PN Pharmacology Practice Predictor B 2017

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

"I will look up when putting the med into my eyes" -The nurse should instruct the client to look up during admin of the eye drops to help protect the cornea and minimize blinking.

A nurse is reinforcing teaching w/ a client who is to start therapy with a nitroglycerin transdermal patch. Which of the following statements by the client indicates an understanding of the teaching?

"While using the patch, I will be careful when rising from a chair" -Nitroglycerin can cause orthostatic hypotension, which can result in dizziness. The client should change position slowly to avoid injury.

A nurse is preparing to admin phenobarbital 3mg/kg PO twice a day to a school-age child who weighs 44 lb. Available is phernobarbitial elix 20 mg/5ml. How many mL should the nurse plan to admin per dose? Round the answer nearest whole number.

15 mL

A nurse is preparing to admin cefazolin 1 g in 100 mL 0.9% sodium chloride to infuse 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 to the nearest

50 gtt/min

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 med and immediately notify the provider of the clients abdominal pain. Manifestations of the pancreatitis include severe, persistent abdominal pain with possible emesis.

A nurse is caring for a client who has genital herpes. Which of the following meds should the nurse nurse expect to admin?

Acyclovir. -The client should receive acyclovir, an antiviral med, to treat genital herpes by reducing symptoms and the rate of viral shedding.

A nurse is caring for a client who is having an acute asthma attack. Which of the following meds should the nurse admin 1st?

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

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

Apical pulse 52/min Hold if HR below 60 Reg HR is 60-100 Beats x Min

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

Ask the client to rate her pain level. -According to evidence-based practice, the nurse should 1st ask the client to rate her pain level to provide a verbal report of pain.

A nurse is reviewing a clients med history before admin hydromorphone for postoperative pain. The nurse should notify the provider of which of the following findings before admin this med?

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

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 disorders in the client's medical record should the nurse report to the provider?

Bening prostatic hyperplasia - Clients who have a benign prostatic hyperplasia might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the med.

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 med ?

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 has bacterial pneumonia and is taking ceftriaxone. Which of the following findings indicates a therapeutic effect of the med?

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 med.

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

Diarrhea - The nurse should monitor the client for diarrhea. A c.diff infectionis an adverse effect of antibiotics, including amoxicillin.

A nurse is performing the third check before admin hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse he does not want to take the med now. Which of the following actions should the nurse take?

Dispose of the med with a sec nurse as a witness.

A nurse erroneously admin zolpidem to the wrong client. Which of the following actions should the nurse take when documenting the med error?

Document the notification of the client's provider.

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

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

A nurse is reinforcing with a client who is receiving enapril 20 mg PO daily. The nurse should instruct the client to monitor for which of the following adverse effects of this meds?

Dry cough - The nurse should identify that a persistent dry cough or nonproductive cough is an adverse effect of enalapril.

A nurse is reviewing the med admin record for a client who has a new prescription for tobramycin to treat a pulmonary infection. Which of the following med should the nurse identify as increasing 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 risk for hearing loss is increased if receiving both of these med at the same time.

A nurse is reviewing the medical admin record of a client who has history of Steven's-Johnson syndrome when taking sulfamethoxazole-trimethprim. Which of the following meds 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 meds are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.

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

Headache. - The nurse should expect the client to have headache as a common adverse effect of taking sublingual nitroglycerin bcus is causes vasodilation.

A nurse is assisting with the admin of a client who reports muscle aches and pains associated with construction work. The provider suggests taking acetaminophen. The nurse should notify the provider about which of the following info obtained from the client?

History of Hep B -Acetaminophen can cause hepatotoxicity. Clients who have a history of liver damage are at risk for further liver damage and can require a lower dose.

A nurse is assisting with the care of client who is in preterm labor and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings indicates magnesium toxicity?

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

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

Hypotension.

A nurse in a community health clinic is preparing to admin the varicella vaccine to a young adult female client who has not yet 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.

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

I will rinse my mouth after i used the inhaler -The client should rinse his mouth after using inhaled glucocorticoids to avoid the development of oral thrush.Therefore, the nurse should identify this statement as an indication as an understanding of the teaching.

A nurse is caring for a client who has a 10 yr 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 precaution.

A nurse is caring for a client who has schizophrenia 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.

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following info 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 drug excretion.

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

Increased Hgb

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 admin of med -the nurse should instruct the patient to massage her nose gently to increase absorption of the med.

A nurse in a provider's office is reviewing the immunization record of a 12 MO infant who is immunocompromised. Which of the following vaccine 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 12 mo and 15 mo, 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 reinforcing discharge teaching with a client who has type 2 diabetes mellitus and a new prescription for metformin. The nurse should instruct the client to monitor for which of the manifestations as an adverse effects if this med? SATA

Muscle pain, Fatigue, and weight gain

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

Oliguria

A nurse is reinforcing teaching with a client who is newly diagnosed w/ 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 the med?

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

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?

Resp depression

A nurse is monitoring a client who has just returned to the unit following a surgery. The client receives an initial dose of morphine 5 mg IV bolus for pain relief. Which of the following adverse effects should the nurse report immediately to the provider?

Resp rate @ 11/min when using ABC approach to a client care, the priority finding is a resp of 11/min which indicates resp depression.

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

Slurred speech -The nurse should recognize that slurred speech is an indication of toxicity and should be reported to the provider.

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

Sore throat -The nuse should monitor for sorethroat and fever bcs these are early indications of agranulocytosis, which is an adverse effect of propylthiouracil.

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

Take a slow deep breath lasting 3-5 sec after releasing the med. - The client should take a slow, deep breath lasting 3-5 sec to allow the med to be distributed deeply into her lungs.

A nurse is collecting data from a client who recently began taking niacin to treat hyperlipidemia. The client report experiencing facial flushing after taking the med. The nurse should expect the provider to make which of the following recommendations?

Take aspirin 30 min before taking the med -The nurse should expect a recommendation of aspirin 30 min prior to each dose to minimize facial flushing. The nurse should inform the client that this manifestation is often transient and diminishes over time.

A nurse is reinforcing teaching about immunizations with a client who is pregnant. Which of the following vaccines should the nurse include in the teaching as safe to admin during preg?

Tetanus and diphtheria (Td) -The nurse should include that either the Td vaccine or the tetanus, diphtheria, and pertussis (tdap) vaccine is safe for admin during preg. Tdap is the preferred vaccine.

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

The client is able to was his face. -Levodopa works by activating dopamine receptors, restoring nerve transmission for client who have Parks 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 reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self-admin 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.

An older adult client who has terminal cancer reports pain at the level of 5 using a 0 to 10 pain scale. The client has a prescription for morphine 15 mg orally every 4 hr. The client's children express concern that the client is receiving too much of the med. Which of the following responses should the nurse make?

The dose should remain constant to prevent breakthrough pain.

A nurse is collecting data from a client who has been taking digoxin for 1 mo. 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 medi-surg unti is preparing to admin med to a client. Which of the following questions should the nurse ask the client to verify the client's identity?

What is your name and your dob?

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 food choice?

Yogurt. - Clients taking phenelzine should avoid consuming tyramine, which can high BP. Yogurt contains little or no tyramine. Therefore, it is an appropriate food choice to include in the teaching.

A nurse is reinforcing teaching about nicotine polacrilex gum with a client who smokes three packs of cigarettes per day. Which of the following statements should the nurse include in the teaching?

You should chew the gum for a full 30 min before discarding

A nurse is collecting for a client who is receiving methylprednisolone. Which of the following lab values should the nurse plan to monitor?

wbc- increase the client's risk for infection serum potassium- cause hypokalemia, as well as fluid and sodium retention. blood glucose- increase blood sugar