pharmacology online practice 2017 B

A nurse is reinforcing discharge teaching with a client who has a prescription for a metered—dose inhaler (MDI). Which of the following information should the nurse include in the teaching?

"Take a s'ow, deep breath lasting 3 to 5 seconds after releasing the medication." The client should take a slow, deep breath lasting 3 to 5 seconds to allow the medication to be distributed deeply into the lungs.

a client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has e prescription for morphine I5 mg orally every 4 hr. The clients adult children express concern that the client is receiving too much of the

'The dose should remain constant to prevent breakthrough pain." Fixed or scheduled dosing around the clock offers the best pain control for clients who have severe and persistent pain.

A nurse is caring for a client who is receiving methylprednisolonet which of the following laboratory values should the nurse plan to monitor? (select all that apply.)

1. white blood cell count 2. serum potassium is correct 3. blood glucose Methylprednisolone can cause increased blood glucose levels.

A nurse is preparing to administer phenobarbital 3 mg/kg P0 twice a day to a school-age child who weighs 44 lb, Available is phenobarbital elixir 20 mg/5 mL, How many mL should the nurse plan to administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

15

A nurse is preparing to administer cefazolin 1 g in 100 mL 0.9% sodium chloride to infuse over 30 min. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

50 The nurse should set the manual IV infusion to deliver cefazolin 1 g in 0.9% sodium chloride 100 mL at 50 gtt/min.

A nurse is preparing to perform tuberculosis skin testing on a client. Which of the following actions should the nurse plan to take?

Administer the injection into the inner forearm The nurse should perform tuberculosis skin testing by administering an intradermal injection of the tuberculin purified protein derivative. The injection should be administered three to four finger-widths below the antecubital space on the client's inner forearm.

A nurse is preparing to administer medications to a group of clients. The nurse should obtain the weight of which of the following clients to verify the correct dose?

An infant who has a fever and a prescription for acetaminophen PO The nurse should check the infant's weight and convert it to kg to correctly calculate the dosage of acetaminophen. The nurse should be aware that the dosages of many pediatric medications are calculated based on the infant or child's weight in kg. Other clients who often require weight-based dosages are those who are critically ill or receiving chemotherapy.

A nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. which of the following conditions in the client's medical record should the nurse report to the provider?

Benign prostatic hyperplasia

A nurse is reviewing a client's medical history before administering hydromorphone for postoperative pain' The nurse should notify the provider of which of the following findings before administering this medication

Benign prostatic hyperplasia A client who has benign prostatic hyperplasia is at increased risk for developing acute urinary retention while taking opioids. Therefore, the nurse should notify the provider about this finding before administering hydromorphone.

A nurse is caring for a client who has an epidural infusion for pain management. Which of the following actions should the nurse take?

Cheick for bladder distention It is important to check for bladder and bowel distention. Bladder and bowel distention are potential complications of an epidural catheter infusion.

A nurse is caring for a client who is prescribed an intermittent IV bolus of an antibiotic medication every 8 hr. The client is currently receiving a continuous IV infusion of 0.9% sodium chloride. Which of the following actions should the Nurse take?

Cleanse the primary tubing port with antiseptic before connecting the antibiotic medication. The nurse should cleanse the port of the primary fluid tubing with an antiseptic and allow it to air dry before connecting the antibiotic medication tubing. The use of the antiseptic decreases the risk for infection from contamination of the IV tubing and fluid.

A nurse is caring for a client who is newly admitted for infection of a surgical site. Which of the following actions should the nurse take prior to administering the first dose of vancomycin?

Collect a sterile wound specimen Prior to the start of an antibiotic, it is important to collect all cultures. The culture results will help determine if vancomycin is the correct antibiotic to eliminate the infection.

A nurse is constituting to the plan of care for a client who is receiving opioid analgesia for postoperative pain management. The nurse should identify that which of the following is a potential adverse effect?

Constipation the nurse should identify that a common adverse effect of opioids is constipation. The nurse should recommend adding preventive measures, measures, such as an ample intake of fluid and, once the clients diet allows, fiber and stool softeners.

A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse they do not want to take the medication now. Which of the following actions should the nurse take?

Dispose of the medication with a second nurse as a witness. The nurse is legally required to have a witness when disposing of a controlled substance.

A nurse is caring for a client who has a new prescription for alprazolam. The nurse should n=monitor the client for which of the following manifestations as an adverse effect of this medication?

Drowsiness The nurse should monitor the client for drowsiness, which is an adverse effect of alprazolam. Alprazolam is a benzodiazepine used in the treatment of anxiety. Other adverse effects include dizziness and depression.

A nurse is reinforcing teaching with a client who is receiving enalapril 20 mg P0 daily, The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Dry cough The nurse should identify that a persistent dry or nonproductive cough is an adverse effect of enalapril. The underlying cause of the dry cough is the accumulation of bradykinin from the medication. The client should notify the provider of this adverse effect.

A nurse is caring for a 6-year old child who received ketorolac IV for pain. Which of the following pain scales should the nurse use to document the effectiveness of the medication?

Face The nurse should use the FACES scale to determine the child's pain level. Children as young as 3 years old can use this scale to report their pain. The nurse should ask the child to point to the face that indicates how they feel. The FLACC scale is for infants and children up to 3 years old. This scale is a behavioral measure of pain and not a self-report scale.

A nurse is reviewing the medication administration record of a client who has a history of STevens-Johnson syndrome when taking sulfamethoxazole-trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client?

Furosemide A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.

A nurse is caring for a client who has multiple chronic disorders. The nurse shold administer magnesium hydroxide PRN in response to which of the following client statements?

I've been having a lot of heartburn since dinner The nurse should identify heartburn as a manifestation of GERD. Magnesium hydroxide is an antacid prescribed for the management of GERD.

A nurse in a provider's office is reviewing the immunization records of a 12-month-old infant who is immunocampramised. which of the following vaccines should the nurse identify as contraindicated for this client?

Measles, mumps, and rubella (MMR) Although most infants should receive the MMR vaccine between the ages of 12 months and 15 months, the nurse should identify that the MMR vaccine is composed of live viruses and is contraindicated for an infant who is immunocompromised.

A nurse is performing an end-of-shift count of controlled substances. Which of the following medications should the nurse include in the count?

Meperidine The nurse should identify that meperidine is a Schedule II controlled substance; therefore, the nurse should ensure that the count is correct at the end of the shift. Meperidine is an opioid agonist prescribed for pain management.

A nurse is collecting data from a client who is postoperative following a total hip arthroplasty. The client received an opioid analgesic 45 min ago. The nurse should identify that which of the following client statements is the best indicator of a decrease in the intensity of the clients pain?

My pain is now a dull ache instead of sharp and stabbing. "My pain is now a five instead of a nine." MY ANSWER Evidence-based practice indicates the nurse should use a pain rating scale, such as a numeric pain intensity scale, to best evaluate for decreased intensity or severity of pain. If the client reported a pain level of nine prior to receiving the pain medication, and reported a pain level of five after the administration, it indicates a decrease in intensity. The nurse should also collect data about the client's quality and location of pain, aggravating or relieving factors, and other manifestations associated with the pain.

A nurse is preparing to administer warfarin to a client has a new diagnosis of atrial fibrillation. Which of the following laboratory values should the nurse check prior to giving the medication?

Prothrombin time Warfarin is an anticoagulant that decreases production of clotting factors VII, IX, and X and prothrombin. Monitoring the prothrombin time is important in dosing warfarin. If the prothrombin time is less than the expected reference range, warfarin may need to be increased.

A nurse is collecting data from a client who is taking penicillin V potassium. Which of the following findings should the nurse report to the provider?

Pruritus The nurse should report pruritus to the provider because itching or a rash is an indication of an allergic or anaphylactic reaction to penicillin V potassium.

A nurse is collecting data from a client who is taking guaifenesin. Which of the following findings should the nurse identify as a manifestation of an allergic reaction to guaifenesin?

Rash A rash can be a manifestation of an allergic reaction to guaifenesin. Other manifestations can include urticaria, hives, a runny nose, or shortness of breath.

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self- administer NPH insulin' Which of the following client actions indicates an understanding of the teaching?

The client wipes the cap with alcohol prior to filling the syringe. The client should wipe the cap with alcohol prior to filling the syringe to reduce the risk for contamination.

A nurse is caring for a client who has cystic fibrosis (CF) and is receiving pancreatic enzymes. The nurse should monitor which of the following to determine the effectiveness of the pancreatic enzymes?

The client's stool output Clients who have CF lack the pancreatic enzymes necessary to digest fats. Undigested fats lead to steatorrhea, or foul-smelling, frothy, fatty stools, and large bulky stools. Pancreatic enzymes are prescribed to minimize steatorrhea and improve the client's nutritional status.

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis? (Select all that apply.)

[] muscle pain []hyperventilation [] Dizziness

A nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately?

abdominal pain The greatest risk to this client is the development of pancreatitis as an adverse effect of exenatide; therefore, the nurse should withhold the medication and immediately notify the provider of the client's abdominal pain. Manifestations of pancreatitis include severe, persistent abdominal pain with possible emesis.

A nurse is caring for a client who has genital herpes. which of the following medications should the nurse expect to administer?

acyclovir The client should receive acyclovir, an antiviral medication, to treat genital herpes by reducing manifestations and the rate of viral shedding.

A nurse is caring for a client who is having an acute asthma attack. Which of the following medications

albuterol According to evidence-based practice, the nurse should administer a short-acting beta2 agonist with a rapid onset when a client is experiencing an acute asthma attack. Therefore, the nurse should administer the albuterol prior to the other medications for prompt relief of airway constriction.

A nurse is monitoring a client who is 2 hr postoperative and has a prescription for opioid analgesics. which of the following actions provides the nurse with the priority data to determine the client's need for analgesia?

ask the client to rate their pain

A nurse is reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

chest tightness The nurse should instruct the client to report chest pain or tightness to the provider because this can be a manifestation of a vasospastic response.

A nurse is collecting data from a client who is taking oral amoxicillin to treat a respiratory infection The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

diarrhea The nurse should monitor the client for diarrhea, which is an adverse effect of antibiotics, such as amoxicillin.

A nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia. which of the following laboratory tests should the nurse plan to obtain prior to administering the first dose?

fasting blood glucose level The development of hyperglycemia can be an adverse effect of risperidone. The nurse should obtain a fasting blood glucose level prior to administration of the first dose and periodically during treatment.

A nurse is reviewing the medication administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxalole-trimethoprim. Which of the following medications should the nurse identify as cantraindicated for this client?

frusomeide

A nurse is reviewing the medication administration record for a client who has a new prescription for tobramycin ta treat a pulmonary infection which. of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin.'

furosemide Tobramycin is an aminoglycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time.

A nurse is monitoring a client when has been receiving long-term hydrochlurothialide therapy for recurring episodes of heart failure. which of the following findings should me nurse identify as an adverse effect of this medication?

hypokalemia Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia due to excessive potassium excretion in the urine.

A nurse is evaluating a client who is receiving amphotericin 8 Via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication?

hypotension The nurse should identify that amphotericin B is considered a high-alert medication due to potentially serious adverse effects, such as hypotension. Therefore, the nurse should report this or other adverse effects of amphotericin, such as nephrotoxicity, hypokalemia, and cardiac dysrhythmias.

A nurse is reinforcing teaching with a client who has a prescription for scopolarnine transderrnal patches to prevent motion sickness. which of the following statements by the client indicates an understanding of the teaching?

i should place the patch behind my ear The nurse should reinforce with the client to place the scopolamine patch on a hairless area of skin behind the ear.

A nurse is reinforcing teaching with a client who has a new prescription for tirnoiai eye drops to treat glaucoma. which of the following client statements indicates an understanding of the teaching?

i will look up when putting the medication into my eyes

A nurse is reinforcing teaching with a client who has a new prescription for a flulicasone inhaler. which of the following client statements indicates an understanding of the teaching?

i will rinse my mouth after i use this inhaler

A nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority?

implement seizure precautions. The greatest risk to the client is injury from seizures and falls. Grand mal seizures can occur during severe alcohol withdrawal. Therefore, the nurse's priority is to implement seizure precautions to reduce the risk of injury if the client experiences a seizure.

A nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective?

improved social interactions Clients who have schizophrenia typically have difficulty interacting with others and maintaining relationships. Manifestations can include dull affect and speech deficiency. Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.

A nurse is reinforcing teaching with a client who recently began taking furosemides Which oi the following instructions should the nurse include in the teaching?

increase dietary potassium while taking the medication The nurse should reinforce with the client to increase dietary intake of potassium because furosemide causes potassium to be excreted in the urine. Increasing dietary potassium will help prevent hypokalemia.

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. which of the following information should the nurse include in the teaching?

increase fluid intake Clients who are taking methotrexate should increase fluid intake to reduce the risk for renal damage and to increase medication excretion.

A nurse is caring for a client who has kidney failure and has been taking epoetin. Which of the following is a therapeutic effect of this medication?

increased HGB Epoetin is used to elevate the erythrocyte count for clients who have kidney failure. An increased Hgb is the desired therapeutic effect of this medication.

A nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching?

massage your nose gently after medication administration The nurse should instruct the client to massage their nose gently to increase absorption of the medication.

A nurse is collecting data from a client who is taking tobramycin, which of the following findings should the nurse report to me provider immediately?

oliguria

A nurse is reinforcing teaching with a client who is newly diagnosed with hypertension and is taking metoprolol. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

peripheral edema The nurse should instruct the client to monitor for and report the development of peripheral edema because this can be an indication of heart failure, which is an adverse effect of metoprolol.

A nurse is collecting data from a client who received morphine IV for pain relief. Which of the following findings is the nurse's priority to report to the provider?

respiration rate 11/min When using the airway, breathing, and circulation approach to client care, the priority finding is a respiratory rate of 11/min, which indicates respiratory depression.

A nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. which of the following adverse reactions is the priority finding to report to the provider?

respiratory depression When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is respiratory depression, which can indicate the client is experiencing acetaldehyde syndrome, a life-threatening event.

A nurse is collecting data from a client who is taking lithium to treat bipolar disorder. which of the following findings should me nurse report to the provider?

slurred speech The nurse should recognize that slurred speech is a manifestation of lithium toxicity and should be reported to the provider.

A nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication?

sore throat The nurse should monitor for sore throat and fever because these are early indications of agranulocytosis, which is an adverse effect of propylthiouracil.

A nurse is collecting data from a client who has been taking levodopa/carlaidopa. which of the following findings should indicate to the nurse that the medication is effective?

the client is able to wash their face Levodopa works by activating dopamine receptors, restoring nerve transmission for clients who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the intestine and periphery. These therapeutic effects assist the client with moving freely and resuming ADLs.

A nurse is collecting data from a client who has been taking digoxin for I month The nurse should identify which of the following findings as a manifestation of digoxin toxicity?

vomiting The nurse should identify vomiting as an early manifestation of digoxin toxicity.

A nurse on a medical-surgical unit is preparing to administer medications to a client which of the following questions should the nurse ask the client to verify the client's identity?

what is your phone number Acceptable client identifiers include the client's name, telephone number, facility identification number, date of birth, and other client-specific identifiers. The nurse must use at least two identifiers to verify the client's identity and should compare the information to what is on the client's wristband or in the medical record.

A nurse is reinforcing teaching with a client who is to start therapy with a nitroglycerin transderrnal patch. which o fthe following statements by the client indicates an understanding of the teaching?

while using this patch i will be carefull when rising from a chair MY ANSWER Nitroglycerin can cause orthostatic hypotension, which can result in dizziness. The client should change positions slowly to reduce the risk for injury.

A nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine, which of the following foods should the nurse include in the teaching as an appropriate land choice?

yogurt Clients taking phenelzine should avoid consuming tyramine, which can cause high blood pressure. Yogurt contains little or no tyramine. Therefore, the nurse should instruct the client that yogurt is an appropriate food choice.

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus and a new prescription for insulin lispro. Which of the following informaton should the nurse include?

Administer this medication immediately before meals Insulin lispro is a rapid-acting insulin and should be administered immediately before eating to assist with reducing the postprandial blood glucose.

A nurse is caring for a client who is to start taking estradiol. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication?

Deep-vein thrombosis The nurse should monitor the client for deep-vein thrombosis (DVT), which is an adverse effect of estradiol. The nurse should notify the provider if manifestations of DVT are present. Manifestations of DVT include aching pain in the affected leg with enlargement of the calf area. The client might also experience malaise and an elevated temperature.

A nurse s reviewing laboratory data from a client who began taking insulin 3 months ago for the management of uncontrolled type 2 diabetes mellitus. The nurse should identify that which of the following findings indicates the medication has been effective?

HbA1c % The nurse should identify that an HbA1c level that is less than 7% indicates effective blood glucose control over the past 100 to 120 days. Therefore, this finding indicates that the insulin therapy has been effective.

A nurse is collecting data from a client who received terbutaline 30 min ago. Which of the following findings should the nurse identify as an adverse effect of terbutaline?

Heart rate 106/min The nurse should identify that tachycardia is an expected adverse effect of terbutaline. A heart rate of 106/min is greater than the expected reference range of 60 to 100/min. Other adverse effects include tremors, nervousness, and insomnia.

A nurse is reinforcing teaching with a client who is taking verapamil. Which of the following client statements indicates an understanding about the management of the adverse effects of this medication?

I should include more high-fiber foods in my diet The nurse should identify that this statement indicates understanding of the management of constipation, which can be an adverse effect of verapamil.

A nurse is reinforcing teaching about the storage of insulin with a client who has diabetes mellitus. The nurse should identify that which of the following clients statements indicates and understanding of the teaching?

I should keep unopen insulin vials in the refrigerator The nurse should identify that this client statement indicates understanding of the storage of insulin. The client should store unopened insulin vials in the refrigerator.

A nurse is preparing to mix NPH and regular insulin into a single syringe for administration to a client who has diabetes mellitus. Which of the following actions should the nurse take first when mixing the insulins?

Inject air into the vial of NPH insulin Using evidence-based practice, the first action the nurse should take when mixing NPH and regular insulin is to inject air into the vial of NPH insulin. The nurse should then inject air into the vial of regular insulin and withdraw the prescribed dose of regular insulin into the syringe. Finally, the nurse should withdraw the prescribed dose of NPH insulin into the syringe.

A nurse is preparing to administer a time-critical medication to a client whose last name is smith. After verifying the identity of the client using the clients' armband, which of the following actions should the nurse plan to take?

Request that the client state their date of birth When following the rights of medication administration, the nurse should use two identifiers to verify the client's identity. Checking the client's armband is one identifier. The second identifier can be the client's birth date or another identifier that is unique to the client.

A nurse is reinforcing teaching with a client who has asthma and a new prescription for an albuterol multi-dose inhaler (MDI) 2 puffs every 4 hr. as needed. Which of the following information should the nurse include in the teaching?

Use the spacer each time you use your MDI. The nurse should instruct the client to use a spacer with their MDI. The spacer helps more of the medication to be delivered lower in the airway. Spacers are also helpful for clients who might have difficulty with hand and breath coordination of an MDI. Wait a minimum of 1 min between puffs. The first time it is used with four test sprays into the air. These test sprays should not be inhaled by the client Inhale upon activation of the MDI. This will allow for the medication to be delivered into the airway

A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?

apical pulse of 52 The nurse should check the client's apical pulse prior to administering digoxin because it can cause bradycardia. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.

A nurse is collecting data from a client who has bacterial pneumonia and is taking ceftriaxone' which of the following findings indicates a therapeutic effect of the medication?

clear bilateral breath sounds The nurse should identify that wheezing and crackles are findings of bacterial pneumonia. A decrease in these manifestations indicates a therapeutic effect of the medication.

A nurse erroneously administered zolpidem to the wrong client. Which of the following actions should :he nurse take?

document the notification of the clients provider In the medical record of the client who received the zolpidem, the nurse should document the objective facts of the error, including follow-up actions and notification of the provider.

A nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication?

drowsiness The nurse should identify drowsiness as an adverse effect of baclofen. Other adverse effects include dizziness, weakness, and fatigue.

A nurse is collecting data from a client who has angina and a new prescription for sublingual nitroglycerin. which of the following manifestations should the nurse expect as an adverse effect of this medication?

headache The nurse should expect the client to have headaches as a common adverse effect of taking sublingual nitroglycerin because it causes vasodilation.

A nurse is assisting with collecting data (or a client who is in preterm labor and is receiving magnesium sulfate via continuous iv infusion. which of the following findings should the nurse identify as an indication of magnesium toxicity?

hyporeflexia Magnesium sulfate depresses neuromuscular activity, causing muscle weakness and paralysis. Therefore, the nurse should identify hyporeflexia as an indication of magnesium toxicity and report it to the charge nurse.

A nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chickenpox or its vaccine, The nurse should withhold the vaccine and collect additional data when the client makes which of the following statements?

i am allergic to neomycin A hypersensitivity to neomycin is a contraindication for receiving the varicella vaccine.