RN Pharmacology Online Practice 2023 A

A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching?

Docusate sodium reduces the surface tension of the stools to change their consistency Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate the stool more easily.

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching?

Drink 2 L of water daily The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys.

NGN: A nurse on a mental health unit is caring for a client. Select the 4 actions the nurse should take. Fluphenazine 2.5 mg PO four times daily LPN entered client's room to administer medication and noted that client did not respond to verbal or tactile stimulation, was diaphoretic, and hot to palpation. Notified RN. Vital signs obtained. Client noted to be incontinent of urine. Client mumbles in response to painful stimuli, muscle rigidity noted. Provider notified. Temperature 40° C (104° F)Heart rate 122/min; Blood pressure 168/112 mm Hg; Respiratory rate 22/min; SpO2 94% on room air

When taking actions, the nurse should administer dantrolene and bromocriptine, apply a cooling blanket, and discontinue the fluphenazine. The client is exhibiting manifestations of neuroleptic malignant syndrome (NMS), a potentially fatal adverse effect of antipsychotic medications, such as fluphenazine. Other manifestations can include electrolyte imbalance, delirium, and dysrhythmias. Dantrolene and bromocriptine can relieve muscle rigidity and decrease body temperature. Cooling blankets can also assist in decreasing body temperature. The fluphenazine should be discontinued and the client should be transferred to a critical care unit for ongoing treatment.

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" Clients should remove the patch each evening for a medication free time of 12 to 14 hours before applying a new patch to avoid developing a tolerance to the medication's effects.

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" The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

a client is prescribed a second dose of iv ceftriaxone postoperatively. the nurse notes urticaria and dyspnea. which of the following actions should the nurse prioritize?

discontinue the infusion The greatest risk to the client is anaphylaxis. Therefore, the priority intervention is to stop the medication.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication?

Total cholesterol The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following effects should the nurse instruct the client to monitor and report to the provider?

yellow-tinged vision The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.

A nurse contacts a client's provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take?

have the provider spell out the unfamiliar medication names The nurse should ask the provider to spell out the name of the medication if the stated name is one the nurse is not familiar with.

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

increased blood pressure The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.

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" The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

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 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

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 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. The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.

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

Bibasilar crackles mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

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 carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

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

Check the clients blood glucose The first action the nurse should take using the nursing process is to assess the client. the client is at risk for hypoglycemia. the nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia.

a nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. which of the following results should the nurse report to the provider due to it increasing the risk for digoxin toxicity?

Decreased potassium level The nurse should notify the provider if a client has hypokalemia prior to administration of digoxin due to the increased risk of developing digoxin toxicity and cardiac dysrhythmias.

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

Digoxin The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicty.

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. The nurse has the responsibility to verify that the client understands the risk of refusing the medication so that an informed decision can be made. the nurse should then document the refusal in the client's medical record and notify the health care provider.

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.)

Dry mouth Blurred vision Dry eyes Oxybutynin is an anticholinergic agent that can cause dry mouth. Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure. Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation.

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 The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately?

Hyperventilation When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This finding indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicated an understanding of the teaching?

I will remove the patch after 14 hours The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.

A nurse is providing discharge instructions to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective?

I will store my unopened bottles of insulin in the refrigerator The client should store unopened vials of insulin in the refrigerator to maintain medication viability. Once opened, the insulin can remain at room temperature for up to 1 month.

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 The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia.

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 Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized.

A nurse is preparing to administer hydrochlorothiazide to a client. Which of the following actions should the nurse take prior to administering the medication?

Obtain the client's blood pressure HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema. The nurse should obtain the client's blood pressure prior to administration of the medication.

A nurse is caring for an older adult client who has a new prescription for spironolactone. Which of the following lab values should the nurse monitor for this client ?

Potassium The nurse should monitor the client's potassium level as spironolactone is a potassium sparing diuretic that can cause hyperkalemia. The client's potassium level should be obtained and monitored within 1 week of beginning spironolactone, with any increase in dosage, and periodically throughout therapy. Additional laboratory results to monitor include sodium, uric acid, glucose, and renal function tests.

A nurse is preparing medication instructions for a client who is receiving end-of-life care and their family. The client has a prescription for fentanyl patches. Which of the following information regarding the manifestations and use of fentanyl should the nurse include in the instructions?

Taking a stool softener daily will be needed. Constipation is an adverse effect of opioid use. Stool softeners can decrease the severity of this adverse effect.

A nurse is caring for a client who is to receive treatment for opioid use disorder. Which of the following medications should the nurse expect to administer?

methadone The nurse should expect to administer methadone for treatment of opioid use disorder. Methadone can be administered for withdrawal and to assist with maintenance and suppressive therapy.

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicated that the medication is effective?

increased cardiac output Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication?

orthostatic hypotension The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position.

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose?

6.3 mL

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity?

cromolyn Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

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 The nurse should admi. the heparin by subQ injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away fro the umbilicus.

A nurse is completing an incident report for a medication error. Which of the following information should the nurse include in the report?

Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication The incident report should clearly and thoroughly report the facts of the error.

A nurse is caring for a client who is taking nitroglycerin for angina and reports feeling faint when standing up. Which of the following actions should the nurse take?

Assist the client into bed, elevate the lower extremities, and check their blood pressure. The nurse should first assist the client into bed to prevent injuries from a fall. The nurse should elevate the client's legs on pillows to enhance venous return from the lower extremities. The nurse should then check the client's blood pressure.

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 cholinergic is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurses should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.

NGN: A nurse is caring for a client in an inpatient setting. The nurse is preparing to administer the client's 1300 antibiotic doses. Click to highlight the findings that would indicate the nurse should hold the next dose of gentamycin until further direction from the provider.

BUN 48 mg/dL (10 to 20 mg/dL); Creatinine 2.7 mg/dL (0.5 to 1.1 mg/dL); Output 60 mL; Urine is dark amber When recognizing cues, the nurse should review the client's EMR, the nurse should recognize the client's elevated BUN, elevated creatinine level, urine output of less than 30mL/hr, and dark amber colored urine are manifestations of nephrotoxicity which is an adverse effect gentamycin and other aminoglycosides. Therefore, the nurse should hold the dose until further directions from the provider.

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 Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is providing teaching to a client who has depression and a new prescription for fluozetine. Which of the following statements by the client indicates an understanding of the teaching?

I should take acetaminophen instead of ibuprofen for my headaches while taking this medication Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking fluoxetine should take acetaminophen for headaches or pain, since acetaminophen does not suppress platelet aggregation.

A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understand the teaching?

I will check my heart rate before I take the medication Diltiazem, a calcium channel blocker, has cardio-suppressant effects at the SA and AV nodes, which can lead to bradycardia. The client should check their heart rate before taking the medication and notify the provider if it falls below the expected reference range.

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 The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. the client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.

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

Presence of U waves The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide

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 The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal.

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

Report yellowing of the skin Famotidine can be hepatotoxic and cause jaundice. the nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

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 the nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.

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) the nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension.

NGN: A nurse at a clinic is evaluating a client. Drag 1 condition and 1 client finding to fill in each blank in the following sentence. Relevant info: Heart rate 110/min Nurses' Notes​: Today: Adult female client is here for 3 month follow up visit after receiving a new prescription 3 months ago. Client reports feeling nervous and being irritable. Client is alert and oriented to person place and time. Skin moist and intact some sweating noted on forehead. Heart rate regular and fast. Respirations even and non-labored. Bowel sounds hyperactive in all 4 quadrants. Reports occasional loose stools that have increased lately. Lab Results: TSH 0.1 mU/L (0.3 to 5 mU/L); Triiodothyronine 220 ng/dL (70 to 205 ng/dL); Thyroxine 4 ng/dL (0.8 to 2.8 ng/dL) Provider Prescriptions: 3 months ago: Levothyroxine 50 mcg PO daily

The client is likely experiencing hyperthyroidism as evidenced by the client's blood thyroxine level.

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 the client's description of the pain is the most accurate assessment of pain.

NGN: A nurse is caring for a client on a medical-surgical unit. Complete the following sentence by using the list of options. CVAD is difficult to flush. Glucose 64 mg/dL (74 to 106 mg/dL)

The nurse should first address the client's glucose level, followed by the client's CVAD. When analyzing cues, the nurse should identify that the client is developing hypoglycemia and experiencing a complication with the central venous line (CVL). Hypoglycemia can occur if the TPN is stopped abruptly. A CVAD can become occluded or infected. Findings of a CVL complication can include difficulty flushing, pain while flushing, fever, or chills.

A nurse is caring for a client who is receiving haloperidol. The nurse should identify which of the following findings as an adverse effect of the medication?

akathisia An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia.

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication?

blurred vision Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause near objects to appear blurry to the client.

A nurse is caring for a client who has magnesium level of 3.1 mEq/L. The nurse should expect to administer which of the following medications?

calcium gluconate The nurse should expect to administer IV calcium gluconate to the client and prepare to provide ventilatory support. This client is at risk for respiratory depression and cardiac dysrhythmias because a magnesium level of 3.1 mEq/L is above the expected reference range of 1.3 to 2.1 mEq/L.