Pharmacology exam 2
The preoperative order for an adult patient reads: "Give scopolamine, 0.7 mg IM on call for surgery." The medication is available in vials of 0.4 mg/mL. How many milliliters will the nurse administer for this dose? (Record your answer using one decimal place.)
1.8 mL
The medication order reads, "niacin, 500 mg PO, every evening." The medication is available in 250-mg tablets. How many tablets will the patient receive per dose?
2 tablets
The patient is being discharged from home with furosemide (Lasix). When providing discharge teaching, which instruction will the nurse include? a. avoid prolonged exposure to the sun b. avoid foods high in potassium content c. stop taking the medication if you feel dizzy d. weigh yourself once a week and report a gain or loss of more than 1 lb
a
A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? a. hypokalemia b. hypoglycemia c. hypouricemia d. hyponatremia
a
A nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicated for this client? a. reserpine b. captopril c. hydralazine d. eplerenone
a
A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? a. raisins b. cabbage c. cheese d. eggs
a
A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following shoudl the nurse instruct the client to avoid while taking this drug? a. grapefruit juice b. milk c. foods high in vitamin k d. NSAIDS
a
A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug? a. headache b. constipation c. hypertension d. hyperglycemia
a
A nurse is teaching a client who has a new prescription for quinidine. Which of the following statements should the nurse include? a. monitor your pulse rate and report changes b. remain upright for 30 minutes after taking this medication c. this medication can decrease digoxin levels d. this medication can cause urinary incontinence
a
A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? a. albuterol will increase the absorption of fluticasone b. albuterol will decrease inflammation c. albuterol will reduce nasal secretions d. fluticasone will reduce the adverse effects of albuterol
a
A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include? a. avoid taking nonsteroidal anti-inflammatory drugs b. rinse your mouth after taking the medication to prevent a yeast infection c. stop taking the medication if you become nauseous d. change position slowly when standing up
a
A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions? a. acute myocardial infarction b. peripheral vascular disease c. ulcerative colitis d. ventricular tachycardia
a
A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? a. migraine headaches b. pancreatitis c. second degree AV block d. angina pectoris
c
A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? a. Ipratropium b. Beclomethasone c. Acetylcysteine d. Azelastine
c
For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over the counter cold products? a. over the counter cold products can also contain guaifenesin b. blood glucose levels are increased c. rebound congestion is likely d. drug tolerance is likely
a
In monitoring laboratory test results for patients receiving loop and thiazide diuretics, the nurse knows to look for which of these results? a. Decreased serum levels of potassium b. Increased serum levels of calcium c. Decreased serum levels of glucose d. Increased serum levels of sodium
a
The nurse administering a cholinergic-blocking drug to a patient who is experiencing drug-induced extrapyramidal effects would assess for which therapeutic effect? a. Decreased muscle rigidity and tremors b. Increased heart rate c. Decreased bronchial secretions d. Decreased GI motility and peristalsis
a
The nurse is assessing a patient who has a prescription for dicyclomine (Bentyl). Which condition is considered a contraindication to this medication? a. GI atony b. Irritable bowel syndrome c. Overactive bladder d. Diabetes mellitus
a
A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? a. decrease viscosity of nasal secretions b. block H2 receptors c. prevent histamine from binding to receptors d. reduce nasal congestion
c
A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? a. start at a low dose and gradually increase it b. take the drug as needed for nasal congestion c. allow at least 2 weeks for the full therapeutic effect d. use the drug prior to exercise
c
The medication order for a patient who receives nutrition via a feeding tube reads: "Give digoxin 0.125 mg per feeding tube once every morning." The medication is available in a liquid form 50 mcg/mL. How many milliliters will the nurse give for each dose?
2.5 mL
When a patient has experienced extravasation of a peripheral infusion of dopamine, the nurse will inject the alpha blocker phentolamine (Regitine) into the area of extravasation and expect which effect? a. Vasoconstriction b. Vasodilation c. Analgesia d. Hypotension
b
When administering an alpha blocker for the first time, it is most important for the nurse to assess the patient for the development of what adverse effect? a. renal failure b. hypotension c. blood dyscrasia d. dysrhythmias
b
Which medication should the nurse inform the patient to administer first for an acute asthma attack? a. Ipratropium (Atrovent) b. Albuterol (Proventil) c. Budesonide (Pulmicort Turbuhaler) d. Montelukast (Singulair)
b
Which statement must be included when the nurse provides education for a patient with heart failure who is taking daily doses of spironolactone (Aldactone)? a. "Be sure to eat foods that are high in potassium." b. "Avoid foods that are high in potassium." c. "Avoid grapefruit juice while taking this medication." d. "A low-fiber diet will help prevent adverse effects of this medication."
b
The nurse is administering an IV solution that contains potassium chloride to a patient in the critical care unit who has a severely decreased serum potassium level. Which action(s) by the nurse are appropriate? (Select all that apply.) a. Administer the potassium by slow IV bolus. b. Administer the potassium at a rate no faster than 20 mEq/hr. c. Monitor the patient's cardiac rhythm with a heart monitor. d. Use an infusion pump for the administration of IV potassium chloride. e. Administer the potassium via IV push.
b, c, d
A patient has been given a prescription for transdermal scopolamine patches (Transderm-Scōp) for motion sickness for use during a vacation cruise. The nurse will include which instructions? (Select all that apply.) a. "Apply the patch as soon as you board the ship." b. "Apply the patch 4 to 5 hours before boarding the ship." c. "The patch needs to be placed on a nonhairy area just behind your ear." d. "Change the patch every 3 days." e. "Rotate the application sites."
b, c, d, e
The nurse providing teaching for a patient who has a new prescription for beta 1 blockers will keep in mind that these drugs may result in which effect? (Select all that apply.) a. Tachycardia b. Impotence c. Bradycardia d. Bradypnea e. Fatigue
b, c, e
When assessing for adverse effects of cholinergic-blocking drug therapy, the nurse knows that the patient may experience which drug effect? (Select all that apply.) a. Diaphoresis b. Dry mouth c. Dilated pupils d. Urinary frequency e. Constipation
b, c, e
When assessing a patient who is about to receive an albumin infusion, which of these conditions must a nurse recognize as a possible contraindication to albumin infusion? (Select all that apply.) a. Pancreatitis b. Heart failure c. Severe burns d. Renal insufficiency e. Fluid-volume deficit
b, d
A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? a. hyperuricemia b. hypernatremia c. hyperkalemia d. hypoglycemia
a
A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug levels indicate toxicity? a. seizures b. constipation c. normal sinus rhythm d. somnolence
a
While assessing a patient with angina who is to start beta blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs are used? (Select all that apply.) a. Diabetes mellitus b. Essential tremors c. Exertional angina d. Asthma e. Hypertension
a,d
The order for patient reads: "Give guaifenesin, 300 mg per enteral feeding tube every 4 hours as needed for cough." The medication comes in a bottle that has 100 mg/5 mL. How many milliliters will the nurse give per dose?
15 mL
A patient is receiving instructions regarding warfarin therapy and asks the nurse about what medications she can take for headaches. The nurse will tell her to avoid which type of medication? Select all that apply. a. aspirin b. acetaminophen c. NSAIDs d. The herbal product gingko e. Caffeine
a, c, d
A patient has a new prescription for transdermal nitroglycerin patches. The nurse teaches the patient that these patches are most appropriately used for which reason? a. To relieve exertional angina b. To prevent palpitations c. To prevent the occurrence of angina d. To stop an episode of angina
c
A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? a. take the drug as needed for acute asthma b. follow a low-sodium diet c. use an alternate-day dosing schedule d. increase weight-bearing activity
d
A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? a. peptic ulcer disease b. a seizure disorder c. anemia d. coronary artery disease
d
A patient with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina? a. Effort b. Unstable c. Crescendo d. Vasospastic
d
The nurse is assessing a patient who has been taking quinidine who asks about adverse effects. Which of these are potential adverse effects of quinidine? Select all that apply. a. Muscle pain b. Tinnitus c. Dyspnea d. Diarrhea e. Anorexia
b, d, e
A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? a. use a spacer to improve inhalation b. take the drug at the onset of bronchospasm c. rinse mouth to prevent an oral fungal infection d. take the drug once a day in the evening
d
A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? a. increases leukocyte activity b. blocks muscarinic receptors c. causes bronchodilation d. reduces inflammation
d
A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? a. check apical pulse before taking the drug b. take the drug only as needed before exercising c. rinse mouth after using the drug d. have laboratory tests performed at regular intervals
d
A 58-year-old patient is recovering in the ICU after a MI. The nurse notes an order for the beta blocker metoprolol (Lopressor). What is the purpose of this drug? a. dilate the coronary arteries b. inhibit stimulation of the myocardium by circulating catecholamines c. provide a positive inotropic effect d. maintain the patient's BP
b
The nurse is reviewing a patient's medication orders for prn medications that can be given to a patient who has bronchitis with a productive cough. Which drug will the nurse choose? a. an antitussive b. an expectorant c. an antihistamine d. a decongestant
b
In assessing a patient who has been taking amiodarone for 6 months, the nurse monitors for which potential adverse effect? a. Hyperglycemia b. Dysphagia c. Photophobia d. Urticaria
c
The patient is prescribed an ACE inhibitor. What primary mechanism of ACE inhibitors will the nurse understand as the therapeutic action? a. inhibit catecholamine release b. to inhibit acetylcholine release c. to inhibit aldosterone secretion d. to prevent vagal stimulation
c
Two days after admission, the nurse is reviewing laboratory results of the patient. Which is the most common electrolyte finding resulting from the administration of furosemide (Lasix)? a. hypocalcemia b. hypophophatemia c. hypokalemia d. hypomagnesemia
c
The order for enoxaparin (Lovenox) reads as follows: Give 1 mg/kg subQ every 12 hours. The patient weighs 242 lb, and the medication is available in an injection form of 120 mg/0.8 mL. How many milligrams will this patient receive? How many milliliters will the nurse draw up for the injection? (Round to hundredths.)
110 mg; 0.73 mL
A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first? a. bronchodilator b. corticosteroid c. it does not matter which is taken first
a
A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time? a. albuterol b. salmeterol c. fluticasone d. salmeterol and fluticasone combination (Advair Diskus)
a
A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? a. A beta agonist, such as albuterol b. A leukotriene receptor antagonist, such as montelukast c. A corticosteroid, such as fluticasone d. An anticholinergic, such as ipratropium
a
When assessing a patient who is to receive a decongestant, the nurse will recognize that a potential contraindication to this drug would be which condition? (select all that apply) a. glaucoma b. fever c. hypertension d. peptic ulcer disease e. allergic rhinitis
a, c
A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effects? (Select all that apply.) a. Orthostatic hypotension b. Increased blood pressure c. Increased urine flow d. Headaches e. Bradycardia
a, c, d
The nurse must watch for symptoms of a cholinergic crisis when giving intravenous cholinergic drugs. Which of these are symptoms of a cholinergic crisis? (Select all that apply.) a. Peripheral tingling b. Hypotension c. Dry mouth d. Syncope e. Dyspnea f. Abdominal cramping
a, c, d
A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? a. blood pressure b. apical heart rate c. respirations d. level of consciousness
c
A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? a. suppresses the cough stimulus b. reduces inflammation c. thins and loosens mucus d. dries secretions
c
A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? a. fever b. bruising c. polyuria d. palpitations
d
A patient is receiving dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. What will the nurse do next? a. Monitor for other signs of a therapeutic response to the drug. b. Titrate the drug to a higher dose to reduce the palpitations. c. Discontinue the dobutamine immediately. d. Assess the patient's vital signs and cardiac rhythm.
d
The nurse is preparing an infusion for a patient who has a deficiency in clotting factors. Which type of infusion is most appropriate? a. Albumin 5% b. Packed RBCs c. Whole blood d. Fresh frozen plasma
d
A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? a. reduced antitussive effect of dextromethorphan b. potentiation of depression of CNS actions c. increased renal reabsorption of the dextromethorphan d. delayed analgesic effect of the opioid
b
The order reads: Give hydralazine (Apresoline) 0.75 mg/kg/day. The child weighs 16 pounds. How much hydralazine will be given? (Record your answer using two decimal places.)
5.45 mg/kg/day
A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention? a. sodium 140 mEq/L b. potassium 5.3 mEq/L c. chloride 100 mEq/L d. magnesium 1.9 mEq/L
b
The nurse is monitoring a patient who is receiving an infusion of a beta-adrenergic agonist. Which adverse effects may occur with this infusion? (Select all that apply.) a. Mild tremors b. Bradycardia c. Tachycardia d. Palpitations e. Drowsiness f. Nervousness
a, c, d, f
A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? a. thins mucus b. relaxes bronchial smooth muscle c. decreases inflammation d. increases the cough threshold
c
A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? a. tachycardia b. dehydration c. diarrhea d. hypotension
d
A patient is taking a decongestant to help reduce symptoms of a cold. The nurse will instruct the patient to observe for which possible symptom, which may indicate an adverse effect of this drug? a. Increased cough b. Dry mouth c. Slower heart rate d. Heart palpitations
d
A nurse is providing teaching to client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy? a. bronchoconstriction b. muscle pain c. lip numbness d. somnolence
b
A patient is in the emergency department with new-onset rapid-rate atrial fibrillation. The nurse is about to add a continuous infusion of diltiazem (Cardizem) at 5 mg/hr but must first give a bolus of 0.25 mg/kg over 2 minutes. The patient weighs 220 pounds. The medication comes in a vial of 25 mg/5 mL. How many milligrams will the patient receive for the bolus dose and how many milliliters will the nurse draw up for this dose?
25 mg, 5 mL
The order reads, "Give metoprolol (Lopressor) 300 mg/day PO in 2 divided doses." The tablets are available in 50-mg strength. How many tablets will the patient receive per dose?
3 tablets per dose
The order reads: Give mannitol 0.5 g/kg IV now, over 2 hours. The patient weighs 165 lb and you have a 100-mL vial of 20% mannitol. How many grams will the patient receive? How many milliliters of mannitol will you prepare for this infusion?
37.5 g, 187.5 mL
A patient has been receiving a dopamine infusion. This morning while on rounds, the nurse noted that the IV has infiltrated. After stopping the infusion, the nurse prepares to administer phentolamine (Regitine). The ordered dose is 10 mg, mixed with 10 mL normal saline, then injected into the area of extravasation. The medication is available in vials that contains 5 mg in 2 mL. How many milliliters of phentolamine will the nurse mix with the normal saline?
4 mL
A patient who has had an accidental overdose of tricyclic antidepressants is to receive physostigmine (Antilirium) 1.5 mg IM stat. The medication is available in a vial that contains 2 mL, with a concentration of 1 mg/mL. How much medication will the nurse draw up into the syringe for this dose?
4 mL
The nurse is preparing to administer the elixir form of theophylline to a patient who has a PEG tube. The dose is 240 mg daily, and the medication is available in a concentration of 80 mg/15 mL. How many milliliters of medication will the nurse give per dose?
45 mL
A patient on a dobutamine drip starts to complain that her intravenous line "hurts". The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first? a. slow the intravenous infusion b. stop the intravenous infusion c. inject the area with phentolamine d. notify the physician health care provider
B
A patient is receiving digoxin 0.25 mg/day as part of treatment for HF. The nurse assesses the patient before medication administration. Which assessment finding out be of most concern? a. apical heart rate of 58 beats/min b. ankle edema +1 bilaterally c. serum potassium level of 2.9 mEq/L d. serum digoxin level of 0.8 ng/mL
C
Which action by the nurse is most appropriate for the patient receiving an infusion of packed red blood cells? a. Flush the IV line with normal saline (NS) before the blood is added to the infusion. b. Flush the IV line with dextrose before the blood is added to the infusion. c. Check the patient's vital signs after the infusion is completed. d. Anticipate that flushed skin and fever are expected reactions to a blood transfusion.
a
Which medication will the nurse teach a patient with asthma to use when experiencing an acute asthma attack? a. albuterol (Ventolin) b. Salmeterol (Serevent) c. Theophylline (Theo-Dur) d. Montelukast (Singulair)
a
Which statement by the patient reflects the need for additional patient education about the calcium channel blocker diltiazem (Cardizem)? a. "I can take this drug to stop an attack of angina." b. "I understand that food and antacids alter the absorption of this oral drug." c. "When the long-acting forms are taken, the drug cannot be crushed." d. "This drug may cause my blood pressure to drop, so I need to be careful when getting up."
a
a nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects? a. myopathy b. hypoglycemia c. irregular pulse d. kidney failure
a
The nurse caring for a patient who is receiving beta1 agonist drug therapy needs to be aware that these drugs cause which effect? (Select all that apply.) a. Increased cardiac contractility b. Mydriasis c. Decreased heart rate d. Bronchoconstriction e. Increased GI tract motility
a, b
When teaching the patient about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the patient to watch for which of these? (Select all that apply.) a. Dizziness b. Visual changes such as halos around lights c. Headaches d. Increased urine output e. Dark stools
a, b, c
A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (select all that apply) a. rash b. distorted taste c. swelling of the tongue d. photosensitivity e. dry cough
a, b, c, e
A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? (select all that apply) a. hyperkalemia b. throat swelling c. constipation d. cough e. joint pain
a, b, d
The nurse is administering an intravenous infusion of a phosphodiesterase inhibitor to a patient who has heart failure. The nurse will evaluate the patient for which therapeutic effects? (Select all that apply.) a. Positive inotropic effects b. Vasodilation c. Decreased heart rate d. Increased blood pressure e. Positive chronotropic effects
a, b, e
The nurse is assessing a patient who has a new prescription for vorapaxar (Zontivity). Which of these conditions are considered contraindications to the use of vorapaxar? (Select all that apply.) a. Impaired renal function b. Impaired liver function c. History of myocardial infarction d. Peripheral artery disease e. History of intracranial hemorrhage
a, b, e
The nurse is reviewing the mechanism of action of alpha adrenergic drugs. Adrenergic blockade at the alpha receptors leads to which effects? (Select all that apply.) a. Miosis b. Vasodilation c. Vasoconstriction d. Bradycardia e. Reduced blood pressure
a, b, e
The nurse is teaching a patient about the possible adverse effects of donepezil (Aricept) for Alzheimer's disease. Which of these are possible adverse effects? (Select all that apply.) a. Constipation b. GI upset c. Drowsiness d. Dizziness e. Blurred vision
a, b, e
A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. What is the nurse's immediate assessment priority? a. determine the time of the child's last mean b. monitor Spo2 with a pulse oximeter c. monitor the child's temperature d. provide education on asthma management
b
After the patient takes a dose of an inhaled corticosteroid, such as fluticasone (Flovent), what is the most important action the patient needs to do next? a. Hold the breath for 60 seconds. b. Rinse out the mouth with water. c. Follow the corticosteroid with a bronchodilator inhaler, if ordered. d. Repeat the dose in 15 minutes if the patient feels short of breath.
b
During a teaching session for a patient who is receiving inhaled salmeterol, the nurse emphasizes that the drug is indicated for which condition? a. Rescue treatment of acute bronchospasms b. Prevention of bronchospasms c. Reduction of airway inflammation d. Long-term treatment of sinus congestion
b
Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? a. respiratory depression b. drug abuse c. drug tolerance d. rebound congestion
b
The common cold is treated with empiric therapy. How can the nurse interpret this meaning? a. medications cure the cold b. medications only treat the symptoms c. herbal medications are useful to eliminate symptoms d. prevention with careful use of medications
b
A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? (select all that apply) a. muscle tremors b. urinary retention c. dry mouth d. insomnia e. tachycardia
b, c
A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? (select all that apply) a. take the drug with food b. report any new intolerances to fried food c. report muscle tenderness d. expect periodic liver function testing e. take the drug once each day
b, c, d
A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs? (select all that apply) a. ACE inhibitor b. MAOI c. general anesthetic d. tricyclic antidepressant e. beta blocker
b, c, d, e
A patient has a new prescription for an ACE inhibitor. During a review of the patient's list of current medications, which would cause concern for a possible interaction with this new prescription? (Select all that apply.) a. A benzodiazepine taken as needed for allergies b. A potassium supplement taken daily c. An oral anticoagulant taken daily d. An opioid used for occasional severe pain e. An NSAID taken as needed for headaches
b, e
The nurse is reviewing the medications that have been ordered for a patient for whom a loop diuretic has just been prescribed. The loop diuretic may have a possible interaction with which of the following? (Select all that apply.) a. Vitamin D b. Antidiabetic drugs c. Penicillins d. NSAIDs e. Corticosteroids f. warfarin
b, e, f
A nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid taking which of the following types of over the counter drugs while taking propranolol? a. antihistamines b. potassium supplements c. NSAIDS d. vitamin C
c
When administering beta blockers, the nurse will follow which guideline for administration and monitoring? a. The drug may be discontinued at any time. b. Postural hypotension rarely occurs with this drug. c. Tapering off the medication is necessary to prevent rebound hypertension. d. The patient needs to stop taking the medication at once if he or she gains 3 to 4 pounds in a week.
c
When giving decongestants, the nurse must remember that these drugs have alpha-adrenergic-stimulating effects that may result in which effect? a. fever b. bradycardia c. hypertension d. CNS depression
c
When preparing an IV solution that contains potassium, which of these conditions must a nurse recognize as a contraindication to the potassium infusion? a. Diarrhea b. Serum sodium level of 145 mEq/L c. Serum potassium level of 5.6 mEq/L d. Dehydration
c
When the nurse is checking the laboratory data for a patient taking spironolactone (Aldactone), which result would be a potential concern? a. Serum sodium level of 140 mEq/L b. Serum calcium level of 10.2 mg/dL c. Serum potassium level of 5.8 mEq/L d. Serum magnesium level of 2.0 mg/dL
c
Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the statin class? a. The drug must be taken on an empty stomach before meals. b. A low-fat diet is not necessary while taking these medications. c. It is important to report muscle pain immediately. d. Improved cholesterol levels will be evident within 2 weeks.
c
Which statement about ARBs does the nurse identify as being true? a. hyperkalemia is more likely to occur than when using ACE inhibitors b. cough is more likely to occur than when using ACE inhibitors c. chest pain is a common adverse effect d. overdose is usually manifested by hypertension and bradycardia
c
a nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication? a. acetylcysteine b. flumazenil c. antigen-binding fragments d. deferoxamine
c
A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (select all that apply) a. apply a new patch at the onset of anginal pain b. apply the patch to dry skin and cover the area with plastic wrap c. apply the patch to a hairless area and rotate sites d. apply a new patch when you start your day e. remove patches for 10 to 12 hours each day
c, d, e
A patient with heart failure will be starting the beta blocker metoprolol (Lopressor). The nurse will monitor for which expected cardiovascular effects? (Select all that apply.) a. Increased heart rate b. Increased myocardial contractility c. Delayed AV node conduction d. Reduced heart rate e. Decreased myocardial automaticity
c, d, e
A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and has a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug? a. the drug can cause hypoglycemia in clients who have a low urine output b. the drug does not reduce blood pressure for clients who have a low urine output c. the drug can increase the risk of pulmonary edema for clients who have renal insufficiency d. the drug does not promote diuresis for clients who have renal insufficiency
d
A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions? a. hyperglycemia b. bradycardia c. hypotension d. hypoglycemia
d
After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is which of these? a. An expected adverse effect of the medication. b. An allergic reaction to the medication. c. An indication that he has received an overdose of the medication. d. An idiosyncratic reaction to the medication.
a
For which of the following reasons should a client attach a spacer to a metered-dose inhaler? a. to increase the amount of drug delivered to the lungs b. to increase the amount of drug delivered to the oropharynx c. to increase the amount of drug delivered on exhalation d. to increase the speed of drug delivery into the mouth
a
The nurse is providing education about cholinergic-blocking drug therapy to an older adult patient. Which is an important point to emphasize for this patient? a. Avoid exposure to high temperatures. b. Limit liquid intake to avoid fluid overload. c. Begin an exercise program to avoid adverse effects. d. Stop the medication if excessive mouth dryness occurs.
a
The nurse is providing teaching to a group of individuals with COPD at a community center. Which statement indicates further teaching is needed? a. if I develop a puffy face, I will stop taking methylprednisolone (Medrol) immediately b. I will inform my prescriber of any weight gain of 2 lb or more in 24 hours or 5 lb or more in 1 week c. I use omalizumab (Xolair) to control my asthma but not for an acute asthma attack d. When taking theophylline (Theo-Dur), I will advise my prescriber if I experience epigastric pain
a
The nurse notes in a patient's medication history that the patient is taking benzonatate (Tessalon Perles) as needed. Based on this finding, the nurse interprets that the patient has which problem? a. Cough b. Seasonal allergies c. Chronic rhinitis d. Motion sickness
a
When administering a loop diuretic to a patient, it is most important for the nurse to determine if the patient is also taking which drug? a. lithium (Eskalith) b. acetaminophen (Tylenol) c. penicillin d. theophylline
a
When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? a. hypotension b. hyperkalemia c. oliguria d. respiratory distress
a
When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs? a. Alpha blockers such as doxazosin (Cardura) b. Diuretics such as furosemide (Lasix) c. ACE inhibitors such as captopril (Capoten) d. Vasodilators such as hydralazine (Apresoline)
a
When monitoring a patient who is receiving an intravenous infusion of nesiritide (Natrecor), the nurse will look for which adverse effect? a. Dysrhythmia b. Proteinuria c. Hyperglycemia d. Hypertension
a
When phentolamine is used to diagnose the presence of pheochromocytoma, the nurse will assess for what indicative finding? a. rapid decrease in blood pressure b. steady increase in blood pressure c. slower heart rate d. reduced cardiac ectopy
a
A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? a. muscle tremors b. drowsiness c. excitation d. insomnia
b
The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about a new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start treatment." Which reply from the nurse is appropriate? a. "The sooner he starts the medicine, the sooner it can have this effect." b. "These effects won't be seen for a few months." c. "These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy." d. "His response to this drug therapy will depend on how far along he is in the disease process."
c
The nurse is reviewing the orders for a newly admitted patient and sees an order for edrophonium (Tensilon). The nurse expects that this drug was ordered for which reason? a. To reduce symptoms and delay the onset of Alzheimer's disease b. To treat the symptoms of myasthenia gravis c. To aid in the diagnosis of myasthenia gravis d. To reverse the effects of nondepolarizing neuromuscular blocking drugs after surgery
d
Which patient would benefit from administration of simvastatin (Zocor) 80 mg? a. a patient with newly diagnosed hyperlipidemia b. a patient with muscle aches who was taking another antilipidemic drug c. a patient who is taking verapamil d. a patient who has already been taking simvastatin (Zocor) for 12 months with no evidence of myopathy
d
While at home, a patient took an accidental overdose of a cholinergic drug. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. Which drug would the nurse expect to use to treat this patient? a. atropine (generic) b. pilocarpine (Salagen) c. bethanechol (Urecholine) d. phentolamine (Regitine)
d
While monitoring a patient who is receiving an infusion of a crystalloid solution, the nurse will monitor for which potential problem? a. Bradycardia b. Hypotension c. Decreased skin turgor d. Fluid overload
d
A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? a. headache b. sleepiness c. hypotension d. constipation
a
A patient with a rapid, irregular heart rhythm is being treated in the emergency department with adenosine. During administration of this drug, the nurse will be prepared to monitor the patient for which effect? a. Nausea and vomiting b. A brief period of systole c. Muscle tetany d. Hypertension
b
A patient who has recently had a myocardial infarction has started therapy with a beta blocker. The nurse explains that the main purpose of the beta blocker for this patient is to a. cause vasodilation of the coronary arteries. b. prevent hypertension. c. increase conduction through the SA node. d. protect the heart from circulating catecholamines.
d
A patient will be taking niacin as part of antilipemic therapy. What is the best way to avoid problems with flushing or pruritis? a. take the medication at bedtime b. take the medication with a small dose of a steroid c. take the medication with a full glass of water on an empty stomach d. start with a low initial dose and then increase it gradually
d
A patient with a creatinine clearance of 20 mL/min is admitted to the medical-surgical unit. The patient is in need of rapid diuresis. Which class of diuretic does the nurse anticipate adminstering? a. potassium sparing b. thiazide c. osmotic d. loop
d
A patient with a tracheostomy developed pneumonia. It is very difficult for the patient to cough up the thick, dry secretions he has developed. The nurse identifies which drug as being the most effective in helping this patient? a. Benzonatate (Tessalon Perles) capsules b. dextromethorphan (Robitussin-DM) oral solution c. codeine cough syrup d. Guaifenesin (Mucinex)
d
A patient with diabetes has a new prescription for a thiazide diuretic. Which statement will the nurse include in teaching the patient about the thiazide drug? a. "There is nothing for you to be concerned about when you are taking the thiazide diuretic." b. "Be sure to avoid foods that are high in potassium." c. "You need to take the thiazide at night to avoid interactions with the diabetes medicine." d. "Monitor your blood glucose level closely because the thiazide diuretic may cause the levels to increase."
d
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient's BP. Which form of nitroglycerin is most appropriate? a. sublingual spray b. transdermal path c. oral capsule d. IV infusion
d
Before initiating therapy with a nonselective beta blocker, the nurse will assess the patient for a history of which condition? a. Hypertension b. Liver disease c. Pancreatitis d. Asthma
d
A patient is being assessed before a newly ordered antilipemic medication is started. Which condition would be a potential contraindication? a. Diabetes insipidus b. Pulmonary fibrosis c. Liver cirrhosis d. Myocardial infarction
c
The order reads: "Infuse 1000 mL of NS over the next 8 hours." The IV tubing has a drop factor of 15 gtt/mL. Calculate the mL/hour rate, and calculate the drops/minute setting for the IV tubing with this gravity infusion.
125 mL/hr; 31 gtt/min
The nurse is teaching a patient about the self-administration of enoxaparin (Lovenox). Which statement will be included in this teaching session? a. "We will need to teach a family member how to give this drug in your arm." b. "This drug is given in the folds of your abdomen, but at least 2 inches away from your navel." c. "This drug needs to be taken at the same time every day with a full glass of water." d. "Be sure to massage the injection site thoroughly after administering the drug."
b
The nurse knows that hte adverse effects of a nonselective beta blocker are likely to be the most immediately lfe threatening in which patient? a. patient with type 1 diabetes b. patient with asthma c. patient with gastroesophageal reflux disease d. patient with hypertension
b
The patient is order furosemide (Lasix). Before administering furosemide, it is important for the nurse to assess the patient for allergies to which drug class? a. aminoglycosides b. sulfonamides c. macrolides d. penicillins
b
The nurse is giving a cholinergic-blocking drug and will assess the patient for which contraindications to these drugs? a. Chronic bronchitis b. Peptic ulcer disease c. Irritable bowel syndrome d. Benign prostatic hyperplasia
d
A patient with type 2 diabetes is taking a beta blocker as part of treatment for hypertension. Which complication is most likely to develop? a. hypertension b. hyperkalemia c. hypoglycemia d. angina
c
The order reads "Dopamine 3 mcg/kg/min IV." The solution available is 400 mg in 250 mL D5W, and the patient weighs 176 pounds. The nurse will set the IV infusion pump to run at how many mL/hour?
9 mL/hour
A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? a. facial edema b. sleepiness c. peripheral edema d. constipation
a
A nurse is reviewing a new prescription for a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia? a. simvastatin b. furosemide c. losartan d. nitroglycerin
a
A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply) a. restlessness b. bradycardia c. insomnia d. muscle pain e. anxiety
a, c, e
The nurse is reviewing drug interactions with a male patient who has a prescription for isosorbide dinitrate (Isordil) as treatment for angina symptoms. Which substances listed below could potentially result in a drug interaction? (Select all that apply.) a. A glass of wine b. Thyroid replacement hormone c. Tadalafil (Cialis), an erectile dysfunction drug d. Metformin (Glucophage), an antidiabetic drug e. Carvedilol (Coreg), a beta blocker
a, c, e
A patient received a double dose of heparin during surgery and is bleeding through the incision site. While the surgeons are working to stop the bleeding at the incision site, the nurse will prepare to take what action? a. Give IV vitamin K as an antidote. b. Give IV protamine sulfate as an antidote. c. Call the blood bank for an immediate platelet transfusion. d. Obtain an order for packed red blood cells.
b
A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the medication with the evening meal or at bedtime. The patient asks why it must be taken at this time of day. What is the nurses' best response? a. the medication is better absorbed at this time b. this timeframe correlates better with the natural diurnal rhythm of cholesterol production c. there will be fewer adverse effects if taken at night instead of with the normal meal d. this time reduces the incidence of myopathy
b
A patient is receiving dabigatran (Pradaxa) 150 mg twice daily as part of treatment for atrial fibrillation. Which condition, if present, would be a concern if the patient were to receive this dose? a. Asthma b. Elevated liver enzymes c. Renal impairment d. History of myocardial infarction
c
When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occurring when this drug is taken to treat hypertension? (Select all that apply.) a. Fatigue b. Nausea c. Dry, nonproductive cough d. Diarrhea e. Dizziness
a, c, e
An older adult patient has been discharged following treatment for heart failure, and he will be taking a loop diuretic. Which instruction(s) from the nurse are appropriate? (Select all that apply.) a. "Take the diuretic at the same time each morning." b. "Take the diuretic only if you notice swelling in your feet." c. "Be sure to stand up slowly because the medicine may make you feel dizzy if you stand up quickly." d. "Drink at least 8 glasses of water each day." e. "Here is a list of foods that are high in potassium; you need to avoid these." f. "Please call your doctor immediately if you notice muscle weakness or increased dizziness"
a, c, f
In administering niacin, the nurse must monitor for which adverse effects? (Select all that apply.) a. Flushing of the skin b. Muscle pain c. Pruritus d. Headache e. Constipation f. GI upset
a, c, f
A 46-year-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. Which is the most appropriate response by the nurse? a. "Not to worry. Eventually, tolerance will develop." b. "The physician can work with you on changing the dose and/or drugs." c. "Sexual dysfunction happens with this therapy, and you will learn to accept it." d. "This is an unusual occurrence, but it is important to stay on your medications."
b
A 68-year-old male patient has been taking the nitrate isosorbide dinitrate (Isordil) for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a prescription for sildenafil (Viagra). Which response would the nurse most likely hear from the prescriber? a. "He will have to be switched to isosorbide mononitrate if he wants to take sildenafil." b. "Taking sildenafil with the nitrate may result in severe hypotension, so a contraindication exists." c. "I'll write a prescription, but if he uses it, he needs to stop taking the isosorbide for one dose." d. "These drugs are compatible with each other, and so I'll write a prescription."
b
A 94-year-old patient has a severe dry cough. He has coughed so hard that the muscles in his chest are hurting. He is unsteady on his feet and slightly confused. Which drug would be the best choice for this patient's cough? a. Benzonatate (Tessalon Perles) capsules b. Dextromethorphan (Robitussin-DM) oral solution c. codeine cough syrup d. Guaifenesin (Mucinex)
b
A nurse administering niacin would implement which action to help to reduce adverse effects? a. Give the medication with grapefruit juice. b. Administer a small dose of aspirin or an NSAID 30 minutes before the niacin dose. c. Administer the medication on an empty stomach. d. Have the patient increase dietary fiber intake.
b
A nurse is obtaining a medication history on a patient presenting with chest pain. What drug classification would necessitate the nurse informing the provider before beginning the prescribed nitroglycerin? a. proton pump inhibitor b. phosphodiesterase inhibitors (Erectile Dysfunction medications) c. inhaled beta blocker d. acetylsalicylic acid (aspirin)
b
A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? a. do not drink anything for 30 minutes after using the drug b. wait minutes between using the drug and another inhaled drug c. This drug is used to thin respiratory secretions d. check pulse rate after inhaling the drug
b
A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? a. suppresses the cough stimulus b. reduces surface tension c. reduces inflammation d. dries mucous membranes
b
A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long term use? a. quinidine b. procainamide c. nitroglycerin d. verpamil
b
A patient is about to receive a dose of the nonprotein plasma expander, dextran. The nurse knows that this product is indicated for which type of blood loss? a. Slow loss of 20% or less b. Slow loss of 20% to 50% c. Slow loss of over 50% or acute loss of 20% d. Loss of 80% or more
b
A patient is currently taking a statin. The nurse considers that the patient may have a higher risk for developing rhabdomyolysis when also taking which product? a. NSAIDs b. A fibric acid derivative c. Orange juice d. Fat-soluble vitamins
b
The nurse is monitoring a patient who is receiving antithrombolytic therapy in the emergency department because of a possible MI. Which adverse effect would be of the greatest concern at this time? a. Dizziness b. Blood pressure of 130/98 mm Hg c. Slight bloody oozing from the IV insertion site d. Irregular heart rhythm
d
The nurse is teaching a patient about the inhaler Advair (fluticasone/salmeterol). Which statements by the patient indicate a correct understanding of this medication? (Select all that apply.) a. "I will rinse my mouth with water after each dose." b. "I need to use this inhaler whenever I feel short of breath, but not less than 4 hours between doses." c. "This medication is taken twice a day, every 12 hours." d. "I can take this inhaler if I get short of breath while exercising." e. "I will call my doctor if I notice white patches inside my mouth."
a, c, e
A patient is taking an aminoglycoside antibiotic for pneumonia and will also be taking the loop diuretic furosemide (Lasix) due to fluid overload. The nurse will monitor carefully for which potential effect from the interaction of these two drugs? a. Nephrotoxicity b. Ototoxicity c. Pulmonary fibrosis d. Hepatotoxicity
b
A patient is prescribed two different types of inhaled medications for treatment of COPD. After administering the first medication, how long should the nurse wait to administer the second medication? a. 1 minute b. 5 minutes c. 10 minutes d. 15 minutes
b
A patient is taking a beta blocker as part of the treatment plan for heart failure. The nurse knows that the purpose of the beta blocker for this patient is to a. increase urine output. b. prevent stimulation of the heart by catecholamines. c. increase the contractility of the heart muscle. d. cause peripheral vasodilation.
b
The nurse knows that an antitussive cough medication would be the best choice for which patient? a. A patient with a productive cough b. A patient with chronic paranasal sinusitis c. A patient who has had recent abdominal surgery d. A patient who has influenza
c
A patient with chronic bronchitis calls the office for a refill of his albuterol inhaler. He just had the prescription filled 2 weeks ago, but he says it is empty. When asked, he tells the nurse, "I use it whenever I need it, but now when I use it, I feel so sick. I've been needing to use it more often". What is the most appropriate action by the nurse? a. the nurse should confirm the pharmacy location for the needed refill b. the nurse should ask the patient to come to the office for an evaluation of his respiratory status c. The nurse should tell the patient not to use this drug too often d. The nurse should consult the prescriber for a different inhaler prescription
b
The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients? a. Dry mouth b. Hypotension c. Restlessness d. Constipation
b
The nurse is reviewing the home medications for a newly admitted patient, and notes that the patient takes Mirabegron (Myrbetriq). The nurse will conclude that the patient has which condition? a. Asthma b. Overactive bladder c. Urinary retention d. Orthostatic hypotension
b
The nurse is reviewing the use of bethanechol (Urecholine) in a patient who is experiencing postoperative urinary retention. Which statement best describes the mechanism of action of bethanechol? a. It causes decreased bladder tone and motility. b. It causes increased bladder tone and motility. c. It increases the sensation of a full bladder. d. It causes the sphincters in the bladder to become tighter.
b
When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect which effect? a. Reduced blood pressure b. Decreased heart rate c. Decreased ectopic beats d. Increased force of cardiac contractions
b
While preparing an infusion of mannitol (Osmitrol), the nurse notices small crystals in the IV tubing. What is the most appropriate action by the nurse? a. administer the infusion slowly b. discard the solution and obtain another bag of medication c. obtain a filter and then infuse the solution d. return the fluid to the IV bag to dissolve the crystals
b
A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.) a. Teach proper subcutaneous administration. b. Administer the oral dose at the same time every day. c. Assess carefully for excessive bruising or unusual bleeding. d. Monitor laboratory results for a target INR of 2 to 3. e. Monitor laboratory results for a therapeutic aPTT value of 1.5 to 2.5 times the control value.
b, c, d
A patient has been taking simvastatin (Zocor) for 6 months. Today he received a call that he needs to come to the office for a "laboratory check." The nurse expects which laboratory studies to be ordered at this time? (Select all that apply.) a. PT/INR b. Total cholesterol c. Triglycerides d. Liver function studies e. Complete blood count f. HDL and LDL levels
b, c, d, f
The nurse is giving an antihistamine and will observe the patient for which side effects? (Select all that apply.) a. Hypertension b. Dizziness c. "Hangover" effect d. Drowsiness e. Tachycardia f. Dry mouth
b, c, d, f
The nurse is giving a dose of bethanechol (Urecholine) to a postoperative patient. The nurse is aware that contraindications to bethanechol include which of these? (Select all that apply.) a. Bladder atony b. Peptic ulcer c. Urinary retention d. Hyperthyroidism e. Cardiac disease
b, c, e
A patient is receiving ipratropium via an inhaler. The nurse will assess the patient for which of these adverse effects? (Select all that apply.) a. CNS depression b. Dry mouth or throat c. Increased appetite d. Nasal congestion e. Headache
b, d, e
The nurse is administering cholestyramine (Questran), a bile acid sequestrant. Which nursing intervention(s) is(are) appropriate? (Select all that apply.) a. Administering the drug on an empty stomach b. Administering the drug with meals c. Instructing the patient to follow a low-fiber diet while taking this drug d. Instructing the patient to take a fiber supplement while taking this drug e. Increasing fluid intake f. Not administering this drug at the same time as other drugs
b, d, e, f
When the nurse is teaching a patient about taking an antidysrhythmic drug, which statements by the nurse are correct? (Select all that apply.) a. "Take the medication with an antacid if stomach upset occurs." b. "Do not chew sustained-release capsules." c. "If a weight gain of 5 pounds occurs within 1 week, notify your physician at the next office visit." d. "If you experience severe adverse effects, stop the drug and notify your physician." e. "If stomach upset occurs, you may take the medication with food."
b, e
A nurse with adequate knowledge about the administration of intravenous nitroglycerin will recognize that which statement is correct? a. The intravenous form is given by IV push injection. b. Because the intravenous forms are short-lived, the dosing must be every 2 hours. c. Intravenous nitroglycerin must be protected from exposure to light through use of special tubing. d. Intravenous nitroglycerin can be given via gravity drip infusions.
c
A patient calls the family practice office to report that he has seen his pills in his stools when he has a bowel movement. How will the nurse respond? a. "The pills are not being digested properly. You need to take them on an empty stomach." b. "The pills are not being digested properly. You need to take them with food." c. "What you are seeing is the wax matrix that contained the medication, but the drug has been absorbed." d. "This indicates that you are not tolerating this medication and will need to switch to a different form."
c
A patient has been ordered the powdered form of the bile acid sequestrant colestipol. Which of the following does the nurse identify as true? a. the nurse should have the patient swallow the dose of the colestipol powder one teaspoon at a time b. the powder should be dissolved and immediately administered c. the colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication d. the colestipol should be administered with meals
c
A patient is in the clinic for a follow-up visit. He has been taking amiodarone (Cordarone) for almost 1 year, and today he tells the nurse, "I am noticing some blue color around my face, neck, and upper arms. Is that normal?" Which is the nurse's correct response? a. "This is an expected side effect and should go away soon." b. "This is a harmless effect. As long as the medication is working, we'll just monitor your skin." c. "This can happen with amiodarone. I will let your doctor know about it right away." d. "How much sun exposure have you had recently?"
c
A patient on a dobutamine drip starts to complain that he feels a "tightness" in his chest that he had not felt before. What will the nurse do first? a. Check the infusion site for possible extravasation. b. Increase the infusion rate. c. Check the patient's vital signs. d. Order an electrocardiogram.
c
A patient who has had an MI is taking a beta blocker. What is the main benefit of beta blocker therapy for this patient? a. vasodilation of the coronary arteries b. increased force of cardiac contraction c. slowing of the heart rate d. maintaining adequate BP
c
A patient who is taking a xanthine derivative for COPD asks the nurse, "I miss my morning coffee. I can't wait to go home and have some." What is the nurse's best response? a. "I know how you feel. I'd miss my coffee too." b. "I can get some coffee for you. I'll be right back." c. "It's important not to take coffee or other caffeinated products with this medicine, as it may cause an increased heart rate as well as other problems." d. "You've been on this medicine for a few days. I can call your prescriber to ask whether you can have some coffee."
c
A patient with a history of HF presents to the emergency department with difficulty breathing, cough and edema of the lower extremities. The nurse anticipates administration of which type of medication? a. positive chronotrope b. negative chronotrope c. positive inotrope d. negative inotrope
c
A patient with a known history of angina was walking his dog and developed chest pain. The patient immediately stops walking and sits down. He continues to experience chest pain when sitting down. When should he call 911? a. immediately b. if the pain becomes more severe c. if one sublingual tablet does not relieve the pain after 5 minutes d. if the pain is not relieved after three sublingual tablets, taken 5 minutes apart
c
Before administering an adrenergic decongestant, it is most important for the nurse to assess the patient for a history of which condition? a. cataracts b. gastric ulcer c. diabetes mellitus d. hypothyroidism
c
Before administering an antihistamine to a patient, it is most important for the nurse to assess the patient for a history of which condition? a. chronic urticaria b. motion sickness c. urinary retention d. insomnia
c
During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singulair), the nurse will tell the patient that the drug has which therapeutic effect? a. Improves the respiratory drive b. Loosens and removes thickened secretions c. Reduces inflammation in the airway d. Stimulates immediate bronchodilation
c
During assessment of a patient who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as a. apical pulse rate of 62 beats/min. b. digoxin level of 1.5 ng/mL. c. serum potassium level of 2.0 mEq/L. d. serum calcium level of 9.9 mEq/L.
c
During the assessment of a patient about to receive a cholinergic-blocking drug, the nurse will determine whether the patient is taking any drugs that may potentially interact with the anticholinergic, including which of these? a. Opioids, such as morphine sulfate b. Antibiotics, such as penicillin c. Tricyclic antidepressants, such as amitriptyline d. Anticonvulsants, such as phenobarbital
c
For a patient receiving a vasoactive drug such as intravenous dopamine, which action by the nurse is most appropriate? a. Monitor the gravity drip infusion closely, and adjust as needed. b. Assess the patient's cardiac function by checking the radial pulse. c. Assess the intravenous site hourly for possible infiltration. d. Administer the drug by intravenous boluses according to the patient's blood pressure.
c
The nurse is assessing a patient who is receiving a milrinone infusion and checks the patient's cardiac rhythm on the heart monitor. What adverse cardiac effect is most likely to occur in a patient who is receiving intravenous milrinone? a. Tachycardia b. Bradycardia c. Atrial fibrillation d. Ventricular dysrhythmia
d
The nurse is administering lidocaine and considers which condition, if present in the patient, is a caution for the use of this drug? a. Tachycardia b. Hypertension c. Ventricular dysrhythmias d. Renal dysfunction
d
The nurse is assessing a patient who will be starting antihypertensive therapy with an ACE inhibitor. Which condition, if present in the patient, would be a reason for cautious use? a. Asthma b. Rheumatoid arthritis c. Hyperthyroidism d. Renal insufficiency
d