Pharmacology Hesi
What should a nurse teach to a patient who will begin taking enapril malteat (vasotec)?
ACE INHIBITOR that causes antihypertensive efffect--Change positions slowly for orthostatic hypotension
MOA of Metoclopramide HCl (Reglan)
Blocks dopamine--risk for EPS
How to mix insulin
Clear before cloudy because you want the cloudy to be injected into the body before the clear.
Adverse effect of too much vitamin C
Diarrhea
Expected reaction to carbamazepine/tegretol
Dizziness and dry mouth
Inject insulin
subcut
Which first line medication would the nurse state is used to treat anaphylactic reactions? 1 Epinephrine 2 Norepinephrine 3 Dexamethasone 4 Diphenhydramine
1
The physician has an order for lovenox IV 0.3 mg/ml. What should the nurse do?
Question the route of administration. Lovenox is given SC, not IV
short acting
Regular insulin (Humulin R) (Clear)
What is the DOC for heart failure?
Digoxin (lanoxin)
A child with cystic fibrosis is receiving ticarcillin disodium (Ticar) for Pseudomonas pneumonia. For which adverse effect should the nurse assess and report promptly to the health care provider?
Petichiae
Diabetic medication Pt teaching
Teach patient how to give own injections
Haloperidol (Haldol) controls...
Tics and vocalizations
What is often the first sign of myasthenia gravis?
Muscle weakness in the head and neck
What drug would be ordered for treating mild to moderate Crohn's disease without systemic manifestations?
STEROIDS--Budesonide (entocort) PO
A patient with AIDS is taking megestrol acetate (megace). What would be the reason why they are taking it?
To increase appetite
What drug should be given after a noticed bradycardia r/t digitalis toxicity?
Atropine which blocks vagus nerve stimulation to allow increased sinus node conduction to increase heart rate from bradycardia
A rapid increase (more than 1 g/dL in a 2-week period) may lead to...
Hypertension
Male patient reports that his mother took diethylstillbestrol (DES) dring pregnancy/ Which concern of the patient requires attention?
Increased risk of testicular cancer
How does allopurinol (zyloprim) act on gout?
Inhibits uric acid formation
Why should phenytoin (dilantin) only be primed with NS and not be infused with any other IV solutions?
It causes a crystallization of the drug
How does aluminum hydroxide (amphojel) work?
It is an antacid that decreases acidity in the stomach--it neutralizes acidic gastric secretions
What is a side effect to consider informing the pt on antifungals?
Phototoxicity
What are symptoms of ineffective drug management of multiple sclerosis?
Ptosis and decreased oral secretions
A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications? 1 Eat yogurt with active cultures daily. 2 Avoid spicy foods. 3 Drink more fruit juices. 4 Take a multivitamin every day
1
A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide? 1 Stimulates the pancreas to produce insulin 2 Accelerates the liver's release of stored glycogen 3 Increases glucose transport across the cell membrane 4 Lowers blood glucose in the absence of pancreatic function
1
A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? 1 Increase the intake of fluids. 2 Strain the urine for crystals and stones. 3 Stop the drug if urinary output increases. 4 Maintain the exact time schedule for taking the drug
1
The nurse is preparing to discharge a client who presented to the emergency room for an acute asthma attack. The nurse notes that upon discharge the healthcare provider has prescribed theophylline 300 mg orally to be taken daily at 9:00 AM. The nurse will teach the client to take the medication on which schedule? 1 With a meal 2 Only at bedtime 3 At a specific time prescribed 4 Until symptoms are gone
3
Pyridoxine (vitamin B6) and isoniazid (INH) are prescribed as part of the chemotherapy protocol for a client with tuberculosis. Which response indicates to the nurse that vitamin B6 is effective? 1 Weight gain 2 Absence of stomatitis 3 Absence of numbness and tingling in extremities 4 Acceleration of dormant tubercular bacilli destruction
3 Vitamin B6 (pyridoxine) supplementation during isoniazid (INH) therapy is necessary in some patients to prevent the development of peripheral neuropathy.
A nurse is caring for a client who has been taking several antibiotic medications for a prolonged time. Because long-term use of antibiotics interferes with the absorption of fat, what prescription does the nurse anticipate? 1 High-fat diet 2 Supplemental cod liver oil 3 Total parenteral nutrition (TPN) 4 Water-soluble forms of vitamins A and E
4
The nurse notes that the hemoglobin level of a client receiving darbepoetin alfa (Aranesp) has increased from 6 to 10 g/dL over the first 2 weeks of treatment. Which action should the nurse take?
Notify the health care provider of the change in the client's laboratory values.
A pregnant patient goes into premature labor and is admitted to the high-risk labor and delivery unit. Which med would the RN anticipate administering to the patient?
Ritodrine (yutopar)--indicated to halt early labor by relaxing uterine muscles and supressing uterine contractions
Urine culture vs urine analysis....which one is more specific?
Urine culture
What test is done to check for UTI?
Urine culture test--do this before administering abx
A client is diagnosed with tuberculosis associated with human immunodeficiency virus infection. What crucial laboratory test results should the nurse review before antitubercular pharmacotherapy is started? 1 Liver function studies 2 Pulmonary function studies 3 Electrocardiogram and echocardiogram 4 White blood cell (WBC) count and sedimentation rate
1
A client with a new diagnosis of type 1 diabetes is told that lifelong insulin will be needed. The client becomes agitated and says, "I am scared of shots. If that is my only option, I'll just have to go into a coma and die!" What is the nurse's best response? 1 "Injections are not the only option available for insulin." 2 "It won't be so bad; you will get used to it if you will only try." 3 "This is one of those times when you need to act like an adult." 4 "Clients have the right to refuse treatment, but I need you to sign this form that removes us from liability for your decision."
1
Loratadine, 10 mg by mouth once a day in the morning, is prescribed for a 15-year-old girl with hay fever. The girl tells the school nurse that she is concerned that she will be sleepy for a quiz the next day. How should the nurse respond? 1 By explaining that this medication rarely causes drowsiness 2 By advising her to take half a tablet in the morning before school 3 By suggesting that she skip the next day's dose if she can tolerate the hay fever 4 By recommending that she call the allergist for a prescription containing a stimulant
1
In what ways can a nurse prevent medication errors? Select all that apply 1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 3 Try to guess what the client is saying if the language is not understood 4 Document each dose of the drug using trailing zeros when recording the dose 5 Check three times before giving a drug by comparing the drug order and medication profile
1,2,5
A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client? 1 Determine the client's emotional state. 2 Give prescribed drugs to promote bronchiolar dilation. 3 Provide education about the impact of a family history. 4 Encourage the client to use an incentive spirometer routinely
2
A client with a history of malabsorption syndrome is admitted to the hospital for medical management. Total parenteral nutrition (TPN) has been prescribed. What action will the nurse take to prevent a major reaction to the TPN infusion? 1 Record the intake and output. 2 Administer the infusion slowly. 3 Change the site every 24 hours. 4 Check the vital signs every 4 hours
2
A health care provider prescribes psyllium 3.5 g twice a day for constipation. What is most important for the nurse to teach this client? 1 Urine may be discolored. 2 Each dose should be taken with a full glass of water. 3 Use only when necessary because it can cause dependence. 4 Daily use may inhibit the absorption of some fat-soluble vitamins
2
A client has an anaphylactic reaction after receiving intravenous penicillin. What does the nurse conclude is the cause of this reaction? 1 An acquired atopic sensitization occurred. 2 There was passive immunity to the penicillin allergen. 3 Antibodies to penicillin developed after a previous exposure. 4 Potent antibodies were produced when the infusion was instituted
3
A client is started on tetracycline antibiotic therapy. What should the nurse do when administering this drug? 1 Administer the medication with meals or a snack. 2 Provide orange or other citrus fruit juice with the medication. 3 Give the medication an hour before milk products are ingested. 4 Offer antacids 30 minutes after administration if gastrointestinal side effects occur
3
A client receiving intravenous vancomycin reports ringing in both ears. Which initial action should the nurse take? 1 Notify the primary healthcare provider. 2 Consult an audiologist. 3 Stop the infusion. 4 Document the finding and continue to monitor the client
3
For a client with difficulty swallowing, the nurse should crush which medication? 1 Metoprolol extended release 2 Felodipine sustained release 3 Acetaminophen extra strength 4 Potassium chloride extended release
3
How soon after administering regular insulin will it begin to have an effect. What should the nurse say?
30 minutes to an hour
A client is receiving dexamethasone to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client? 1 Hyperkalemia 2 Liver dysfunction 3 Orthostatic hypotension 4 Increased blood glucose
4
A pt on haloperiodol (Haldol) reports dizziness when changing from supine to sitting position. What should the first intervention be for the nurse?
Because haloperidol (Haldol) causes CNS effects of sedation and decreased thirst, the nurse should assess for signs of dehydration
In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of Alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs?
Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal.
Epoetin alfa (epogen) is used to elevate what lab levels?
Hemoglobin and hematocrit
Fast acting insulin
Lispro
A patient with rheumatoid arthritis is placed on methotrexate. What lab studies should be monitored regularly?
Liver enzymes (AST and ALT)
Oral Anti-diabetic drugs
Metformin, glipizide, pioglitazone, repaglinide, stigliptin.
A patient is present with a head injury. What drugs are automatically ruled out?
Narcotics and sedatives
A 19-year-old male client who has sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside?
Neostigmine bromide (Prostigmin) and atropine sulfate (Atropine), both anticholinergic drugs, reverse the respiratory muscle paralysis caused by pancuronium bromide.
Long acting
Never mix
Fluphenazine (Prolixin) an antipsychotic for schizophrenics is often seen in pts that...
Noncompliant with medications Fluphenazine (prolixin) has a rapid onset (1 to 2 hours) and a long duration of action (up to 3 or 4 weeks)
Pseudomonas can change urine to what color?
Purple
If a patient taking nitroglycerin starts to have a headache, what should the nurse tell them?
The headache will last 5-20 minutes ...don't stop taking it
Important interventions for a pt taking methotrexate for rheumatoid arthritis?
-Confirm with another nurse that it is not intended as chemo -Assess LFTs -Monitor I&Os -Expected side effect: stomatitis
What solution is the intial fluid for the situation of significant blood loss?
0.9% NS
A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? 1 "Exercise increases the need for carbohydrates and decreases the need for insulin." 2 "Exercise increases the need for insulin and increases the need for carbohydrates." 3 "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." 4 "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."
1
A healthcare provider prescribes an antibiotic intravenous piggyback twice a day for a client with an infection. The healthcare provider prescribes peak and trough levels 48 and 72 hours after initiation of the therapy. The client asks the nurse why there is a need for so many blood tests. What reason does the nurse provide? 1 "They determine adequate dosage levels of the drug." 2 "They detect if you are having an allergic reaction to the drug." 3 "The tests permit blood culture specimens to be obtained when the drug is at its lowest level." 4 "These allow comparison of your fever to when the blood level of the antibiotic is at its highest."
1
Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching? 1 "I will drink 2 to 3 quarts (2 to 3 liters) of fluid a day." 2 "Any reconstituted solution must be discarded in 1 week." 3 "I can continue driving my car as long as I have the stamina." 4 "While taking this medicine I should be able to continue my usual activity."
1 Interferons (IFNs, /ˌɪntərˈfɪərɒn/) are a group of signaling proteins made and released by host cells in response to the presence of several viruses.
A client with tuberculosis is started on a chemotherapy protocol that includes rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? 1 "I need to drink a lot of fluid while I take this medication." 2 "I can expect my urine to turn orange from this medication." 3 "I should have my hearing tested while I take this medication." 4 "I might get a skin rash because it is an expected side effect of this medication.
2
A client with type 1 diabetes requests information about the differences between penlike insulin delivery devices and syringes. What information does the nurse provide about the penlike devices? 1 The penlike devices have a shorter injection time 2 Penlike devices provide a more accurate dose delivery. 3 The penlike delivery system uses a smaller-gauge needle. 4 Penlike devices cost less by having reusable insulin cartridges
2
A health care provider prescribes ranitidine for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works? 1 Ranitidine increases gastrointestinal peristalsis. 2 Ranitidine reduces gastric acidity in the stomach. 3 Ranitidine neutralizes the acid that is present in the stomach. 4 Ranitidine stops production of hydrochloric acid in the stomach
2
A health care provider prescribes vancomycin peak and trough levels for a client who is receiving vancomycin intravenous piggyback (IVPB). When should the nurse have the laboratory obtain a blood sample to determine a peak level of the antibiotic? 1 Halfway between two doses of the drug 2 Between 30 and 60 minutes after a dose 3 Immediately before the medication is administered 4 Anytime it is convenient for the client and the laboratory
2
A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug? 1 Arterial blood pH 2 Intake and output 3 Fasting serum glucose 4 Pulse and respiratory rates
2
A nurse determines that the teaching about the side effects of azithromycin has been understood when the adolescent client identifies which problem as the most common side effect of this medication? 1 Tinnitus 2 Diarrhea 3 Dizziness 4 Headache
2
A nurse evaluates that a client understands appropriately how to take the antacids prescribed by the primary health care provider when the client makes which statement? 1 "I will take this antacid at the onset of pain." 2 "I will take this antacid 30 minutes after meals." 3 "I will take this antacid every 4 hours around the clock." 4 "I will take this antacid each time I have something to eat."
2
A nurse is reviewing a newly admitted client's medication administration record (MAR). Which element, if missing, makes the record incomplete? 1 Height 2 Allergies 3 Vital signs 4 Body weight
2
What interventions are needed to help prevent accidental poisoning of children? Select all that apply 1 Medicines should be referred to as candy. 2 Potent poisons should be kept out of reach of children. 3 Containers of the poisonous substances should be tightly closed. 4 Old unused and unnecessary medications should be safely disposed. 5 Medications should be transferred from their original containers to alternate ones
2,3,4
A client admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease has received a prescription for a medication that is delivered via a nebulizer. When teaching about use of the nebulizer, the nurse should teach the client to do what? 1 Hold the breath while spraying the medication into the mouth. 2 Position the lips loosely around the mouthpiece and take rapid, shallow breaths. 3 Seal the lips around the mouthpiece and breathe in and out, taking slow, deep breaths. 4 Inhale the medication from the nebulizer, remove the mouthpiece from the mouth, and then exhale.
3
A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which drug does the nurse expect the health care provider to prescribe? 1 Psyllium 2 Bisacodyl 3 Loperamide 4 Docusate sodium
3
A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe? 1 NPH insulin 2 Inhaled insulin 3 Regular insulin 4 Insulin glargine
3
A client is receiving penicillin G and probenecid for syphilis. What rationale should the nurse give for the need to take these two drugs? 1 Each drug attacks the organism during different stages of cell multiplication. 2 The penicillin treats the syphilis, whereas the probenecid relieves the severe urethritis. 3 Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods. 4 Probenecid decreases the potential for an allergic reaction to penicillin, which treats the syphilis
3
A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? 1 Overeating 2 Intestinal virus 3 Aerobic exercise 4 Missed insulin dose
3
A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide? 1 To augment the immune response 2 To potentiate the effect of antacids 3 To treat Helicobacter pylori infection 4 To reduce hydrochloric acid secretion
3
A healthcare provider prescribes ampicillin for a client with an infection. What information should the nurse include in the teaching plan about this medication? 1 Take the ampicillin with meals. 2 Store the ampicillin in a light-resistant container. 3 Notify the healthcare provider if diarrhea develops. 4 Continue the drug until a negative culture is obtained
3
A client develops a fever after surgery. Ceftriaxone is prescribed. For which potential adverse effect should the nurse monitor the client? 1 Dehydration 2 Heart failure 3 Constipation 4 Allergic response
4
A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? 1 "Eliminating fluids with meals will prevent pain." 2 "I will increase my food intake to avoid an empty stomach." 3 "Taking an aspirin with milk will relieve my pain and coat my ulcer." 4 "Taking an antacid preparation will decrease pain due to gastric acid."
4
A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse? 1 "Sedatives can be given to help you relax." 2 "We can give you immune serum globulin." 3 "Vitamin supplements are frequently helpful and hasten recovery." 4 "There are medications to help reduce viral load and liver inflammation.
4
A client with type 1 diabetes tells the nurse, "I take guaifenesin cough syrup when I have a cold." What important instruction does the nurse include in client teaching about this medication? 1 Substitute an elixir for the cough syrup. 2 Increase fluid intake and use a humidifier to control the cough. 3 The small amounts of sugar in medications are not a concern with diabetes. 4 Include the glucose in the cough syrup when calculating daily carbohydrate allowance
4
A health care provider prescribes daily docusate sodium for a client. The nurse explains to the client that this drug has what action? 1 Lubricates the feces 2 Creates an osmotic effect 3 Stimulates motor activity 4 Lowers the surface tension of feces
4
A healthcare provider prescribes famotidine and magnesium hydroxide/aluminum hydroxide antacid for a client with a peptic ulcer. The nurse should teach the client to take the antacid at what time? 1 Only at bedtime, when famotidine is not taken 2 Only if famotidine is ineffective 3 At the same time as famotidine, with a full glass of water 4 One hour before or 2 hours after famotidine
4
A nurse has provided teaching to a client with a newly prescribed proton pump inhibitor (PPI). The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of which condition? 1 Diarrhea 2 Vomiting 3 Cardiac dysrhythmias 4 Gastroesophageal reflux disease (GERD
4
The postoperative prescriptions for a client who had repair of an inguinal hernia include docusate sodium daily. Before discharge, the nurse instructs the client about what potential side effect? 1 Rectal bleeding 2 Fecal impaction 3 Nausea and vomiting 4 Mild abdominal cramping
4
What information should the nurse include when teaching a client about antacid tablets? 1 Take them at 4-hour intervals. 2 Take them 1 hour before meals. 3 They are as effective as the liquid forms. 4 They interfere with the absorption of other drugs
4
Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? 1 "I will need to have my eyes and vision examined once a year." 2 "I will need to check my blood sugar at home to evaluate my response to my treatment plan." 3 "I can improve metabolic and cardiac risk factors of this disease if I follow a low-calorie diet and lose weight." 4 "Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."
4
A client is receiving pyridostigmine bromide (Mestinon) to control the symptoms of myasthenia gravis. Which client behavior would indicate that the drug therapy is effective?
Clear speech--this shows increased muscle strength
Long-term corticosteroids should be taken at what time of the day?
Morning since the drug should be given around the time of the natural release of cortisol--day time.
Chemotherapy--daunorubicin HCl (Cerubidine) sign of effective treatment
Red urine
Side effect of linezolid (Zyvox)
Severely watery diarrhea
How do antibiotics work?
They block growth of essential components of the bacterial cell by inhibiting/interfering protein synthesis leading to cell death or dysfunction
How do immunizations work?
They enhance the immunological defenses of the host by stimulating the production of protective antibodies (active immunization)
What is the DOC for status epilepticus? (short-term)
Valium
What is the therapeutic range of theophylline (theo-dur)
10-20 mcg Caution for toxicity
A 67-year-old client has tested positive for influenza A. The client also has asthma. Which drug would the nurse recommend be avoided in this client? 1 Ribavirin 2 Zanamivir 3 Oseltamivir 4 Amantadine
2
A nurse administers a tube of glucose gel to a client who is hypoglycemic. What explanation does the nurse share regarding the reversal of hypoglycemia? 1 It liberates glucose from hepatic stores of glycogen. 2 It provides a glucose source that is rapidly absorbed. 3 Insulin action is blocked as it competes for tissue sites. 4 Glycogen is supplied to the brain as well as other vital organs
2
A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action? 1 NPH insulin 2 Insulin lispro 3 Regular insulin 4 Insulin glargine
2
What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators? 1 Is able to obtain pulse oximeter readings 2 Demonstrates use of a metered-dose inhaler 3 Knows the healthcare provider's office hours 4 Can identify the foods that may cause wheezing
2
What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy? 1 Exercise regularly. 2 Rotate injection sites. 3 Use the Z-track technique. 4 Avoid massaging the injection site
2
Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate? 1 Antacids should be taken 30 minutes before a meal. 2 Sucralfate should be taken on an empty stomach one hour before meals. 3 Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease. 4 Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects
2
S/S Hypoglycemia
Confusion, jittery, shaking, sweaty, CNS related is 1st sign , hungry, weak or tired, headache, Nervous or upset
A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel (Taxotere) chemotherapy. What symptom would indicate a need for an immediate response by the nurse prior to implementing another dose of this chemotherapeutic agent?
Cough that is new and persistent--fluid retention --> pleural effusion, dyspnea, cardiac tamponade, and abdominal distention
What is an indication for haloperidol (haldol)
For agitation, violence, and bizarre thoughts associated w/ dementia
What is the indication of allopurinol (zyloprim)?
For gout
Pt education on tetracycline (Vibramycin)
Oral contraceptives may not be effective
What is the antidote for heparin?
Protamine sulfate
How does Humibid (guaifenesin) primarily work?
Thin and loosen respiratory tract secretions--it is an expectorant.
What is the acceptable dose range of morphine sulfate IV?
0.1-0.2 mg/kg
What color is dobutamine?
Brown
A male patient taking antihypertensive dry methyldopa (aldomet). This drug is known to cause what adverse reaction?
Decreased erectile ability
Lispro
Eat within 15 minutes before
Succinylcholine
Untraceable, removed quickly from body; Cardiac dysrythmia, body paralysis yet brain is still alert and active.
The major reason neuroleptics such as haloperidol (haldol) may be used for treating patients w/ severe psychiatric disorder is to...
decrease psychotic symptoms
A client who has been prescribed tetracycline continues the course of treatment during the first trimester of pregnancy. Which teratogenic effect may occur in the fetus? 1 Bone anomalies 2 Central nervous system malformations 3 Facial malformations 4 Internal organ defects
1
A client with type 1 diabetes self-administers NPH insulin every morning at 8 am. The nurse evaluates that the client understands the action of the insulin when the client identifies which time range as the highest risk for hypoglycemia? 1. 2 pm to 8 pm 2. 8 pm to noon 3. 9 am to 10 am 4. 10 am to 11 am
1
Which Food and Drug Administration pregnancy risk category do drugs that have not undergone any studies in animal and pregnant women belong to? 1 Category B 2 Category C 3 Category D 4 Category X
2
Clozapine (clozaril) is known to cause what adverse reaction?
Agranulocytosis--monitor WBC count
What drug is given when there are PVCs?
Amiodarone for antidysrhythmias
A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering?
Butorphanol (Stadol)--is a mixed agonist-antagonist analgesic resulting in good analgesia but with less respiratory depression, nausea, and vomiting compared with opioid agonist analgesics
What is the antagonist to magnesium sulfate for preeclampsia?
Calcium gluconate
A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement?
Clients should be taught to recognize signs of overmedication and undermedication so that they can modify the dosage themselves
Indication of venlafaxine (Effexor XR)
Depression
Which intervention is most important for a nurse to implement prior to administering atropine PO?
Determine the presence of 5 to 35 bowel sounds/min.
Doxorubicin HCl (Adriamycin)
Do ECG for risk for cardiotoxicity
Where is the DPT injection done in infants younger than 2 yrs?
IM--vastus lateralis
How does acyclovir (zovirax) work?
Inactivate the virus
What is important to include in pt education in a patient taking sulfasalazine (Azulfidine)?
Increase fluid intake 8 glasses and take after a meal If not enough fluid is taken, sulfa drugs can crystallize urine
Intermediate
Insulin isophane suspension (NPH) (cloudy)
Long acting insulin
Lantus (glargine), Levemir (detimir) (Clear) once daily dose, usually at night
Which complication is assessed through frequent laboratory testing of carbamazepine (tegretol)?
Myelosuppression
The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication?
Potassium levels---amphotericin B changes cellular permeability. This will allow potassium to leave the cell. Watch for hypokalemia.
Chloramphenicol (Chloromycetin)
Risk for irreversible, fatal bone marrow depression The nurse should monitor the client's platelet count
Are steroids best taken on an empty or full stomach?
Steroids can cause gastric irritation, so it is best to take it with food
How should the nurse explain how a sulfonyura drug works for a newly diagnosed type 2 DM patient?
Stimulate pancreatic cells to produce insulin
During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride (Sumycin) for urethritis. Which medication taken concurrently with Sumycin could interfere with its absorption?
Sucralfate (Carafate) (A) is used to treat duodenal ulcers and will bind with tetracycline hydrochloride (Sumycin), inhibiting this antibiotic's absorption.
What drug is used for conscious sedation?
Midalozam (versed)
A nurse is preparing to administer insulin to a client with diabetes. In which order should the nurse perform the actions associated with insulin administration? 2. Rotate the vial of insulin between the palms of the hands. 4 Instill air into the vial of insulin equal to the desired dose. 3. Wipe the top of the insulin vial with an alcohol swab. 5. Withdraw the correct amount of insulin from the inverted vial. 1. Wash hands with soap and water
1,2,3,4,5
A nurse is caring for a female client who is receiving rifampin for tuberculosis. Which statements indicate that the client understands the teaching about rifampin? Select all that apply 1 "This drug may be hard on my liver so I must avoid alcoholic drinks while taking it." 2 "This drug may reduce the effectiveness of the oral contraceptive I am taking." 3 "I cannot take an antacid within 2 hours before taking my medicine." 4 "My healthcare provider must be called immediately if my eyes and skin become yellow.
1,2,4
A healthcare provider prescribes a medication to be administered via a metered-dose inhaler (MDI) for a young adult with asthma. List in order the steps the nurse teaches the client to follow when using the inhaler. 1. Shake the inhaler for 30 seconds. 2. Hold the inhaler upright in the mouth. 3. Exhale slowly and deeply to empty the air from the lungs. 4. Start breathing in and press down on the inhaler once
1,3,2,4
A nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply 1 Irritability 2 Glycosuria 3 Dry, hot skin 4 Heart palpitations 5 Fruity odor of breath
1,4
A nurse plans an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin. What is the purpose of this snack? 1 Encouragement to stay on the diet 2 Food to counteract late insulin activity 3 Added calories to promote weight gain 4 High carbohydrates to provide nourishment for immediate use
2
A senior nurse teaches a nursing student about how to treat poisoning in young children. Which statement by the nursing student indicates the need for further teaching? 1 "An emergency team should be called if the victim stops breathing." 2 "Syrup of ipecac should be administered immediately after poisoning." 3 "The National Poison Control hotline should be called if a poison is ingested." 4 "The child should be removed from the hazardous environment if the poison has been inhaled."
2
A client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important? 1 "Report any changes in vision." 2 "Take the medicine with my meals." 3 "Call my doctor if my urine or tears turn red-orange." 4 "Continue taking the medicine even after I feel better.
4
A client is diagnosed with type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. For what side effect should the nurse teach this client to monitor? 1 Ketonuria 2 Weight loss 3 Ketoacidosis 4 Low blood sugar
4
A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? 1 "I will take the drug with food." 2 "I must swallow my medication whole and not crush or chew it." 3 "I will notify my doctor if I develop muscular or abdominal discomfort." 4 "I will stop taking metformin for 24 hours before and after having a test involving dye."
4
A healthcare provider prescribes ophthalmic drops for a client. What should a nurse include in the instructions for a client learning to self-administer eyedrops? 1 Lie on the unaffected side for administration. 2 Instill drops onto the pupil to promote absorption. 3 Close eyes tightly after administering the eyedrops. 4 Apply pressure to the nasolacrimal duct after instillation
4
Ampicillin 250 mg by mouth every 6 hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin? 1 "I should drink a glass of milk with each pill." 2 "I should drink at least six glasses of water every day." 3 "The medicine should be taken with meals and at bedtime." 4 "The medicine should be taken one hour before or two hours after meals
4
Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? 1 Increases gastric motility 2 Neutralizes gastric acidity 3 Facilitates histamine release 4 Inhibits gastric acid secretion
4
During infusion of Mechlorethamine HCl (nitrogen mustard) and actinomycin (Actinomycin D), what should the nurse do first?
Assess for extravasation--they are vesicants Watch for blisters and tissue sloughing
A nurse identifies that an older adult has not achieved the desired outcome from a prescribed proprietary medication. When assessing the situation, the client shares that the medication is too expensive and that the prescription was never filled. What is an appropriate nursing response? 1 Ask the pharmacist to provide a generic form of the medication. 2 Encourage the client to acquire the medication over the Internet. 3 Inform the healthcare provider of the inability to afford the medication. 4 Suggest that the client purchase medical insurance that covers prescription medications
3
A nurse is administering a histamine H2 antagonist to a client who has extensive burns. The nurse explains to the client that this drug is given prophylactically during the first few weeks after extensive burns. What complication of burns will it prevent? 1 Colitis 2 Gastritis 3 Stress ulcer 4 Metabolic acidosis
3
During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. What is the priority nursing intervention? 1 Restart the client's infusion at another site. 2 Slow the rate of the client's infusion of the TPN. 3 Interrupt the client's infusion and notify the healthcare provider. 4 Obtain the vital signs and continue monitoring the client's status
3
Naltrexone is used to treat clients with substance abuse problems. In which situation does the nurse anticipate that naltrexone will be administered? 1 To treat opioid overdose 2 To block the systemic effects of cocaine 3 To decrease the recovering alcoholic's desire to drink alcohol 4 To prevent severe withdrawal symptoms from antianxiety agents
3
Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client identifies which times for the medication schedule? 1 At bedtime with a snack 2 Three times a day with meals 3 In the early morning with food 4 One hour before or two hours after eating
3
A client with tuberculosis is to begin combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, "I've never had to take so much medication for an infection before." How will the nurse respond? 1 "This type of organism is difficult to destroy." 2 "Streptomycin prevents side effects of the other drugs." 3 "You'll only need to take the medications for a couple of weeks." 4 "Aggressive therapy is needed because the infection is well advanced."
1 Multiple drugs are administered because of the concern regarding drug resistance. Streptomycin sulfate is an antibiotic; it does not prevent the side effects of Rifater therapy. Multiple antitubercular drugs are necessary for an extended period, approximately six to eight months depending on the individual. Aggressive therapy may increase anxiety and may not be needed even when the infection is well advanced.
A mother complains that her child's teeth have become yellow in color. With prolonged use, which medication may be responsible for the child's condition? 1 Tetracycline 2 Promethazine 3 Chloramphenicol 4 Fluoroquinolones
1 Tetracycline is used to treat many different bacterial infections of the skin, intestines, respiratory tract, urinary tract, genitals, lymph nodes, and other body systems.
A client with gastroesophageal reflux disease (GERD) receives a prescription for an H2 receptor antagonist. Which medications are within the classification of an H2 receptor antagonist? Select all that apply 1 Nizatidine 2 Ranitidine 3 Famotidine 4 Lansoprazole 5 Metoclopramide
1,2,3
After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with a gastric ulcer. The client receives a prescription for ranitidine 150 mg twice a day. What concern prompts the nurse to contact the health care provider about the prescription? 1 Ranitidine can increase bleeding risk. 2 An administration route is not specified. 3 Ranitidine is contraindicated for gastric ulcers. 4 The recommended dose is higher than prescribed
2
Daily regular insulin has been prescribed for a client with type 1 diabetes. The nurse administers the insulin at 8 am. When should the nurse monitor the client for a potential hypoglycemic reaction? 1 At breakfast 2 Before lunch 3 Before dinner 4 In the early afternoon
2
During a teaching session about insulin injections, a client asks the nurse, "Why can't I take the insulin in pills instead of taking shots?" What is the nurse's best response? 1 "Insulin cannot be manufactured in pill form." 2 "Insulin is destroyed by gastric juices, rendering it ineffective." 3 "Your health care provider decides the route of administration." 4 "Your health care provider will prescribe pills when you are ready."
2
The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling? 1 At bedtime 2 With meals 3 One hour before meals 4 On arising each morning
2
Which nursing action is the priority when administering chelation therapy for a toddler-age client? 1 Assessing vital signs 2 Monitoring urine output 3 Conducting a behavioral assessment 4 Providing education to reduce lead exposure
2
A nurse administers beclomethasone by inhalation to a client with asthma, and the client asks why this medication is necessary. What should the nurse explain is the purpose of this pharmacologic therapy? 1 Promotes comfort 2 Decreases inflammation 3 Stimulates smooth muscle relaxation 4 Reduces bacteria in the respiratory tract
2 Inhaled beclomethasone is used to prevent asthma attacks. It is not used to relieve an asthma attack that has already started.
What are the desired outcomes that the nurse expects when administering a nonsteroidal antiinflammatory drug (NSAID)? Select all that apply 1 Diuresis 2 Pain relief 3 Antipyresis 4 Bronchodilation 5 Anticoagulation 6 Reduced inflammation
2,3,6
A client newly diagnosed with diabetes arrives at the emergency department complaining of dizziness and weakness. The client's spouse reports that the client has been confused since this morning. The spouse reports that the client administered the morning dose of 10 units of regular insulin and 25 units of NPH insulin with difficulty and did not eat much breakfast. What does the nurse identify as the most likely cause of the client's signs and symptoms? 1 Hyperglycemia 2 Hyperlipidemia 3 Hypoglycemia 4 Hypocalcemia
3
A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? 1 Is the easiest method for administering needed nutrition 2 Is the safest method for meeting the client's nutritional requirements 3 Will satisfy the client's hunger without the discomfort associated with eating 4 Will meet the client's nutritional needs without causing the discomfort precipitated by eating
4
A health care provider prescribes bisacodyl for a client with cardiac disease. The nurse explains to the client that this drug acts by what mechanism? 1 Producing bulk 2 Softening feces 3 Lubricating feces 4 Stimulating peristalsis
4
The nurse is preparing to administer an intravenous piggyback antibiotic that has been newly prescribed. Shortly after initiation, the client becomes restless and flushed and begins to wheeze. The nurse determines the that appropriate priority action will be to stop the antibiotic infusion and then do what? 1 Notify the physician immediately about the client's condition. 2 Take the client's blood pressure. 3 Obtain the client's pulse oximetry. 4 Assess the client's respiratory status
4
The nurse provides discharge teaching to a client with tuberculosis. Which treatment measure does the nurse reinforce as the highest priority? 1 Getting sufficient rest 2 Getting plenty of fresh air 3 Changing the current lifestyle 4 Consistently taking prescribed medication
4
The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs?
Develops a sore throat--Blood dyscrasias (aplastic anemia, leukopenia, anemia, and thrombocytopenia) can be an adverse effect of carbamazepine (Tegretol). Flulike symptoms, such as pallor, fatigue, sore throat, and fever, are indications of such dyscrasias.
