Safety #2
A child is recently prescribed levetiracetam (Keppra). The nurse understands which of the following medications would be prescribed to minimize side effects of this drug? A. Vitamin A B. Vitamin C C. Vitamin B6 D. Vitamin D
C
A client who has had a transient ischemic attack (TIA) has an order for aspirin 160mg daily. When administering the medications, the client says, "I don't need the aspirin today. I don't have any other aches or pains." The nurse: A. Documents the aspirin was refused B. Calls the health care provider to clarify the medication order C. Explains that the aspirin is ordered to decrease stroke risk D. Teaches that aspirin is used to prevent aches
C
A patient is receiving enoxaparin (Lovenox) and warfarin (Coumadin) therapy for a venous thromboembolism (VTE). Which lab value indicates that anticoagulation is adequate and enoxaparin (Lovenox) can be discontinued? A. The patient's activated partial thromboplastin time (aPTT) is half of the control value B. The patient's prothrombin time (PT) is 0.5 times normal C. The patient's international normalized ratio (INR) is 2.5 D. The patient's K+ level is 3.5
C
A client realizes they forgot to take their anticonvulsant medication. What should they do?
Take it ASAP
A client is prescribed valproic acid (Depakote) for seizure control. The nurse must check other meds the client is taking because which adverse effect can occur?
Bleeding
Which medication should the nurse anticipate administering first to a child in status epileptics? A. Establish an IV line, and administer IV lorazepam (Ativan) B. Administer rectal diazepam (Valium) C. Administer an oral glucose gel to the side of the child's mouth D. Administer oral diazepam (Valium)
B
Which of the following medications is available in "sprinkles" (making it easier to administer to children) A. levetiracetam (Keppra) B. ethosuxumide (Zarontin) C. zonisamide (Zonegran) D. valproic acid (Depakote)
D
The nurse needs to know that the therapeutic range for phenytoin (Dilantin) is?
10-20 mcg/mL
The nurse is preparing to administer warfarin (Coumadin), an oral anticoagulant, to a patient with a mechanical valve replacement. The patient's INR is 2.7. Which action should the nurse take? A. Administer the medication as ordered B. Prepare to administer vitamin K C. Hold the medication and notify the HCP D. Assess the patient for abnormal bleeding
A
A nurse is caring for a client in liver failure with ascites who is receiving spironolactone (Aldactone). Which of the following outcomes should the nurse expect from this client's medication therapy? A. Increased sodium excretion B. Decreased urinary output C. Increased potassium excretion D. Decreased chloride excretion
A
A nurse is caring for a client who is hospitalized with deep vein thrombosis and has been on IV heparin for 5 days. The provider prescribes oral warfarin (Coumadin) without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate nursing response? A. "The warfarin (Coumadin) takes several days to work, so the IV heparin will be used until the warfarin (Coumadin) reaches a therapeutic level" B. "I will call the provider to get a prescription for discontinuing the IV heparin today" C. "Both heparin and warfarin (Coumadin) work together to dissolve the clots" D. "The IV heparin increases the effects of the warfarin (Coumadin) and decreases the length of your hospital stay"
A
As a home health nurse obtaining an admission history on a client who has a deep vein thrombosis and is taking warfarin (Coumadin) 2mg daily, which statement indicates more education is needed? A. "I have started to eat more healthy foods like green salads and fruits" B. "The doctor said it is important to avoid becoming constipated" C. "warfarin (Coumadin) makes me feel nauseated unless I take it with food" D. " I will need to have blood testing done once or twice a week"
A
What is the only route of administration mannitol (Osmitrol) can be given? A. IV B. PO C. SQ D. PR
A
When taking carbamazepine (Tegretol), what fluid places raw client at risk for drug toxicity? A. Grapefruit juice B. Orange juice C. Cranberry D. Apricot juice
A
Which of the following drugs is the antidote to warfarin (Coumadin) A. Vitamin K B. Protamine Sulfate C. Aspirin D. Clopidrogel (Plavix)
A
Which of the following medications is considered a thrombolytic? A. Alteplase B. Heparin C. warfarin (Coumadin) D. enoxaparin (Lovenox)
A
Which of the following medications is used for partial seizures, restless leg syndrome, and neuralgia? A. gabapentin (Neuronitin) B. valproic acid (Depakote) C. phenytoin (Dilantin) D. lamotrigine (Lamictal)
A
A nurse is caring for a client who is receiving the muscle relaxant vecuronium for ARDS. Which of the following medications should the nurse anticipate administering with this medication? SELECT ALL THAT APPLY A. fentanyl (Sublimaze) B. furosemide (Lasix) C. midazolam (Versed) D. famotidine (Pepcid) E. dexamethasone (Decadron)
A, C
While caring for a client with acute respiratory distress syndrome (ARDS), the nurse will: SELECT ALL THAT APPLY A. Elevated the head of the bed 45-90 degrees B. Administer large amounts of IV fluids C. Cluster client's ADL's together D. Assess lung sounds
A, C, D
A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. Two or three oral anticonvulsant medications so that dosing can be low and side effects minimized B. One oral anticonvulsant medication to observe effectiveness and minimize side effects C. One rectal gel to be administered in the event of a seizure D. A combination of oral and intravenous anticonvulsant medications to ensure compliance
B
A client who has had a transient ischemic attack (TIA) has been placed on aspirin therapy every day. The nurse relates the expected outcome is prevention of: A. Headaches that accompany TIAs B. Platelet aggregation C. Increased intracranial pressure D. Intracranial hemorrhage
B
A nurse is caring for a client who is recovering from surgical placement of an artificial heart valve and is to be started on warfarin (Coumadin) prior to discharge. Which of the following diagnostic tests should the nurse use to monitor the effect of this therapy? A. Platelet count B. Prothrombin time (PT) C. Bleeding time D. aPTT
B
A nurse is teaching a client who takes furosemide (Lasix) and has a serum potassium level of 3.2mEq/L/ Which of the following foods should the nurse tell the patient to include in his/her diet? A. Carrots B. Bananas C. Cheddar cheese D. Baked chicken
B
For a client receiving a continuous heparin infusion for a DVT (deep vein thrombosis), the infusion rate will be adjusted according to the: A. Platelet count B. PTT C. PT/INR D. CBC w/diff
B
A patient admitted to the medical surgical unit with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin (Coumadin). The patient asks the nurse why two medications are needed. The patient asks the nurse why two medications are needed. Which response by the nurse is accurate? A. "Administration of two anticoagulants decreases the risk of recurrent venous thrombosis" B. "enoxaparin (Lovenox) will dissolve the clot, and warfarin (Coumadin) will prevent any more clots from occurring" C. "The enoxaparin (Lovenox) will work immediately, but the warfarin (Coumadin) takes several days to reach its full effect" D. "Because of the potential for a pulmonary embolism, it is important for you to have at least two anticoagulants"
C
The nurse understands the purpose of administering dexamethasone (Decadron) to a patient with ARDS is? A. "The medication is used to treat infections" B. "The medication is given to facilitate ventilation" C. "The medication is given to decrease inflammation" D. "The medication is given to reduce anxiety"
C
Whenever a nurse is caring for clients who are receiving heparin, which of the following medications should the nurse have on hand in the event of an overdose? A. Iron B. Glucagon C. Protamine Sulfate D. Vitamin K
C
Which of the following baseline laboratory data should be establish before a client is started on tissue plasminogen activator or alteplase recombinant? A. Potassium level B. Lee-White clotting time C. Hgb, Hct, and Platelet count D. Blood glucose level
C
Why is it necessary for clients to avoid alcohol intake when taking barbiturates?
CNS toxicity -- interrupts effects of the medication
A nurse is teaching medication safety to a group of healthy older adults at a community center. The nurse explains that due to the high frequency of food-drug interactions, the clients should avoid taking their medications with which of the following? A. Carbonated beverage B. Milk C. Orange juice D. Grapefruit juice
D
During anticoagulant therapy, the nurse monitors the client for which common undesirable effect? A. Dysrhythmias B. Nausea and vomiting C. Anaphylactic reactions D. Internal and superficial bleeding
D