SAUNDERS Pharm Test 3 Questions

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement? 1. "I use my corticosteroid inhaler each time I feel short of breath." 2. "I see my doctor if I have an upper respiratory infection and always get a flu shot." 3. "I use my bronchodilator inhaler before walking so I don't become short of breath." 4. "I use my bronchodilator inhaler before I visit places like the zoo because of my allergies."

1. "I use my corticosteroid inhaler each time I feel short of breath." Rationale: Most asthma medications are administered via inhalation because of their fast action via this route. Inhaled corticosteroids are preferred for long-term control of persistent asthma. They decrease inflammation and reduce bronchial hyperresponsiveness. Bronchodilator medications are considered "rescue" types because their onset is faster. Clients would use this type of medication to provide rapid relief of symptoms such as bronchospasm, which can be caused by a variety of triggers. Clients need to be evaluated for understanding of their disease, identifying triggers, and the proper use of equipment and medications.

A client is admitted to the emergency department with a diagnosis of myocardial infarction (MI). The health care provider (HCP) prescribes the administration of alteplase. The registered nurse (RN) preceptor is orienting a new RN in the use of this medication. Which statement by the new RN indicates that teaching has been effective? 1."Administer the medication within 4 to 6 hours after onset of chest pain." 2."Administer the medication concurrently with the administration of heparin." 3."Administer the medication with the administration solution set protected from light." 4."Administer the medication after the results of all laboratory tests have been received."

1."Administer the medication within 4 to 6 hours after onset of chest pain." Rationale: Alteplase is a fibrinolytic medication. In a client with an acute coronary artery thrombosis that evolves into a transmural MI, fibrinolytic therapy is most effective when started within 4 to 6 hours after onset of symptoms. The solution does not need to be protected from light. Heparin may be administered after the administration of alteplase but not concurrently, and it is not appropriate to wait for all laboratory tests to administer the medication.

The nurse has provided instruction to a client with chronic kidney disease who has a prescription for epoetin alfa. Which statement by the client indicates that teaching was effective? 1."I have to receive this medication subcutaneously." 2."This medication has to be administered using the Z-track method." 3."I will take this medication orally with the rest of my morning pills." 4."I will receive this medication through intramuscular injection."

1."I have to receive this medication subcutaneously." Rationale: Epoetin alfa is administered parenterally by the intravenous or subcutaneous route. It cannot be given orally because it is a glycoprotein and would be degraded in the gastrointestinal tract.

A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? 1."The medication may need to be changed." 2."The cough must be the start of a respiratory infection." 3."The medication needs to be taken with large amounts of water to prevent the cough." 4."This sometimes happens, and you will need to take a cough medication with each dose of medication."

1."The medication may need to be changed." Rationale: An ACE inhibitor is used to treat hypertension or heart failure. An side effect of ACE inhibitors is a characteristic dry, nonproductive cough. This can be quite bothersome to a client, and the medication may need to be changed. The cough is reversible with discontinuation of therapy. The remaining options are incorrect.

A health care provider (HCP) prescribes warfarin sodium for a client. The home care nurse visits the client at home and teaches the client about the medication and its administration. Which statement by the client indicates a need for further teaching? 1."The urine normally changes to orange." 2."This medicine will still be working 4 to 5 days after it is discontinued." 3."This medication will require frequent blood work to monitor its effects." 4."I cannot take aspirin or any aspirin-containing medications while I'm on this medication."

1."The urine normally changes to orange." Rationale: Orange urine indicates blood in the urine from an overdose of the medication.

A client having a myocardial infarction is receiving alteplase therapy. Which action should be carried out by the nurse to monitor for the most frequent side/adverse effect? 1.Check for signs of bleeding. 2.Assess for allergic reaction. 3.Evaluate the client for muscle weakness. 4.Monitor for signs and symptoms of infection.

1.Check for signs of bleeding. Rationale: Alteplase is a thrombolytic medication, which means that it breaks down or dissolves clots; therefore, bleeding is a concern. Allergic reaction is not a frequent response. Muscle weakness is not a side/adverse effect of this medication. Local or systemic infection could occur with poor aseptic technique during medication administration, but it is rare and not specifically associated with this medication.

The nurse is preparing a plan of care for a client with sickle cell crisis who will be admitted to the nursing unit. The nurse should include which intervention as a priority in the plan of care for the client? 1.Initiate an intravenous (IV) line for the administration of fluids. 2.Consult with the psychiatric department regarding genetic counseling. 3.Call the blood bank and request preparation of a unit of packed red blood cells. 4.Call the respiratory department to prepare for intubation and mechanical ventilation.

1.Initiate an intravenous (IV) line for the administration of fluids. Rationale: The priorities in management of sickle cell crisis are hydration therapy and pain relief.

The nurse is preparing to perform an assessment on a client being admitted to the hospital with a diagnosis of sickle cell crisis, vaso-occlusive crisis. Which findings should the nurse expect to note on assessment of the client? Select all that apply. 1.Pallor 2.Fever 3.Joint swelling 4.Blurred vision 5.Abdominal pain

1.Pallor 2.Fever 3.Joint swelling 5.Abdominal pain Rationale: Sickle cell crises are acute exacerbations of the disease. Vaso-occlusive crisis is caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction. Manifestations include pallor; fever; painful swelling of hands, feet, and joints; and abdominal pain. Blurred vision is not a manifestation of vaso-occlusive crisis.

The nurse is caring for a client who is receiving heparin sodium intravenously as a continuous infusion. Which laboratory finding requires immediate nursing intervention? 1.Platelet count of 100,000 mm3 (100 × 109/L) 2.Red blood cell count of 4.2 cells (4.2 × 1012/L) 3.International normalized ratio (INR) of 1.2 (1.2) 4.Activated partial thromboplastin time (aPTT) of 60 seconds (60 seconds)

1.Platelet count of 100,000 mm3 (100 × 109/L) Rationale: The platelet count indicates that the client receiving heparin sodium is at risk for heparin-induced thrombocytopenia (HIT). HIT should be suspected whenever platelet counts fall below normal. If severe thrombocytopenia develops (platelet count less than 100,000 mm3 [100 × 109/L]), heparin sodium should be discontinued. The aPTT in option 4 represents an expected finding for intravenous heparin sodium therapy. Option 3 is not a value measured for heparin sodium therapy but is used to measure a response to warfarin sodium therapy, and the red blood cell count in option 2 is normal.

The nurse is providing discharge instructions to a client taking warfarin sodium. Which statement, based on health care provider (HCP) permission, is appropriate to include in client teaching for this medication? 1."Alcohol can be consumed as long as it is in small amounts." 2."You need to check with your doctor about what can be taken for headache." 3."It doesn't matter what time the daily dose is taken as long as it is taken each day." 4."It is all right to take over-the-counter medications as long as they do not contain vitamin K."

2."You need to check with your doctor about what can be taken for headache." Rationale: Warfarin sodium is an anticoagulant that prevents further extension of formed existing clots and also prevents new clot formation and secondary thromboembolic complications. Because the medication places the client at risk for bleeding, the client is instructed to avoid salicylates (acetylsalicylic acid, or aspirin) and alcohol. The medication should be taken exactly as prescribed and at the same time daily. The client needs to avoid all over-the-counter medications and needs to consult with the HCP before taking any other medications because of the risk for medication interactions.

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? Select all that apply. 1. A low arterial PCo2 level 2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise 4.A widened diaphragm noted on the chest x-ray 5.Pulmonary function tests that demonstrate increased vital capacity

2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise Rationale:Clinical manifestations of chronic obstructive pulmonary disease (COPD) include hypoxemia, hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use of accessory muscles of respiration. Chest x-rays reveal a hyperinflated chest and a flattened diaphragm if the disease is advanced. Pulmonary function tests will demonstrate decreased vital capacity.

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results? 1.Prothrombin time of 12.5 seconds 2.Activated partial thromboplastin time of 60 seconds 3.Activated partial thromboplastin time of 28 seconds 4.Activated partial thromboplastin time longer than 120 seconds

2.Activated partial thromboplastin time of 60 seconds Rationale: Common laboratory ranges for activated partial thromboplastin time (aPTT) are 30 to 40 seconds. Because the aPTT should be 1.5 to 2.5 times the normal value, the client's aPTT would be considered therapeutic if it was 60 seconds. Prothrombin time assesses response to warfarin therapy.

A client who had surgery 3 days earlier is receiving heparin sulfate by subcutaneous injection every 12 hours. In planning for the client's morning care, the priority nursing intervention is which action? 1.Allow the client to sit only at the bedside. 2.Assist the client to shave using an electric razor. 3.Monitor the prothrombin time (PT) every 4 hours. 4.Tell the client that brushing the teeth is not allowed.

2.Assist the client to shave using an electric razor. Rationale: Clients receiving heparin are at risk for bleeding. An electric razor rather than a straight blade razor is used for shaving. Allowing the client to only sit on the side of the bed and prohibiting brushing of the teeth are inappropriate and unnecessary nursing actions. It is not necessary to monitor laboratory values every 4 hours when the client is taking subcutaneous heparin. The PT is monitored when the client is taking warfarin.

The nurse is caring for a client with hyperlipidemia who is taking cholestyramine. Which nursing assessment is most significant for this client relative to the medication therapy? 1.Observe for joint pain. 2.Auscultate bowel sounds. 3.Assess deep tendon reflexes. 4.Monitor cardiac rate and rhythm.

2.Auscultate bowel sounds. Rationale: Cholestyramine is used to treat hyperlipidemia. The site of action of the medication is the bowel; therefore, option 2 is correct. The remaining options are unrelated assessments.

A client in the postpartum care unit who is recovering from disseminated intravascular coagulopathy is to be discharged on low dosages of an anticoagulant medication. In developing home care instructions for this client, the nurse should include which priority safety instruction regarding this medication? 1.Avoid brushing the teeth. 2.Avoid taking acetylsalicylic acid (aspirin). 3.Avoid walking long distances and climbing stairs. 4.Avoid all activities because bruising injuries can occur.

2.Avoid taking acetylsalicylic acid (aspirin). Rationale: Aspirin can interact with the anticoagulant medication to increase clotting time beyond therapeutic ranges. Avoiding aspirin is a priority. The client does not need to avoid brushing the teeth; however, the client should be instructed to use a soft toothbrush. Walking and climbing stairs are acceptable activities. Not all activities need to be avoided.

A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results? 1.Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. 2.Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. 3.Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. 4.Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran etexilate in place of warfarin sodium.

2.Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. Rationale: When a client is receiving warfarin for clot prevention due to atrial fibrillation, an INR of 2 to 3 is appropriate for most clients. Until the INR has achieved a therapeutic range, the client should be maintained on a continuous heparin infusion with the aPTT ranging between 60 and 80 seconds. Therefore, the nurse should collaborate with the HCP to obtain a prescription to increase the heparin infusion and to administer the warfarin as prescribed.

The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 1.Fluid overload 2.Peripheral vasoconstriction 3.Inability to perform self-care 4.Inability to discriminate hot or cold sensations

2.Peripheral vasoconstriction

Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? 1.Vitamin K 2.Protamine sulfate 3.Potassium chloride 4.Aminocaproic acid

2.Protamine sulfate Rationale: The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage should occur. Vitamin K is an antidote for warfarin sodium. Potassium chloride is administered for a potassium deficit. Aminocaproic acid is the antidote for thrombolytic therapy.

The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure? 1.Beclomethasone first and then the salmeterol 2.Salmeterol first and then the beclomethasone 3.Alternating a single puff of each, beginning with the salmeterol 4.Alternating a single puff of each, beginning with the beclomethasone

2.Salmeterol first and then the beclomethasone Rationale: Salmeterol is an adrenergic type of bronchodilator and beclomethasone dipropionate is a glucocorticoid. Bronchodilators are always administered before glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the bronchodilator, which then makes the glucocorticoid more effective.

The nurse should monitor the client receiving the first dose of albuterol for which side or adverse effect of this medication? 1.Drowsiness 2.Tachycardia 3.Hyperkalemia 4.Hyperglycemia

2.Tachycardia Rationale: Albuterol is a bronchodilator. Side and adverse effects include tachycardia, hypertension, chest pain, dysrhythmias, nervousness, restlessness, and headache. The nurse monitors for these effects during therapy. The items in the other options are not side and adverse effects of this medication.

The nurse has given a client the prescribed dose of intravenous hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameter? 1.Pulse rate 2.Urine output 3.Blood pressure 4.Potassium level

3. Blood pressure Rationale: Hydralazine is an antihypertensive medication used in the management of moderate to severe hypertension. It is a vasodilator medication that decreases afterload. The blood pressure needs to be monitored. The remaining options are unrelated to the use of this medication.

A client is receiving epoetin alfa. The nurse should check which assessment to monitor for the most significant adverse effect of the medication? 1. Temperature 2. Paresthesias 3. Blood pressure 4. Muscle strength

3. Blood pressure Rationale: Epoetin alfa is generally well tolerated. The most significant adverse effect is hypertension. Therefore, the nurse would monitor the client's blood pressure. Options 1, 2, and 4 are unrelated to adverse effects of this medication.

The nurse has provided instructions to a client who will receive alteplase for the treatment of acute myocardial infarction. The nurse determines that teaching was effective if the client states that the main action of alteplase is what? 1."It will slow the clotting of my blood." 2."It will keep my blood thin to prevent clotting." 3."It will dissolve any clots that are obstructing the coronary arteries." 4."It will prevent any further clots from forming anywhere in the body."

3."It will dissolve any clots that are obstructing the coronary arteries."

The nurse is evaluating the results of laboratory studies for a client receiving epoetin alfa. When should the nurse expect to note a therapeutic effect of this medication? 1.Immediately 2.After 3 days of therapy 3.After 2 weeks of therapy 4.After 1 week of therapy

3.After 2 weeks of therapy Rationale: Epoetin alfa stimulates erythropoiesis. It takes 2 to 6 weeks after initiation of therapy before a clinically significant increase in hematocrit is observed. Therefore, this medication is not intended for clients who require immediate correction of severe anemia, and it is not a substitute for emergency blood transfusions.

A client with chronic kidney disease is receiving epoetin alfa for the past 2 months. What should the nurse determine is an indicator that this therapy is effective? 1.A decrease in blood pressure 2.An increase in white blood cells 3.An increase in serum hematocrit 4.A decrease in serum creatinine level

3.An increase in serum hematocrit Rationale: Epoetin alfa stimulates red blood cell production. Initial effects should be seen within 1 to 2 weeks, and the hematocrit reaches normal levels in 2 to 3 months.

A man has developed atrial fibrillation and has been placed on warfarin. The nurse is doing discharge dietary teaching with the client and determines that the client needs additional education if he states that he would choose which food while taking this medication? 1.Cherries 2.Potatoes 3.Broccoli 4.Spaghetti

3.Broccoli Rationale: Anticoagulant medications work by antagonizing the action of vitamin K, which is needed for clotting. When a client is taking an anticoagulant, foods high in vitamin K are often omitted from the diet. Vitamin K is found in large amounts in green leafy vegetables, such as broccoli, cabbage, turnip greens, and lettuce. The other options listed are foods that are lower in vitamin K.

The health care provider (HCP) writes a prescription for atorvastatin for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 1.Renal calculi 2.Chronic heart failure 3.Carcinoid of the liver 4.Coronary artery disease

3.Carcinoid of the liver Rationale: Atorvastatin is a (HMG-CoA) reductase inhibitor that is used to treat hypercholesterolemia and hypertriglyceridemia. Contraindications to the medication include active liver disease, unexplained elevated liver function tests, pregnancy, and lactation. The conditions noted in the remaining options are not contraindications to this medication.

A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). The client is started on alteplase therapy. The nurse determines that teaching has been effective when the client's significant other states that the purpose of the medication is to perform which action? 1.Thin the blood. 2.Slow the clotting of the blood. 3.Dissolve any clots in the coronary arteries. 4.Prevent further clots from forming in the coronary arteries.

3.Dissolve any clots in the coronary arteries. Rationale: Alteplase converts plasminogen in the blood to plasmin. Plasmin is an enzyme that digests or dissolves fibrin clots wherever they exist. Heparin sodium and warfarin sodium thin the blood, slow clotting, and prevent further clots from forming.

Gemfibrozil is prescribed for a client. Which laboratory finding should alert the nurse to the need to withhold the medication and contact the health care provider? 1.Elevated glucose 2.Elevated triglycerides 3.Elevated liver function tests 4.Elevated blood urea nitrogen (BUN)

3.Elevated liver function tests Gemfibrozil is used to treat hypercholesterolemia. One adverse effect is hepatotoxicity. The medication does not affect glucose. An elevated triglyceride level is not an indication to hold the medication. An elevated BUN is unrelated to this medication and would not be an indication that the medication should be held.

A postpartum client with deep vein thrombosis is being treated with anticoagulant therapy. The nurse teaches the client that the health care provider (HCP) should be contacted for which noted side and adverse effects? Select all that apply. 1.Vertigo 2.Dysuria 3.Epistaxis 4.Hematuria 5.Ecchymosis

3.Epistaxis- bleeding from nose 4.Hematuria- blood in urine 5.Ecchymosis

Atorvastatin has been prescribed for a client, and the client asks the nurse about the side and adverse effects of the medication. What should the nurse tell the client is a frequent side effect of this medication? 1.Tremors 2.Lethargy 3.Headache 4.Tiredness

3.Headache Rationale: A frequent side effect is headache. Occasional side effects include myalgia, rash or pruritus (signs of an allergic reaction), flatulence, and dyspepsia.

The nurse is preparing to administer albuterol to a client. Which parameters should the nurse assess before and during therapy? 1.Nausea and vomiting 2.Headache and level of consciousness 3.Lung sounds and presence of dyspnea 4.Urine output and blood urea nitrogen level

3.Lung sounds and presence of dyspnea Rationale: Albuterol is an adrenergic bronchodilator. The nurse assesses respiratory pattern, lung sounds, pulse, and blood pressure before and during therapy. The nurse also notes the color, character, and amount of sputum.

A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and is receiving a tissue plasminogen activator, alteplase. Which action is a priority nursing intervention? 1.Monitor for kidney failure. 2.Monitor psychosocial status. 3.Monitor for signs of bleeding. 4.Have heparin sodium available.

3.Monitor for signs of bleeding. Rationale: Tissue plasminogen activator is a thrombolytic. Hemorrhage is a complication of any type of thrombolytic medication. The client is monitored for bleeding. Monitoring for renal failure and monitoring the client's psychosocial status are important but are not the most critical interventions. Heparin may be administered after thrombolytic therapy, but the question is not asking about follow-up medications.

The nurse is caring for a client who is taking warfarin. The nurse notes the presence of gross hematuria and large areas of bruising on the client's body. The nurse notifies the health care provider (HCP) and ensures that which prescribed medication is available? 1.Heparin sulfate 2.Protamine sulfate 3.Phytonadione (vitamin K) 4.Oral potassium supplements

3.Phytonadione (vitamin K) Rationale: Warfarin is an oral anticoagulant. The effects of warfarin overdose can be reversed with phytonadione (vitamin K). Vitamin K is an antagonist to the action of warfarin that can reverse warfarin-induced inhibition of clotting factor synthesis. For mild bleeding, vitamin K should be administered orally; a dose of 10 to 20 mg will cause prothrombin levels to normalize within 24 hours. If bleeding is severe, parenteral vitamin K is indicated. Protamine sulfate is the antidote for heparin sulfate, an anticoagulant that would cause increased bleeding. The question presents no data suggesting that potassium supplements are indicated.

A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA) by infusion. Which parameter should the nurse determine requires the least frequent assessment to detect complications of therapy with tPA? 1.Neurological signs 2.Blood pressure and pulse 3.Presence of bowel sounds 4.Complaints of abdominal and back pain

3.Presence of bowel sounds Rationale: Thrombolytic agents dissolve existing clots, and bleeding can occur anywhere in the body. The nurse monitors for any obvious signs of bleeding and also for occult signs of bleeding, which would include hemoglobin and hematocrit values, blood pressure and pulse, neurological signs, assessment of abdominal and back pain, and the presence of blood in the urine or stool.

A client receiving heparin sodium by continuous intravenous (IV) infusion removes the tubing from the pump to change his hospital gown. The nurse is concerned that the client received a bolus of medication. After requesting a prescription for a stat partial thromboplastin time (PTT), the nurse should check for the availability of which medication in the medication cart? 1.Enoxaparin 2.Phytonadione 3.Protamine sulfate 4.Aminocaproic acid

3.Protamine sulfate Rationale: If the tubing is removed from an IV pump and the tubing is not clamped, the client will receive a bolus of the solution and the medication contained in the solution. The client who receives a bolus dose of heparin sodium is at risk for bleeding. If the results of the next PTT are extremely high, a dose of protamine sulfate, the antidote for heparin sodium, may be prescribed. Enoxaparin is an anticoagulant. Phytonadione is the antidote for warfarin sodium. Aminocaproic acid is an antifibrinolytic agent (inhibits clot breakdown).

A client with iron-deficiency anemia is taking an iron supplement and tells the nurse that she is going to stop the medication because it causes constipation. The nurse most appropriately responds by making which statement? 1."In time you will get used to this side effect." 2."Constipation is bothersome, but it is much more important to take the medication." 3."Never stop taking any medication without talking to the primary health care provider first." 4."Constipation is most intense during initial therapy and becomes less bothersome with continued use."

4."Constipation is most intense during initial therapy and becomes less bothersome with continued use."

The home care nurse is making a monthly visit to a client with a diagnosis of pernicious anemia who has been receiving a monthly injection of cyanocobalamin. Before administering the injection, the nurse evaluates the effects of the medication and determines that a therapeutic effect is occurring if the client makes which statement? 1."I feel really lightheaded." 2."I no longer have any nausea." 3."I have not had any pain in a month." 4."I feel stronger and have a much better appetite."

4."I feel stronger and have a much better appetite." Rationale: Cyanocobalamin is essential for DNA synthesis. It can take up to 3 years for the vitamin B12 stores to be depleted and for symptoms of pernicious anemia to appear. Symptoms can include weakness, fatigue, anorexia, loss of taste, and diarrhea. To correct deficiencies, a crystalline form of vitamin B12, cyanocobalamin, can be given intramuscularly. The client statements in options 1, 2, and 3 do not identify a therapeutic effect of the medication.

The nurse has provided instructions to a client with sickle cell disease regarding measures that will prevent a sickle cell crisis. Which client statement indicates an understanding of these measures? 1."I need to avoid any exercise." 2."I need to avoid increasing my fluid intake." 3."I need to avoid going outdoors in warm weather." 4."I need to avoid situations that may lead to an infection."

4."I need to avoid situations that may lead to an infection."

The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which statement, if made by the parent, indicates an understanding of the administration of this medication? 1."I should give the iron with food." 2."I can mix the iron with cereal to give it." 3."I should add the iron to the formula in the baby's bottle." 4."I should use a medicine dropper and place the iron near the back of the throat."

4."I should use a medicine dropper and place the iron near the back of the throat." Rationale: An oral iron supplement should be administered through a straw or medicine dropper placed at the back of the mouth because it will stain the teeth. The parents should be instructed to brush or wipe the teeth after administration. Iron is administered between meals because absorption is decreased if there is food in the stomach. Iron requires an acidic environment to facilitate its absorption in the duodenum.

The nurse provides discharge instructions to a client who is taking warfarin sodium. Which statement, by the client, reflects the need for further teaching? 1."I will avoid alcohol consumption." 2."I will take my pills every day at the same time." 3."I have already called my family to pick up a MedicAlert bracelet." 4."I will take coated aspirin for my headaches because it will coat my stomach."

4."I will take coated aspirin for my headaches because it will coat my stomach." Rationale: Aspirin-containing products need to be avoided when a client is taking this medication. Alcohol consumption should be avoided by a client taking warfarin sodium. Taking the prescribed medication at the same time each day increases client compliance. The MedicAlert bracelet provides health care personnel with emergency information.

Which statement made by a client taking montelukast indicates the need for further teaching? 1."I will need to have my liver function checked." 2."I can take the medication with food or without." 3."I may be able to decrease the use of my metered-dose inhaler." 4."I will take the medication when I first notice I am having trouble breathing."

4."I will take the medication when I first notice I am having trouble breathing." Rationale: Montelukast cannot be used for quick relief of an asthma attack because effects of the medication develop too slowly. For prophylaxis and maintenance therapy of asthma, maximal effects develop within 24 hours of the first dose and are maintained with once-daily dosing in the evening. The remaining options are correct statements.

The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine and the nurse teaches the client about the medication. Which statement, by the client, indicates the need for further teaching? 1."Constipation and bloating might be a problem." 2."I'll continue to watch my diet and reduce my fats." 3."Walking a mile each day will help the whole process." 4."I'll continue my nicotinic acid from the health food store."

4."I'll continue my nicotinic acid from the health food store." Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin needs to be avoided. Constipation and bloating are the 2 most common adverse effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.

A client is prescribed nicotinic acid for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? 1."It is not necessary to avoid the use of alcohol." 2."The medication should be taken with meals to decrease flushing." 3."Clay-colored stools are a common side effect and should not be of concern." 4."Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing."

4."Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing." Rationale: Flushing is an adverse effect of this medication. Aspirin or a nonsteroidal antiinflammatory drug can be taken 30 minutes prior to taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this effect. The medication should be taken with meals to decrease gastrointestinal upset; however, taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be reported to the health care provider (HCP) immediately.

A client is being discharged on warfarin sodium, and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates to the nurse that the client understands the teaching provided? 1."I'll stop my medication if I see bruising." 2."Stiff joints are common while taking warfarin." 3."This medication will prevent me from having a stroke." 4."If I notice blood-tinged urine, I will call the health care provider."

4."If I notice blood-tinged urine, I will call the health care provider."

The nurse is providing dietary instructions to the client with anemia. The client tells the nurse that the iron pills are very expensive and it will be difficult to pay for the pills and buy the proper food. What is the most appropriate nursing response? 1."You will have to find a way to afford both." 2."You will be fine as long as you take the iron pills." 3."Why don't you ask your family to help you out financially?" 4."Would you like for me to check into some other options for you?"

4."Would you like for me to check into some other options for you?"

The nurse is caring for a postpartum client with a diagnosis of deep vein thrombosis who is receiving a continuous intravenous infusion of heparin sodium. Review of which laboratory result is the most important by the nurse? 1.Platelet count 2.Prothrombin time (PT) 3.International normalized ratio (INR) 4.Activated partial thromboplastin time (aPTT)

4.Activated partial thromboplastin time (aPTT) Rationale: Anticoagulation therapy may be used to prevent the extension of thrombus by delaying the clotting time of the blood. The aPTT time should be monitored, and the heparin sodium dose should be adjusted to maintain a therapeutic level of 1.5 to 2.5 times the control value in seconds. The platelet count cannot be used to determine an adequate dosage for the heparin sodium infusion. The PT and the INR are used to monitor coagulation time when warfarin sodium is used.

A client with a subarachnoid hemorrhage needs to have surgery delayed until a stable clinical condition is achieved. The nurse prepares to administer which medication as prescribed to prevent clot breakdown and dissolution? 1.Alteplase 2.Heparin sodium 3.Warfarin sodium 4.Aminocaproic acid

4.Aminocaproic acid Rationale: Aminocaproic acid is an antifibrinolytic agent that prevents clot breakdown or dissolution. It is commonly prescribed after subarachnoid hemorrhage if surgery is delayed or contraindicated, to prevent further hemorrhage. Alteplase is a fibrinolytic that actively breaks down clots. Warfarin sodium and heparin sodium are anticoagulants that interfere with propagation or growth of a clot.

The nurse administers diphenhydramine 25 mg by mouth to an older client as prescribed for an allergic reaction. The assistive personnel (AP) later reports that the client is confused. The nurse should perform which priority nursing action? 1.Document the report by the AP. 2.Evaluate the effectiveness of the medication. 3.Check the chart for previous reports of confusion. 4.Assess the client's vital signs and level of consciousness

4.Assess the client's vital signs and level of consciousness

A client is scheduled to have heparin sodium 5000 units subcutaneously. What is the most appropriate nursing intervention? 1.Inject via an infusion device. 2.Inject ½ inch (1.25 cm) from the umbilicus. 3.Massage the injection site after administration. 4.Avoid aspirating prior to injecting the medication.

4.Avoid aspirating prior to injecting the medication. Rationale: Aspiration should be avoided before injecting the heparin because it can cause hematoma at the administration site. Heparin sodium administered subcutaneously does not require an infusion device and is injected at least 2 inches (5 cm) from the umbilicus or any scar tissue. The needle is withdrawn rapidly, and the site is not massaged (although pressure is applied).

A client with chronic kidney disease is receiving ferrous sulfate. The nurse instructs the client that which finding is a common side/adverse effect associated with this medication? 1.Fatigue 2.Headache 3.Weakness 4.Constipation

4.Constipation Ferrous sulfate is an iron supplement used to treat anemia. Constipation is a frequent and uncomfortable side effect associated with the administration of oral iron supplements. Stool softeners often are prescribed to prevent constipation. Options 1, 2, and 3 are not side or adverse effects associated with this medication.

The nurse is preparing to care for a client with chronic kidney disease and anemia. Which describes the relationship between chronic kidney disease and anemia? 1.Lack of angiotensin I may cause anemia. 2.Increased production of aldosterone leads to anemia. 3.Anemia is caused by insufficient production of renin. 4.Decreased production of erythropoietin is causing anemia.

4.Decreased production of erythropoietin is causing anemia. Rationale: Clients with chronic kidney disease do not manufacture adequate amounts of erythropoietin, which is a glycoprotein needed to synthesize red blood cells.

The nurse is caring for a client who was just admitted to the hospital for the treatment of iron overload. The nurse anticipates that the health care provider will prescribe which medication to treat the iron overload? 1.Terbinafine 2.Granisetron 3.Ketoconazole 4.Deferoxamine

4.Deferoxamine Rationale: Deferoxamine is a medication used to treat iron overload.

The nurse is preparing to administer filgrastim by intravenous (IV) infusion. Which nursing action is the most appropriate for administering this medication? 1.Shake the solution before drawing it up. 2.Dilute the medication in normal (0.9%) saline. 3.Discard the medication if it has been refrigerated. 4.Dilute the medication in 5% dextrose in water (D5W).

4.Dilute the medication in 5% dextrose in water (D5W). Rationale: Filgrastim may be administered by continuous IV infusion. It is diluted only with D5W when administered by the IV route. The solution should not be shaken. It should be stored in a refrigerator and should be discarded if it has been exposed to room temperature for more than 6 hours.

The nurse is monitoring a client who is receiving epoetin alfa for adverse effects of the medication. Which finding indicates a side/adverse effect? 1.Diarrhea 2.Depression 3.Bradycardia 4.Hypertension

4.Hypertension Rationale: Epoetin alfa generally is well tolerated. The most significant adverse effect is hypertension, and its use is contraindicated in uncontrolled hypertension. Occasionally a tachycardia may occur as a side effect. This medication also may cause an improved sense of well-being.

The nurse is preparing to administer filgrastim to a client with a diagnosis of agranulocytosis. The client asks the nurse about the purpose of the medication. Which information should the nurse include in the response regarding action of this medication? 1.It prevents bleeding. 2.It prolongs the clotting time. 3.It increases the red blood cell count. 4.It promotes the growth of neutrophils.

4.It promotes the growth of neutrophils. Rationale: Filgrastim is a granulocyte colony-stimulating factor produced by human recombinant DNA. It is administered to clients with agranulocytosis to promote the growth of neutrophils and enhance the function of mature neutrophils. Options 1, 2, and 3 are not actions of this medication.

The nurse is reviewing the laboratory test results for a client who is receiving filgrastim. Which reported value would indicate an effective response to this medication? 1.Hematocrit of 42% (0.42) 2.Blood glucose level of 110 mg/dL (6 mmol/L) 3.Platelet count of 150,000 mm3 (150 × 109/L) 4.Neutrophil count of 10,000 mm3 (10 × 109/L)

4.Neutrophil count of 10,000 mm3 (10 × 109/L) Rationale: Filgrastim is used to promote the growth of neutrophils and enhance the function of mature neutrophils. Treatment is continued until the absolute neutrophil count reaches 10,000 cells/mm3. Options 1, 2, and 3 are unrelated to the action of this medication.

A client is scheduled to have alteplase. Which item should the nurse obtain to monitor side/adverse effects of the medication therapy? 1.Flashlight 2.Pulse oximeter 3.Suction equipment 4.Occult blood test strips

4.Occult blood test strips Rationale: Alteplase is a thrombolytic medication that dissolves thrombi or emboli. Bleeding is a frequent and potentially severe adverse effect of therapy. The nurse assesses for signs of bleeding in clients receiving this therapy using occult blood test strips to test urine, stool, or nasogastric drainage. A flashlight is used for pupil assessment as part of the neurological examination in the client who is neurologically impaired. Pulse oximeter and suction equipment would be needed if the client had evidence of oxygenation or respiratory problems.

A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence? 1.Insufficient dosage of the medication, which needs to be increased 2.Probable interaction of this medication with an over-the-counter cold remedy 3.Tolerance to the medication, indicating a need for a stronger type of bronchodilator 4.Paradoxical bronchospasm, which must be reported to the health care provider (HCP)

4.Paradoxical bronchospasm, which must be reported to the health care provider (HCP) Rationale: The client taking adrenergic bronchodilators may experience paradoxical bronchospasm, which is evidenced by the client's wheezing. This can occur with excessive use of inhalers. Further medication should be withheld and the HCP should be notified. The remaining options are incorrect interpretations.

The nurse is performing an assessment on a client with a diagnosis of pernicious anemia. Which finding would the nurse expect to note in this client? 1.Dyspnea 2.Dusky mucous membranes 3.Shortness of breath on exertion 4.Red tongue that is smooth and sore

4.Red tongue that is smooth and sore Rationale: Classic signs of pernicious anemia include weakness, mild diarrhea, and a smooth red tongue that is sore.

The primary health care provider writes a prescription for atorvastatin for a client who was admitted to the hospital. The nurse should contact the primary health care provider and verify the prescription if which condition is noted in the assessment data? 1. Cirrhosis of the liver 2. Chronic heart failure 3. Hypertriglyceridemia 4. Coronary artery disease

1. Cirrhosis of the liver Rationale: Atorvastatin is a 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitor used to treat hypercholesterolemia and hypertriglyceridemia. Contraindications to the medication include active liver disease, unexplained elevated liver function tests, pregnancy, and lactation. The items noted in options 2, 3, and 4 are not contraindications to this medication.

The nurse has completed client teaching on use of thrombolytic medications in acute ischemic stroke. The nurse determines that the educational session was effective if the client states that thrombolytics are used for what purpose? 1.To dissolve clots 2.To prevent ischemia 3.To prevent bleeding 4.To decrease anxiety

1. To dissolve clots

The primary health care provider writes a prescription for atenolol for a client who was admitted to the hospital. The nurse should contact the primary health care provider and verify the prescription if which finding is noted in the assessment data? 1. Temperature is 100.1° F (37.8° C). 2. Apical heart rate is 48 beats/min. 3. Blood pressure is 118/72 mm Hg. 4. Pedal pulses are bounding and strong

2. Apical heart rate is 48 beats/min.

Atorvastatin has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1."This medication will lower my cholesterol level." 2."I will need to have blood tests drawn while I am taking this medication." 3."I won't need to adhere to a low-fat diet as long as I take this medication faithfully." 4."I need to talk to the health care provider before taking any over-the-counter medications."

3."I won't need to adhere to a low-fat diet as long as I take this medication faithfully."

The nurse has a prescription to administer a dose of iron by the intramuscular route to the client. What are the most appropriate nursing actions? Select all that apply. 1.Use a Z-track method. 2.Administer the medication only in the deltoid. 3.Aspirate for blood after the needle is inserted. 4.Use an air lock when drawing up the medication. 5.Change the needle after drawing up the dose and before injection. 6.Massage the injection site well after injection to hasten absorption.

1.Use a Z-track method. 4.Use an air lock when drawing up the medication. 5.Change the needle after drawing up the dose and before injection. Rationale: An air lock and a Z-track method should both be used when administering iron by the intramuscular route. Proper technique includes changing the needle after drawing up the medication but before giving it to prevent staining of skin. Only the dorsogluteal site should be used, and proper identification of appropriate landmarks is essential. The site should not be massaged after injection because massaging could cause staining of the skin.

The nurse is caring for a client with a diagnosis of venous thrombosis in the left lower leg who is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should monitor the client for which manifestation indicating an adverse effect of this therapy? 1. Nausea 2. Dark Urine 3. Left Calf Tenderness 4. Increased Blood Pressure

2. Dark Urine Rationale: The client who receives heparin sodium is at risk for bleeding. The nurse monitors for signs of bleeding, which include bleeding from the gums, ecchymoses on the skin, red or dark urine, black or red stools, and body fluids that test positive for occult blood. Tenderness is likely to be noted in the area of the thrombosis. Nausea and increased blood pressure are not signs of an adverse effect of the medication.

The primary health care provider prescribes diphenhydramine to be administered to a client before a blood transfusion. The nurse should tell the client that this medication has been prescribed to have which therapeutic effect? 1. Prevent chills and a fever 2. Prevent an urticarial reaction 3. Assist in the absorption of the blood product 4. Promote movement of the red blood cells into the bone marrow

2. Prevent an urticarial reaction Rationale: An urticarial reaction is characterized by a rash accompanied by pruritus (itching). This type of transfusion reaction is prevented by pretreating the client with an antihistamine such as diphenhydramine. Options 1, 3, and 4 are incorrect statements.

A nurse provides dietary instructions to a client who will be taking warfarin sodium. The nurse should tell the client to avoid which food item? 1.Grapes 2.Spinach 3.Watermelon 4.Cottage cheese

2. Spinach Rationale: Warfarin sodium is an anticoagulant. Anticoagulant medications act by antagonizing the action of phytonadione (vitamin K), which is needed for clotting. When a client is taking an anticoagulant, foods high in phytonadione often are omitted from the diet. Phytonadione-rich foods include green leafy vegetables, fish, liver, coffee, and tea.

The nurse is preparing to administer filgrastim to the client. Which route of administration should the nurse determine is the most appropriate for this medication? 1.Oral 2.Subcutaneous 3.Intramuscular 4.Intravenous bolus

2. Subcutaneous Rationale: Filgrastim is a granulocyte colony-stimulating factor produced by human recombinant DNA technology. It is given by subcutaneous injection or continuous intravenous infusion.

The clinic nurse notes that a client is taking metoprolol. The nurse should perform which assessment to determine medication effectiveness? 1. Take the client's temperature 2. Take the client's blood pressure 3. Check the client's peripheral pulses 4. Check the client's eyes for peripheral vision

2. Take the client's blood pressure Rationale: HomeHelpCalculatorIndicate Strategies Study Mode Question 13 of 112 QN: 139 | ID: 139 PreviousGoNext StopBookmark Rationale Strategy Nursing Tip Submit The clinic nurse notes that a client is taking metoprolol. The nurse should perform which assessment to determine medication effectiveness? Rationale:Metoprolol is a β-blocker that is used to treat mild-to-moderate hypertension. Therefore, to determine medication effectiveness, the nurse should monitor the client's blood pressure. Options 1, 3, and 4 are unrelated to medication effectiveness.

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should notify the primary health care provider if which finding is noted? 1.Weakness 2.Tarry stools 3.Decreased pulse rate 4.Increased blood pressure

2. Tarry stools Rationale: The client who receives a continuous IV infusion of heparin sodium is at risk for bleeding. The nurse assesses for signs of bleeding, which include bleeding from the gums, ecchymoses on the skin, cloudy or pink-tinged urine, tarry stools, and body fluids that test positive for occult blood. The other options are not related adverse effects of this medication.

A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. Adequate learning would be evident if the client makes which statements? Select all that apply. 1."I may take over-the-counter medications as needed." 2."I will inform my dentist that I am taking this medication." 3."I should alternate the timing of my daily dose of this medication." 4."I should use a firm-bristled toothbrush to prevent the side effects of this medication." 5."I will have my blood levels checked as prescribed by my health care provider (HCP)." 6."I will report any signs of blood in my urine or stool to my health care provider (HCP)."

2."I will inform my dentist that I am taking this medication." 5."I will have my blood levels checked as prescribed by my health care provider (HCP)." 6."I will report any signs of blood in my urine or stool to my health care provider (HCP)."

When obtaining assessment data from a client with a microcytic normochromic anemia, which should the nurse question the client about? 1.Folic acid intake 2.Dietary intake of iron 3.A history of gastric surgery 4.A history of sickle cell anemia

2.Dietary intake of iron

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should notify the health care provider if ongoing nursing assessment reveals which finding? 1.Tinnitus 2.Ecchymosis 3.Increased pulse rate 4.Increased blood pressure

2.Ecchymosis (a bruise) Rationale: The client who receives a continuous IV infusion of heparin sodium is at risk for bleeding. The nurse assesses for signs/symptoms of bleeding, which include bleeding from the gums, ecchymosis on the skin, cloudy or pink-tinged urine, tarry stools, and body fluids that test positive for occult blood. The other options are not side or adverse effects related to this medication.

Atorvastatin has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? 1.Neutrophil count 2.Liver function studies 3.White blood cell (WBC) count 4.Complete blood cell (CBC) count

2.Liver function studies Rationale: Metabolized in the liver

Atorvastatin has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond? 1. "It increases plasma cholesterol." 2. "It increases plasma triglycerides." 3. "It decreases low-density lipoproteins (LDLs)." 4. "It decreases high-density lipoproteins (HDLs)."

3. "It decreases low-density lipoproteins (LDLs)." Rationale: Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. It decreases LDL cholesterol and plasma triglycerides and increases HDL cholesterol (the good cholesterol). The remaining options are not actions of this medication.

A client scheduled to take a subcutaneous anticoagulant at home says to the nurse, "I'm not sure I will be able to take this medication at home." Which statement by the nurse is appropriate? 1. "Maybe your spouse can give you your shots." 2. "You'll be fine once you get used to giving your own shots." 3. "What are your concerns about taking this medication at home?" 4. "Don't worry. Your health care provider knows what's best for you."

3. "What are your concerns about taking this medication at home?"

A client is diagnosed with iron deficiency anemia, and ferrous sulfate is prescribed. The nurse should tell the client that it would be best to take the medication with which food? 1.Milk 2.Boiled egg 3.Tomato juice 4.Pineapple juice

3. Tomato juice Rationale: Ferrous sulfate is an iron preparation, and the client is instructed to take the medication with orange juice or another vitamin C-containing product or a product high in ascorbic acid to increase the absorption of the iron. Among the options presented, tomato juice is highest in vitamin C and ascorbic acid. Milk and eggs inhibit absorption of iron.

A client taking albuterol by inhalation cannot cough up secretions. What should the nurse suggest that the client do to assist in expectoration of secretions? 1.Get more exercise each day. 2.Use a dehumidifier in the home. 3.Drink increased amounts of fluids every day. 4.Take an extra dose of albuterol before bedtime.

3.Drink increased amounts of fluids every day.

A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication? 1.Thrombolytics suppress the production of fibrin. 2.Thrombolytics act to prevent thrombus formation. 3.Thrombolytics act to dissolve thrombi that have already formed. 4.Thrombolytics have been proved to reverse all detrimental effects of heart attacks.

3.Thrombolytics act to dissolve thrombi that have already formed. Rationale: Thrombolytics are most effective when started within 4 to 6 hours after symptom onset and act to dissolve or lyse existing thrombi that are causing a blockage. The remaining options are incorrect.

The nurse is preparing to administer heparin sodium subcutaneously. Which nursing action is the most appropriate? 1.Apply heat after the injection. 2.Use a 21- to 23-gauge, 1-inch (2.5 cm) needle. 3.Use a 25- to 26-gauge, ⅝-inch (1.5 cm) needle. 4.Aspirate before injection of the medication.

3.Use a 25- to 26-gauge, ⅝-inch (1.5 cm) needle. Rationale: For subcutaneous heparin sodium injection, a 25- to 26-gauge, ⅝-inch (1.5 cm) needle is used to prevent tissue trauma and inadvertent intramuscular injection. The application of heat may affect the absorption of the heparin sodium and cause bleeding. A 1-inch (2.5 cm) needle would inject the heparin sodium into the muscle. Aspiration before injection is an incorrect technique with heparin sodium administration because it could cause bleeding in the tissues.

A registered nurse (RN) is orienting a new RN on the use of atorvastatin. Which statement by the new RN indicates that the teaching has been effective? 1. "It is used in heart failure." 2. "It helps to control hypertension." 3. "It helps to reduce episodes of angina pectoris." 4. "It is given to clients with hypercholesterolemia."

4. "It is given to clients with hypercholesterolemia." Rationale: Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. The statements made in the remaining options are incorrect.

The nurse is reviewing heparin infusion therapy and pertinent laboratory values to monitor with the nursing student. Which statement by the student indicates that teaching has been effective? 1."Bleeding time assesses for therapeutic effect of heparin." 2."Thrombin time assesses for therapeutic effect of heparin." 3."Prothrombin time assesses for therapeutic effect of heparin." 4."Partial thromboplastin time assesses for therapeutic effect of heparin."

4. "Partial thromboplastin time assesses for therapeutic effect of heparin." Rationale: The partial thromboplastin time will assess the therapeutic effect of heparin. The prothrombin time is one test that will assess for the therapeutic effect of warfarin. Bleeding time and thrombin time are hematological studies that may be prescribed for clients with coagulopathy or other disorders.

A client who experiences allergic rhinitis asks the nurse about a nasal corticosteroid. How should the nurse reply? 1."Clear the nasal passages after use." 2."Take the medication only as needed." 3."The medication should start to work immediately." 4."The medication works locally and decreases inflammation."

4. "The medication works locally and decreases inflammation." Rationale: Intranasal corticosteroids may be used to treat allergic rhinitis. The medication works locally and decreases inflammation. The client should be instructed to clear the nasal passages before use for best medication effectiveness. The client should take the medication regularly as prescribed in order for the effect to be achieved. The medication may take several days to achieve maximal effect because it works by decreasing inflammation.

The nurse is monitoring the laboratory test results for a client who is taking warfarin sodium after mechanical heart valve replacement. The nurse should expect the international normalized ratio (INR) for this client to be at what value in order to be therapeutic? 1. 0.2 2. 0.5 3. 1.0 4. 3.0

4. 3.0 Rationale: The normal value for INR is 0.81 to 1.2 (0.81 to 1.2). The target INR or therapeutic level for a client receiving warfarin sodium is 2.5 to 3.5 (2.5 to 3.5).

The nurse is administering a dose of intravenous hydralazine to a client. The nurse should ensure that which item is in place before injecting the medication? 1. Central line 2. Foley catheter 3. Pulse oximeter 4. Blood pressure cuff

4. Blood pressure cuff Rationale: Hydralazine is an antihypertensive medication used in the management of moderate to severe hypertension. The blood pressure and pulse should be monitored frequently after administration, so a blood pressure cuff is one item to have in place. The items in the remaining options are not necessary.

The nurse provides instructions to a pregnant client who is preparing to take iron supplements. The nurse should tell the client to take the supplements with which item? 1. Tea 2. Milk 3. Coffee 4. Tomato juice

4. Tomato juice Rationale: Foods containing ascorbic acid will increase the absorption of iron. Calcium and phosphorus in milk and tannin in tea decrease iron absorption. Coffee binds iron and prevents it from being fully absorbed. Tomato juice is the only item that contains ascorbic acid and will increase the absorption of iron supplements.