PN VATI PHARMACOLOGY
A nurse is reinforcing teaching with a client who has a new prescription for insulin. The client is taking propranolol. The nurse should teach the client to monitor for which of the following findings as a manifestation of hypoglycemia? ➖ Tachycardia ➖ Difficulty breathing ➖ Sleep disturbance ➖ Hunger
ANSWER: HUNGER. Adverse Effects of Propranolol Insomnia and nightmares, and can cause difficulty breathing.
A nurse is collecting data from a client who is taking prednisone for rheumatoid arthritis. Which of the following findings should the nurse identify as adverse effects of this medication? (SATA) ➖ Low blood glucose ➖ Weight gain ➖ Susceptibility to infection ➖ Renal failure ➖ Gastrointestinal ulceration
Answer & Rationale: Weight gain Susceptibility to infection Gastrointestinal ulceration
A nurse is reinforcing teaching with a client whose provider discontinued their prescription for phenelzine. The client has a new prescription for citalopram. The nurse should instruct the client to wait at least how long before beginning the new medication? ➖ 48 hr ➖ 1 week ➖ 2 weeks ➖ 24 hr
Answer: 2 weeks.
A nurse is reinforcing teaching with a client who has a new prescription for fentanyl 100 mcg buccal tablets. Which of the following statements should the nurse include in the teaching? ➖ "Take the medication with sips of water." ➖ "Place the medication between your cheek and gums." ➖ "Mix the medicine with juice before taking it." ➖ "Suck the tablet for 1 minute and then swallow it."
ANSWER: "PLACE THE MEDICATION BETWEEN YOUR CHEEK AND GUMS."
A nurse is reinforcing teaching with a client who has a prescription for levothyroxine. to treat hypothyroidism. Which of the following instructions should the nurse include? ➖ "Take an antacid with levothyroxine to avoid upsetting your stomach." ➖ "Take levothyroxine with food to help promote its absorption." ➖ "Take your iron supplement at least 4 hours from taking levothyroxine." ➖ "Take levothyroxine for 6 months to a year until your thyroid hormone levels stabilize."
ANSWER: "TAKE YOUR IRON SUPPLEMENT AT LEAST 4 HOURS FROM TAKING LEVOTHYROXINE."
A nurse is reinforcing teaching with a client who has a new prescription for zolpidem. Which of the following statements by the client indicates teaching was effective? ➖ "I should expect a sore throat while taking this medication." ➖ "I should take this medication after I eat my evening meal." ➖ "This medication will also help with my anxiety." ➖ "This medication might make me dizzy."
ANSWER: "THIS MEDICATION MIGHT MAKE ME DIZZY."
A nurse is reinforcing teaching with a client who is prescribed an albuterol inhaler, two puffs every 4 hrs. Which of the following statements by the client indicates an understanding of the teaching? ➖ "I will wait 5 seconds in between each puff." ➖ "I will hold my breath for 10 seconds after inhaling the medication." ➖ "I will experience a slowed heart rate after taking this medication." ➖ "I can increase my dosage if my asthma gets worse."
ANSWER: " I WILL HOLD MY BREATH FOR 10 SECONDS AFTER INHALING THE MEDICATION."
A nurse is reinforcing teaching with a client who has chronic stable angina and a prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching? ➖ "Replace your bottle of tablets every 3 months for best effectiveness." ➖ "Place one tablet under the tongue 30 minutes before exercise to prevent angina chest pain." ➖ "Call 911 if chest pain is not relieved within 20 minutes of taking nitroglycerin." ➖ " As soon as chest pain occurs, place one tablet under the tongue."
ANSWER: "AS SOON AS CHEST PAIN OCCURS, PLACE ONE TABLET UNDER THE TONGUE."
A nurse is reinforcing teaching with a client who has a new prescription for spironolactone. Which of the following information should the nurse include in the teaching? ➖ "Avoid salt substitutes containing potassium while taking this medication." ➖ "Take this medication at bedtime." ➖ "Adverse effects o this medication can include elevated blood glucose levels." ➖ "This medication might cause hearing loss."
ANSWER: "AVOID SALT SUBSTITUTES CONTAINING POTASSIUM WHILE TAKING THIS MEDICATION."
A nurse is reinforcing teaching with a client who is prescribed disulfiram to treat alcohol use disorder. Which of the following information should the nurse include in the teaching? ➖ "Cigarettes are contraindicated while taking this medication." ➖ "Monitor your pulse rate daily while taking this medication." ➖ "Avoid using aftershave or cologne while taking this medication." ➖ "Drinking grapefruit juice while taking this medication can cause adverser effects."
ANSWER: "AVOID USING AFTERSHAVE OR COLOGNE WHILE TAKING THIS MEDICATION."
A nurse is reinforcing teaching with a client who is starting phenytoin therapy to help manage a seizure disorder. Which of the following instructions should the nurse include? ➖ "Take the medication on an empty stomach." ➖ "Brush and floss your teeth after each meal." ➖ "Expect tinnitus for the first week or two." ➖ " Take aspirin if you develop headaches."
ANSWER: "BRUSH AND FLOSS YOUR TEETH AFTER EACH MEAL."
A nurse is reinforcing teaching with a client who has been prescribed isoniazid. Which of the following client statements indicates an understanding of the teaching? ➖ "I should expect my urine to turn reddish in color." ➖ "I will have a skin test to determine when I am no longer contagious." ➖ "I should notify my provider if I develop numbness in my feet." ➖ "I should expect to take this medication for 6 weeks."
ANSWER: "I SHOULD NOTIFY MY PROVIDER IF I DEVELOP NUMBNESS IN MY FEET."
A nurse is reinforcing teaching with a newly licensed nurse regarding safe procedures for medication administration. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? ➖ "I will identify the client by verifying the client's name using the room number." ➖ "I can administer antibiotics 1 hour before the scheduled time." ➖ "I will check the label on the client's medication three times before administering it." ➖ "I will leave the client's medication at the client's bedside."
ANSWER: "I WILL CHECK THE LABEL ON THE CLIENT'S MEDICATION THREE TIMES BEFORE ADMINISTERING IT."
A nurse is reinforcing teaching with a client who is taking rifampin. Which of the following statements should the nurse make? ➖ "Many people who take this medication experience a dry mouth." ➖ "Some people who take this medication experience hair loss." ➖ "You might urinate more frequently when taking this medication." ➖ "You might be unable to wear contact lenses when taking this medication"
ANSWER: "YOU MIGHT BE UNABLE TO WEAR CONTACT LENSES WHEN TAKING THIS MEDICATION."
A nurse is administering a varicella immunization to a young adult client who did not receive the immunization as a child. The client asks the nurse if they will need additional doses of the vaccine. Which of the following responses should the nurse make? ➖ "You will require a total of three doses about 6 months apart." ➖ "You should return for a second dose in 4 to 8 weeks." ➖ "You can get a booster dose every 10 years." ➖ "You should get another dose in 2 weeks."
ANSWER: "YOU SHOULD RETURN FOR A SECOND DOSE IN 4 TO 8 WEEKS."
A nurse is reinforcing dietary teaching with a client who is taking furosemide. Which of the following foods should the nurse recommend as the best source of potassium? ➖ 1 cup baked potatoes ➖ 1 cup fresh blueberries ➖ 1 cup fresh watermelon ➖ 1 cup raw chopped cabbage
ANSWER: 1 CUP BAKED POTATOES.
A nurse is preparing to administer ampicillin 100mg/kg/day PO every 6 hrs to a toddler who weighs 22 lb. Available is ampicillin oral suspension 125mg/5mL. How many mL should the nurse administer per dose? ( Round answer to nearest whole number.)
ANSWER: 10 mL/dose.
A nurse is preparing to administer Lactated Ringer's solution 350 mL to infuse over 1 hr. The drop factor of the tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round answer to the nearest whole number.)
ANSWER: 58 gtt/min. Rationale: 350mL divided by 60 minutes times drop factor of 10 = 58.333
A nurse is receiving change-of-shift report about four clients. Which of the following clients should the nurse see first? ➖ A client who has diabetes mellitus, is taking propranolol, and reports difficulty concentrating ➖ A client who has unstable angina, is taking atenolol, and reports a sleep disturbance ➖ A client who has a history of depression and started metoprolol 2 days ago ➖ A client who has a blood pressure of 100/60 mm Hg and is taking carvedilol
ANSWER: A CLIENT WHO HAS DIABETES MELLITUS, IS TAKING PROPRANOLOL, AND REPORTS DIFFICULTY CONCENTRATING.
A nurse is assisting with the care of a client who has oral benzodiazepine toxicity. The client has an IV infusing and is nonresponsive. Which of the following interventions should the nurse anticipate first? ➖ Administering norepinephrine via continuous IV infusion ➖ Administering IV flumazenil ➖ Performing gastric lavage ➖ Preparing the client for mechanical ventilation
ANSWER: ADMINISTERING IV FLUMAZENIL.
A nurse is collecting data from four clients prior to administering morning medications. Which of the following findings indicates the nurse should withhold the prescribed medication? ➖ Respiratory rate of 14/min for a client who is receiving oxycodone ➖ Fasting blood glucose level of 90 mg/dL for a client who is receiving insulin lispro ➖ Blood pressure of 104/68 mmHg for a client who is receiving enalapril ➖ Apical pulse of 48/min for a client who is receiving metoprolol
ANSWER: APICAL PULSE OF 48/MIN FOR A CLIENT WHO IS RECEIVING METOPROLOL.
A nurse is assisting with the care of a client who has a myasthenia gravis and is experiencing a cholinergic crisis. Which of the following medications should the nurse expect the RN to administer? 💊 Bethanechol 💊 Propranolol 💊 Atropine 💊 Epinephrine
ANSWER: ATROPINE.
A nurse is collecting data from a client who is taking metoprolol. Which of the following findings indicates the medication is having the desired therapeutic effect? ➖ Pulse oximetry reading is 95% ➖ Blood pressure is 116/75 mmHg ➖ Casual blood glucose is 118 mg/dL ➖ Urine output is 60 mL/hr and clear amber
ANSWER: BLOOD PRESSURE IS 116/75 mmHg.
A nurse is collecting data from a client who received amiodarone 400 mg PO 2 hrs. ago. The nurse suspects that the client received an extra dose of the medication. For which of the following adverse effects should the nurse monitor? ➖ Anemia ➖ Hypertension ➖ Neutropenia ➖ Bradycardia
ANSWER: BRADYCARDIA.
A nurse is reinforcing discharge teaching with a client who has a new prescription for warfarin. The nurse should instruct the client that which of the following medications is contraindicated with warfarin therapy? ➖ Cimetidine ➖ Guaifenesin ➖ Diphenhydramine ➖ Magnesium hydroxide
ANSWER: CIMETIDINE.
A nurse is caring for a client who has diabetes mellitus. The client received a dose of regular insulin prior to an episode of vomiting and is now unable to eat. For which of the following manifestations should the nurse monitor? ➖ Deep respirations ➖ Polyuria ➖ Increased thirst ➖ Confusion
ANSWER: CONFUSION.
A nurse is caring for a client who is 2 days post-operative and is receiving morphine for acute pain. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? ➖ Urinary frequency ➖ Constipation ➖ Muscle rigidity ➖ Physical dependency
ANSWER: CONSTIPATION.
A nurse is preparing to reinforce teaching with a newly licensed nurse about physiologic changes in older adult clients that can alter pharmacokinetics. Which of the following should the nurse include as an age-related change? ➖ Decreased absorption of oral medications. ➖ Decreased kidney function ➖ Increased gastrointestinal motility ➖ Increased hepatic enzyme function
ANSWER: DECREASED KIDNEY FUNCTION.
A nurse is reinforcing teaching with a client who has a new prescription for tetracycline 500 mg PO twice daily. Which of the following instructions should the nurse include? ➖ Take an antacid when taking this medication. ➖ Avoid grapefruit juice while taking this medication. ➖ Take the second dose of this medication at bedtime. ➖ Drink 240 mL (8 oz.) of water when taking this medication.
ANSWER: DRINK 240 mL (8 oz. ) OF WATER WHEN TAKING THIS MEDICATION.
A nurse is collecting data from a client who is receiving furosemide. Which of the following findings should the nurse identify as an adverse effect of this medication? ➖ Dry mouth ➖ Serum Potassium 4.0 mEq/L ➖ Urine Specific Gravity 1.020 ➖ Painful Urination
ANSWER: DRY MOUTH.
A nurse is reinforcing teaching with a client who has Type 1 Diabetes Mellitus about the use of over-the-counter supplements. The nurse should include in the teaching that which of the following supplements can cause hypoglycemia? ➖ Glucosamine ➖ Green Tea ➖ Ginger Root ➖ Garlic
ANSWER: GINGER ROOT.
A nurse is collecting data from a client who has heart failure and is scheduled to receive a dose of digoxin. For which of the following findings should the nurse withhold the dose and notify the provider? ➖ Heart Rate 50/min ➖ Digoxin level 0.8 ng/mL ➖ Respiratory rate 18/min ➖ Potassium 4.6 mEq/L
ANSWER: HEART RATE 50/MIN.
A nurse is preparing to administer vaccines to a client. The nurse should check for an allergy to eggs prior to administering which of the following vaccines? ➖ Meningococcal conjugate ➖ Hepatitis B ➖ Inactivated Influenza ➖ Human Papillomavirus
ANSWER: INACTIVATED INFLUENZA.
A nurse is monitoring a client who received a titration of naloxone IV 30 min ago. Which of the following findings should the nurse expect? ➖ Decreased Respirations ➖ Increased Urine Output ➖ Decreased level of consciousness ➖ Increased pain
ANSWER: INCREASED PAIN.
A nurse is administering ear drops into an adult client's right ear. Which of the following actions should the nurse take? ➖ Straighten the ear canal by pulling the auricle down and back. ➖ Assist the client into Fowler's position. ➖ Place a cotton ball in the ear canal for 30 min after instilling the drops. ➖ Instill drops holding the dropper 1 cm (0.4 in.) above the ear canal.
ANSWER: INSTILL DROPS HOLDING THE DROPPER 1 cm (0.4 in.) ABOVE THE EAR CANAL.
A nurse is reinforcing teaching with a client who has a prescription for rosuvastatin to treat high cholesterol levels. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider immediately? ➖ Muscle weakness ➖ Headache ➖ Abdominal pain ➖ Insomnia
ANSWER: MUSCLE WEAKNESS.
A nurse is collecting data from a client who is receiving morphine to relieve post-operative pain. The client's respiratory rate is 9/min. The nurse should notify the provider and expect a stat prescription for which of the following medications? 💊 Naloxone 💊 Glucagon 💊Flumazenil 💊 Protamine
ANSWER: NALOXONE.
A nurse is reviewing the medical record of a client who has a new prescription for lisinopril. The nurse should identify that which of the following medications interacts with lisinopril? ➖ Acetaminophen ➖ Calcium Supplements ➖ Potassium Supplements ➖ Omeprazole
ANSWER: POTASSIUM SUPPLEMENTS.
A nurse is reviewing the medical history of a client who requires ophthalmic medication to treat glaucoma. Which of the following factors in the client's history is a contraindication for using beta-adrenergic blocking eye drops to treat this disorder? ➖ Diabetes Mellitus ➖ Peptic Ulcer Disease ➖ Migraine Headaches ➖ Sinus Bradycardia
ANSWER: SINUS BRADYCARDIA.
A nurse is caring for a client who has bipolar disorder and a new prescription for lithium. Which of the following laboratory values should the nurse plan to monitor for potential adverse effects? Prothrombin Time Hematocrit Sodium Potassium
ANSWER: SODIUM.
A nurse is collecting data about herbal supplement use from a client who has a new prescription for fluoxetine. The nurse should identify that which of the following supplements is contraindicated with this medication? ➖ St. John's Wort ➖ Saw Palmetto ➖ Echinacea ➖ Ginkgo biloba
ANSWER: ST. JOHN'S WORT.
A nurse is collecting data from a client who is scheduled to receive an initial dose of tobramycin. Which of the following findings should the nurse report to the provider? ➖ The client reports taking acetaminophen for pain. ➖ The client's potassium level is 4.1 mEq/L. ➖ The client has an allergy to sulfonamides. ➖ The client's creatinine level is 2.2 mg/dL.
ANSWER: THE CLIENT'S CREATININE LEVEL IS 2.2 mg/dL.
A nurse is observing a newly licensed nurse administer medications to a client. Which of the following actions by the newly licensed nurse indicates an understanding of the process? (SATA) A. Reviewing the client's medical record B. Asking the client for an allergy history C. Checking the expiration date of the medication D. Administering time-critical medications within 60 min of the scheduled time E. Using two client identifiers before administering the medication
Answer & Rationale: A. Reviewing the client's medical record B. Asking the client for an allergy history C. Checking the expiration date of the medication E. Using two client identifiers before administering the medication
A nurse is reinforcing teaching with a client who is starting to take amitriptyline. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication at bedtime." B. "I might need to decrease my fluid intake while taking this medication." C. "I might experience a decrease in appetite when taking this medication." D. "I will experience a slower heart rate with this medication."
Answer: A. "I should take this medication at bedtime."
A nurse is collecting data from a client who is taking lithium to treat bipolar disorder and has a lithium level of 2.4 mEq/L. The nurse should identify which of the following findings as indicating lithium toxicity? A. Headache B. Slurred speech C. Pruritus D. Hyperglycemia
Answer: B. Slurred Speech.
A nurse is reinforcing teaching about transdermal nicotine patches with a client who is attempting to quit smoking. Which of the following client statements indicates an understanding of the teaching? A. "I will need to obtain a prescription from my provider." B. "I should avoid using other nicotine products to reduce cravings while the patch is on." C. "I might develop a local skin reaction when I begin wearing the patch." D. "I can apply the patch to my thigh."
Answer: C. "I might develop a local skin reaction when I begin wearing the patch."
A nurse is collecting data from a client who has intestinal amebiasis and is taking metronidazole. For which of the following findings should the nurse withhold the metronidazole? A. Dry mouth B. Metallic taste C. Motor ataxia D. Dark-colored urine
Answer: C. Motor Ataxia.
A nurse is preparing to administer enoxaparin 30 mg subcutaneously to a client who had total knee surgery. Which of the following actions should the nurse plan to take? ➖ Expel the air bubble from the pre-filled syringe before injecting the medication. ➖ Administer the medication into the vastus lateralis muscle of the anterior thigh. ➖ Pinch up the skin at the injection site before inserting the needle. ➖ Pull back on the plunger for 5 seconds and watch for blood aspiration before injecting the medication.
Answer: Pinch up the skin at the injection site before inserting the needle.
A nurse is monitoring a client who is receiving a blood transfusion and develops itching and hives. Which of the following actions should the nurse take first? ➖ Prepare a dose of a prescribed antihistamine ➖ Stop the transfusion ➖ Measure the client's vital signs ➖ Report the client findings to the charge nurse.
Answer: Stop the transfusion.
A nurse is reinforcing teaching with a client about a new prescription for oral bisacodyl. Which of the following instructions should the nurse provide the client? A. "Decrease fluid intake when taking this medication for better results." B. "Take this medication with milk to reduce gastric upset." C. "This medication will work quicker if the tablet is crushed." D. "Long-term use of this medication can cause dependence."
Answer: D. "Long-term use of this medication can cause dependence."