of smell D) Hypoglycemia
B) Hyperkalemia
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching? A) I should apply a patch every 5min if I develop chest pain B) I will take the patch off right after my evening meal C) I will leave the patch off at least 1 day each week D) I should discard the used patch by flushing it down the toilet
B) I will take the patch off right after my evening meal Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects.
A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? A) Aspirin B) Ibuprofen C) Ranitidine D) Bisacodyl
B) Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.
A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? A) Paresthesia B) Inc BP C) Fever D) Respiratory depression
B) Inc BP
A nurse is teaching a client who has an upper respiratory infection about guaifenesin. Which of the following statements should the nurse include in the teaching? A) Constipation is expected adverse effect B) Inc fluid intake to at least 2L a day C) Store med in fridge D) Expect insomnia
B) Inc fluid intake to at least 2L a day
A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all that apply.) A) take 2nd dose at bed time B) Inc intake of potassium rich food C) Obtain weight weekly D) Monitor for muscle weakness E) Dangle your legs from the side of the bed before standing
B) Inc intake of potassium rich food D) Monitor for muscle weakness E) Dangle your legs from the side of the bed before standing
A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? A) Methadone B) Naloxone C) Diazepam D) Bupropion
B) Naloxone
A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication? A) Tachycardia B) Oliguria C) Hyperkalemia D) Weight gain
B) Oliguria
A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? A) Hypoglycemia B) Orthostatic hypotension C) Bradycardia D) Xanthopsia
B) Orthostatic hypotension
A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? A) Schedule the client for the last surgery of the day. B) Place monitoring cords and tubes in a stockinet. C) Choose rubber injection ports for fluid administration. D) Ensure phenytoin IV is readily available.
B) Place monitoring cords and tubes in a stockinet.
A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? A) Serum calcium B) Pregnancy test C) 24hr urine collection for protein D) Asparate aminotransferase level
B) Pregnancy test The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.
A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? A) Muscle weakness B) Sedation C) Tinnitus D) Peripheral edema
B) Sedation
A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A) Tingling toes B) Sexual dysfunction C) Absence of dreams D) Pica
B) Sexual dysfunction
A nurse is teaching a client who is to start taking diltiazem. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A) Blurred vision B) Shortness of breath C) Muscle twitching D) Dry cough
B) Shortness of breath
A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching? A) Stop taking med when stomach pain is gone B) Smoking makes med less effective C) Take med anytime my stomach hurts D) Med will turn my stools black
B) Smoking makes med less effective
A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in her instructions? A) Take one tablet 3 time a day before meals B) Take one tablet at onset of migraine C) Take up to 8 tablets as needed within a 24h period D) Take one tablet every 15m until migraine subsides
B) Take one tablet at onset of migraine The client should take one tablet immediately after the onset of aura or headache.
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? A) Constipation B) Tinnitus C) Hypoglycemia D) Joint pain
B) Tinnitus Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.
A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? A) Troponin B) Total cholesterol C) Creatinine D) Thyroid stimulating hormone
B) Total cholesterol
A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? A) Will need lab tests prior to refilling med B) Use med for short time C) 1 week before results D) Need to change meds to prevent tolerance
B) Use med for short time
A nurse is providing teaching about adverse effects of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider? A) Orange urine B) Watery diarrhea C) Weight gain D) Headache
B) Watery diarrhea
A nurse has administered 2 doses of betamethasone to a client in preterm labor. After delivery of the newborn, the nurse understands the medication was effective when she observes which of the following? A) newborn is free of infection B) newborn has norm respiratory patterns C) mothers BP is within expected reference range D) mothers postpartum bleeding is minimal
B) newborn has norm respiratory patterns
A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A) "I can apply the patch to a chest area that has hair." B) "I can take this medication if using an erectile dysfunction product." C) "I will remove the patch after 14 hours." D) "I need to apply a new patch to the same area every day."
C) "I will remove the patch after 14 hours."
A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? A) 1000 B) 0900 C) 0830 D) 1200
C) 0830
A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? A) Client's provider is required to complete med reconciliation B) Med reconciliation at discharge is limited to the med ordered at time of discharge C) A transition in care requires the nurse to conduct med reconciliation D) Med reconciliation is limited to the name of the meds that the client is currently taking
C) A transition in care requires the nurse to conduct med reconciliation The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.
A nurse in the emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? A) Potassium iodide B) Glucagon C) Atropine D) Protamine
C) Atropine A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.
A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? A) Difficulty seeing in the dark B) Pinpoint pupils C) Blurred vision D) Excessive tearing
C) Blurred vision
A nurse is providing teaching about insulin glargine to a client who has type 1 diabetes mellitus. Which of the following information should the nurse include in the instructions? A) Observe for hypoglycemia when insulin peaks B) Admin insulin immediately before meals C) Do not mix this med in a syringe with other insulin D) Rotate the bottle gently prior to drawing up the insulin
C) Do not mix this med in a syringe with other insulin
A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? A) Plan to inc dosage each weak by 200mg increments B) Prolonged use of med can cause glaucoma C) Drink 2L of water daily D) Fine red rash is transient and can be treated with antihistamines
C) Drink 2L of water daily
A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? A) Take med with food B) Expect a fine, red rash as a transient effect C) Drink 8-10 glasses of water daily D) Store med in fridge
C) Drink 8-10 glasses of water daily
A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A) Tinnitus B) Urinary frequency C) Dry mouth D) Diarrhea
C) Dry mouth
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? A) Diphenhydramine B) Albuterol inhaler C) Epinephrine D) Prednisone
C) Epinephrine
A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? A) Ondansetron B) Magnesium sulfate C) Flumazenil D) Protamine sulfate
C) Flumazenil The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam.
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? A) Dec stomach acid secretion B) Neutralizes acids in the stomach C) Forms a protective barrier over ulcers D) Treats ulcers by eradicating H. pylori
C) Forms a protective barrier over ulcers Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.
A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? A) I should take the med with food B) I should take naproxen if I develop joint pain C) I should tell my provider if I develop a sore throat D) I should expect the med to cause orange urine
C) I should tell my provider if I develop a sore throat
A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A) I will apply patch once a week for two weeks B) I will leave existing patch on for 4rhs after applying new patch C) I will fold the sticky sides of the old patch together before disposing D) I will apply the patch within 14 days of menses
C) I will fold the sticky side of the old patch together before disposing
A nurse is teaching about a new prescription for ciprofloxacin to an older adult client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? A) I will take this med with an antacid to prevent GI upset B) I will stop taking this med when I no longer have pain upon urination C) I will report any signs of tendon pain/swelling D) I will take this med with milk
C) I will report any signs of tendon pain or swelling
A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? A) Dec BP B) Inc HR C) Inc cardiac output D) Dec serum potassium
C) Inc cardiac output
A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching? A) Take med with antacids to minimize GI upset B) Does not require blood monitoring C) Let dentist know about med D) Expect unusual eye movement
C) Let dentist know about med
A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? A) Infuse 0.9% Sodium chloride 1,000mL IV fluid bolus B) Schedule client for an electroencephalogram C) Obtain WBC with absolute neutrophil count D) Place client on tyramine free diet
C) Obtain WBC with absolute neutrophil count
A nurse is providing follow-up care to a client who is taking lisinopril. Which of the following manifestations should the nurse instruct the client to report as an adverse effect of lisinopril? A) Drowsiness B) Hallucinations C) Persistent cough D) Weight gain
C) Persistent cough
A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include? A) Take med on empty stomach for full effect B) You may discontinue this med when stomach discomfort subsides C) Report skin yellowing D) Store med in fridge
C) Report skin yellowing
A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? A) Avoid getting rid of air bubble in syringe B) Inject insulin into thigh for fastest absorption C) Store unopened bottles in fridge D) Shake insulin before using
C) Store unopened bottles in fridge
A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? A) Inc saliva production B) Continue med till rash disappears C) Taper off med before discontinuing D) Report urinary incontinence
C) Taper off med before discontinuing The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia.
A nurse is caring for a client who is taking atenolol. Which of the following findings should indicate to the nurse that the medication is effective? A) The client has an increase in urinary output. B) The client reports an improvement in memory. C) The client has a decrease in blood pressure. D) The client reports having an increase in libido.
C) The client has a decrease in blood pressure
A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? A) Diarrhea B) Cough C) Urinary retention D) Inc libido
C) Urinary retention
A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that he is allergic to penicillin. Which of the following actions should the nurse take first? A) Update client's medical record B) Notify provider C) Withhold med D) Inform pharmacist of clients allergy to penicillin
C) Withhold med
A nurse is teaching a client who has tuberculosis about the adverse effects of isoniazid. The nurse should instruct the client to report to the provider which of the following findings as an adverse effect of the medication? A) Reddish-orange urine B) Photosensitivity C) Yellowish skin tones D) Headache
C) Yellowish skin tones
A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider? A) Hot flashes B)Gastrointestinal irritation C)Vaginal dryness D)Leg tenderness
Leg tenderness
A nurse is providing teaching to a client who is to start taking lisinopril. Which of the following findings is an adverse effect that the nurse should instruct the client to monitor and report to the provider? A) Hair loss B) Ringing in the ears C) Facial flushing D) Dry cough
D) Dry cough
A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? A) "Take beclomethasone to avoid an acute attack." B) "Use beclomethasone 5 minutes before using albuterol." C) "Limit your calcium and vitamin D intake when taking beclomethasone." D) "Rinse your mouth after inhaling the beclomethasone."
D) "Rinse your mouth after inhaling the beclomethasone." The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? A) Weight loss B) Inc intraocular pressure C) Auditory hallucinations D) Bibasilar crackles
D) Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.
A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? A) Hypertension B) Low INR C) Constipation D) Bleeding gums
D) Bleeding gums
A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for long-term complications of prednisone? A) Pulmonary function tests B) Electrocardiograms C) Liver function studies D) Bone density scans
D) Bone density scans
A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instructions should the nurse plan to include? A) Take med on empty stomach B) Avoid crowds C) Discontinue med if palpation occur D) Change positions slowly
D) Change positions slowly
A nurse is reviewing laboratory results for a client who is to receive a dose of ceftazadime via intermittent IV bolus. Which of the following laboratory findings is the priority for the nurse to report to the provider before administering the medication? A) total bilirubin 0.4mg/dL B) Alanine aminotransferase 26u/L C) Platelet count 360,000/mm^3 D) Creatinine 2.6mg/dL
D) Creatinine 2.6mg/dL
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? A) The med should be taken prior to 1hr prior to eating B) It takes 48hr for therapeutic effects to occur C) Tablets should not be crushed or chewed D) Decreased respiration might occur
D) Decreased respiration might occur The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.
A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to receiving which of the following medications? A) Acetaminophen B) Ipatropium C) Benzonatate D) Doxycycline
D) Doxycycline
A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? A) This med inc risk for hypertension B) Avoid potassium rich foods in your diet C) Take each dose in evening before bed D) Drink a glass of milk with each dose
D) Drink a glass of milk with each dose
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? A) Dyspepsia B) Diarrhea C) Dizziness D) Dyspnea
D) Dyspnea When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.
A nurse is caring for a client in the emergency department following a diazepam overdose. Which of the following medications should the nurse anticipate administering to the client? A) Naloxone B) Leucovorin C) Neostigmine D) Flumazenil
D) Flumazenil
A nurse is caring for a client who is receiving cefazolin IV. The nurse should identify that which of the following medications can potentiate nephrotoxicity if administered concurrently? A) Famotidine B) Levofloxacin C) Metoclopramide D) Gentamicin
D) Gentamicin
A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? A) I will drink a glass of milk when I take med B) I will take med 15min after my evening meal C) I should take antacid with the med to avoid nausea D) I should sit up for 30min after taking the med
D) I should sit up for 30min after taking the med
A nurse is providing teaching to a client who has depression and has a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? A) I should start to feel better within 24h of starting med B) I will avoid foods with tyramine C) I will continue to take St. John's Wort to inc effects of med D) I should take acetaminophen instead of ibuprofen for my headaches while taking this med
D) I should take acetaminophen instead of ibuprofen for my headaches while taking this med
A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A) I will stop taking the med if I get dizzy B) I should not drink OJ while taking the med C) I should expect to gain weight while taking this med D) I will check my HR before I take the med
D) I will check my HR before I take the med
A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? A) Dec in WBC count B) Dec in amount of time sleeping C) Inc in appetite D) Inc in ability to focus
D) Inc in ability to focus
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? A) cough B) Joint pain C) Alopecia D) Insomnia
D) Insomnia Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia.
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect? A) Tachycardia B) Oliguria C) Xerostomia D) Miosis
D) Miosis
A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include? A) Limit continuous use to 7-10 weeks B) Schedule doses for early morning before breakfast C) Expect that it will take 4 nights before benefits are noticed D) Plan to withdraw from the med gradually
D) Plan to withdraw from the med gradually
A nurse is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings? A) Potassium mEq/L B) aPTT times the control C) Hemoglobin g/dL D) Platelets 96,000/mm^3
D) Platelets 96,000/mm^3 A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion.
A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? A) Minimizes diaphoresis B) Maintain abstinence C) Lessen craving D) Prevent delirium tremens
D) Prevent delirium tremens The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal.
A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? A) Admin reconstituted med slowly over 5min B) Store reconstituted med in fridge C) Use the reconstituted med within 12hr D) Reconstitute the initial dose with 60mL of sterile water w/o a bacteriostatic agent
D) Reconstitute the initial dose with 60mL of sterile water w/o a bacteriostatic agent
A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? A) Chew on med stick to release med B) Leave med stick in one location until melted C) Allow med 1hr for analgesia effects to begin D) Store unused med sticks in storage container
D) Store unused med sticks in storage container The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.
A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family? A) Provider will prescribe naloxone at home for respiratory depression B) Remove the patch to reverse the adverse effects immediately C) Expect an inc in urinary output D) Take a stool softener on a daily basis
D) Take a stool softener on a daily basis
A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? A) Gastric distress B) Oliguria C) Excessive bruising D) Tinnitus
D) Tinnitus
A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? A) Dry cough B) Pedal edema C) Bruising D) Yellow-tinged vision
D) Yellow-tinged vision
A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication the morphine has been effective? A) vitals are within norm limits B) has not requested additional med C) is resting comfortably with eyes closed D) rates the pain at a 3
D) rate the pain at a 3 The client's description of the pain is the most accurate assessment of pain.
