Pharmacology Practice A

A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hrs. instead of over 8 hrs. as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?

0.9% sodium chloride 1 liter infused over 4 hr. Vital signs stable, provider notified

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages?

2 months

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report?

0830

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client client who has hyperkalemia. Which of the following action should the nurse plan to take?

Monitor client for constipation

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include int he teaching plan? (select all that apply)

-Report muscle pain to the provider -Avoid taking the medication with grapefruit juice -Expect therapy with this medication to be lifelong

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescriptions for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?

" I have tendonitis, so I haven't been able to exercise"

A nurse is teaching a client about warfarin. The client asks if she can take aspirin while taking the warfarin. Which of the following responses should the nurse make?

"Aspirin will increase risk of bleeding"

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?

"I should tell my provider if I develop a sore throat."

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understating of the teaching?

"I will take the patch off right after my evening meal"

A nurse is preparing to administer Ciprofloxacin 15mg/kg PO every 12 hr to a child who weighs 44lbs. How many mg should the nurse administer per dose?

300 mg

A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching?

A transition in care requires the nurse to conduct medication reconciliation.

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medication?

Acetylcysteine

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take?

Administer the medication outside the 5cm (2in) radius of the umbilicus

A nurse in the emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?

Atropine

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?

Bibasilar Crackles

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?

Blood in urine

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives?

Carbamazepine

A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the actions should the nurse take first?

Check the clients blood glucose

A nurse is caring for a client who has cancer and is taking morphine and docusate sodium. The nurse should instruct the client that taking the dosusate sodium daily can minimize which of the following adverse effects of morphine?

Constipation

A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?

Decreased respiration might occur

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. which of the following interventions should the nurse include in the plan of care?

Determine apical pulse prior to administration

A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medication can interact with calcium gluconate?

Digoxin

A nurse is preparing to administer medication to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following action should the nurse take?

Document the refusal and inform the client's provider.

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

Dry mouth Blurred vision Dry eyes

A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately?

Dyspnea

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications?

Ibuprofen

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves disease. Which of the following findings should the nurse identify as as an indication of the medication has been effective?

Increase in ability to focus

A nurse is caring for a client who is receiving filgrastim. Which of the following finds should the nurse document to indicate the effectiveness of the therapy?

Increased neutrophil count

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. which of the following finding should the nurse identify as an adverse effect of the medication?

Insomnia

A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?

Morphine 5mg SQ every 4 hr PRN severe pain

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?

Naloxone

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. the nurse should include that the spacer deceases the risk for which of the following adverse effect of the medication?

Oral candidiasis

A nurse is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings?

Platelets 96000/mm3

A nurse is reviewing the lab results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider?

Potassium level 2.8 mEq/L

A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following as an indication of hypokalemia?

Presence of U-waves

A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following to the provider as a manifestation of neuroleptic malignant syndrome (NMS)?

Temperature of 39.7 (103.5)

A nurse is assessing a client 1 hours after administering morphine for pain. The nurse should identify which of the following findings as best indication that them morphine has been effective?

The client rates pain as 3 on a scale of 0/10

A nurse is assessing a client who is postoperative following an outpatient endoscopy using midazolam. A nurse should monitor for which of the following findings as an indication that the client is ready for discharge ?

The client's capnography has returned to baseline.

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication?

Tinnitus

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first?

Turn the client to a side lying position

A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?

obtain the clients blood pressure

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report?

tingling of fingers

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective?

"I will taper off the medication before discontinuing."

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?

"Report yellowing of the skin"

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?

"Rinse your mouth after inhaling the beclomethasone"

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in her instructions?

"Take one tablet at onset of migraine."

A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first?

Epinephrine

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering?

Flumazenil

A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching?

Forms a protective barrier

A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The clients BP is 144/86, heart Rate is 55 and RR is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings

Heart Rate

A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching?

Hot flashes

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching?

I should sit up for 30 minutes after taking the risedronate.

A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgarism. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?

Pregnancy Test

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide?

Prevent delirium tremens

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry flavored lozenges on a stick. Which of the following information should the nurse include in the teaching?

Store unused medication sticks in a storage container.

A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

100 gtt/min 400ml/60 min *15gtt/1ml = 100gtt/min

A nurse is assessing a client who has myasthenia graves and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect?

Miosis

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (SATA)

-Blood glucose levels will be monitored during therapy -Avoid contact with people who have known infections -Grapefruit juice can increase the effects of the medication

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor?

Sedation

A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?

Sexual Dysfunction