Test 2 RX Questions.

The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? SELECT ALL THAT APPLY 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred vision 5. Nausea and vomiting

2 Diarrhea 4.Blurred vision 5. nausea and vomiting Rationale: Digoxin (Lanoxin) is a cardiac glycoside. The risk of toxicity can occur with the use of this medication. Toxicity can lead to life-threatening events and the nurse needs to monitor the client closely for signs of toxicity. Early signs of toxicity include gastrointestinal manifestations such as anorexia, nausea, vomiting, and diarrhea. Subsequent manifestations include headache; visual disturbances such as diplopia, blurred vision, yellow-green halos, and photophobia; drowsiness; fatigue; and weakness. Cardiac rhythm abnormalities can also occur. The nurse also monitors the digoxin level. Therapeutic levels for digoxin range from 0.5-2ng/ml

Variable deceleration caused by

Cord compression

A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication? 1.coffee, cola and chocolate 2. oysters, lobster and shrimp 3. melons, oranges and pineapple 4. cottage cheese, cream cheese and dairy creamers

1. Coffee, cola and chocolate Theophylline is a methylxanthine bronchodilator. the nurse teaches the client to limit the intake of xanthine-containing foods while taking the medication. these foods include coffee, cola and chocolate.

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side and adverse effects of the medication should the nurse monitor? Select all that apply. 1. signs of hepatitis 2. flu like symptoms 3. low neutrophil count 4. vitamin b6 deficiency 5. ocular pain or blurred vision 6. tingling and numbness of fingers.

1. signs of hepatitis 2. flu like symptoms 3. low neutrophil count 5. ocular pain or blurred vision rifabutin may be prescribed for client with active MAC disease and TB. it inhibits mycobacterial DNA-dependent RNA polymerase and suppress protein synthesis. side and adverse effects include rash, GI disturbances, neutropenia (low neutrophil count), red-orange colored body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea and flu like symptoms.

The nurse is planning to administer hydrochlorothiazide to a client. The nurse understands that which is a concern related to the administration of this medication? 1. Sulfa allergy 2. Osteoporosis 3. Hypokalemia 4. Hypouricemia 5. Hyperglycemia 6. Hypercalcemia

1.sulfa allergy 3..Hypokalemia, 5 Hyperglycemia, 6..Hypercalcemia Rationale: Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.

The nurse in monitoring a client who is taking propranolol. Which assessment data indicates a potential adverse complication associated with this medication? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline BP of 150/80mmHg followed by a BP of 138/72mmHg after two doses of the medication 4. A baseline resting HR of 88bpm followed by a resting HR of 72bmp after two doses of the medication

2. The development of audible expiratory wheezes Rationale: Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. B-blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in BP and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored.

A client has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? 1. diarrhea 2. heartburn 3. flatulence 4. constipation

2. heartburn Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation (heartburn). Omeprazole is not used to treat 1, 3 or 4

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesia, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1.hypercalemia 2. peripheral neuritis 3. small blood vessel spasm 4. impaired peripheral circulation

2. peripheral neuritis isoniazid is an antitubercular medication. common side effects are peripheral neuritis, manifested by numbness tingling and paresthesia in the extremities. this can be minimized with pyridozine b6 intake.

A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2. Checking the frequency and consistency of bowel movements 3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed

2.Checking the frequency and consistency of bowel movements Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea.

Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical history for which disorder in which the medication should be used with caution? 1.osteoarthritis 2. hypothyroidism 3. diabetes mellitus 4. polycystic disease

3. Diabetes mellitus is contraindicated in client with hypersensitivity to sympathomimetics. it should be used with caution in clients with impaired cardiac function, Diabetes mellitus, hypertension, hyperthyroidism, or history of seizures.

A client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication? 1. constipation 2. abdominal pain 3. an episode of diarrhea 4. hematest-positive nasogastric tube drainage

3. an episode of diarrhea Rationale- Loperamide is an antidiarrheal agent. It is used to manage acute and chronic diarrhea in condition such as IBS. Loperamide can also be used to reduce volume of drainage from an ileostomy.

A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed? 1. Electrolytes levels 2. coagulation times 3. liver enzyme levels 4. serum creatinine level

3. liver enzyme levels Isoniazid therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore, liver enzymes levels are monitored when therapy is initiated and during the first 3 months of therapy.

The home health care nurse is visiting a client with Coronary artery disease with elevated triglyceride levels and a serum cholesterol level of 398mg/dl. The client is taking cholestyramine. Which statement, by the client, indicates the NEED FOR FURTHER EDUCATION? 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 two most common side effects/ Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.

A client has an as needed prescription for ondansetron. For which condition should the nurse administer this medication? 1. paralytic ileus 2. incisional pain 3. urinary retention 4. Nausea and Vomiting

4. Nausea and vomiting Rationale- Ondansetron is an antiemetic used to teat postop nausea and vomiting as well as N/V associated with chemotherapy.

A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse should schedule the medication for which times? 1. with meals and at bedtime 2. every 6 hours around the clock 3. one hour after meals and at bedtime 4. one hour before meals and at bedtime

4. One hour before meals and at bedtime. Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hr before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation.

A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication? 1. insomnia 2. constipation 3. hypotension 4. bronchospasm

4. bronchospam is a inhaled nonsteroidal antiallergy agent and a mast cell stabilizer. undesirable effects associated with this are bronchospasms, cough, nasal congestion, throat irritation, and wheezing

A client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. intestinal obstruction 2. peptic ulcer with melena 3. diverticulitis with perforation 4. vomiting following cancer chemotherapy

4. vomiting following cancer chemotherapy metoclopramide is a GI stimulant and antiemetic. Because its a GI Stimulant, it is contraindicated with GI obstruction, hemorrhage, or perforation. It is used in the treatment of vomiting after surgery, chemotherapy or radiation.

Early deceleration caused by

Fetal head compression

The nurse is monitoring a client in preterm labor who is receiving IV magnesium sulfate. The nurse should monitor for which adverse effect of this medication Flushing HTN Increased urine output depressed respirations Extreme muscle weakness Hyperactive deep tendon reflexes

Flushing depressed respirations Extreme muscle weakness Magnesium sulfate is a central nervous system depressant and relaxes smooth muscle including the uterus. It is used to halt preterm labor contractions and is used for preeclamptic clients to prevent seizures. Adverse effects include flushing, depressed respirations, depressed deep tendon reflexes, hypotension, extreme muscle weakness, decreased urine output, pulmonary edema, and elevated serum magnesium levels

The nurse asked the nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates the need for further teaching? I will flush the eyes after instilling the ointment I will clean the newborns eyes before instilling the ointment I need to administer the eye ointment within one hour after delivery I will instill the eye ointment into each of the newborn conjunctival sacs

I will flush the eyes after instilling the ointment Eye prophylactics protects the newborn against gonorrhea and chlamydia. The eyes are not flush after installation of the medication because that flush would wash away the administered medication. Options 2, 3 and four are correct statements regarding the procedure for administering a medication to the newborn

A nurse is preparing to administer exogenous surfactant to a premature infant who has respiratory distress syndrome. The nurse prepares to administer the medication by which route? Intradermal, intratracheal, subcutaneous, or intramuscular

Intratracheal Respiratory distress syndrome is a serious lung disorder caused by immaturity and the inability to produce surfactant resulting in hypoxia and acidosis. It is common in premature infants and may be due to lung immaturity as a result of surfactant deficiency. The mainstay of treatment is the administration of Exogenous surfactant which is administered by intratracheal route.

IV heparin therapy is prescribed for a client with atrial fibrillation. While implementing this prescription the nurse ensures that which medication is available on nursing unit? Vitamin K Protamine sulfate Potassium chloride Amino caproic acid

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

A client receiving thrombolytic therapy with a continuous infusion of Alteplase suddenly becomes extremely anxious and reports itching. The nurse hears stridor and notes generalized urticaria and hypotension. Which intervention should the nurse anticipate? Select all that apply. Stop the infusion Raise the head of the bed Administer protamine sulfate Administer diphenhydramine Call for the rapid response team

Stop the infusion Administer diphenhydramine Call for the rapid response team The client is experiencing anaphylactic reaction. Therefore the priority action is to stop the infusion and notify the RRT. The client may be treated with anti-histamines. Raising the head of the bed would not be helpful as that may exacerbate the hypotension. Protamine sulfate is the antidote for heparin so it is not useful for a patient receiving alteplase.

The nurse is monitoring a client who is receiving oxytocin to induce labor. Which assessment findings should cause the nurse to immediately discontinue the oxytocin infusion? Fatigue Drowsiness Uterine hyperstimulation Late decelerations of the fetal heart rate Early decelerations of the fetal heart rate

Uterine hyperstimulation Late deceleration of the fetal heart rate Oxytocin stimulates uterine contractions and is a pharmacological method to induce labor. Late decelerations in nonreassuring fetal heart rate pattern is an ominous sign indicating fetal distress. Oxytocin infusion must be stopped with any signs of uterine hyperstimulation, late deceleration or other adverse effects occur. Some obstetricians prescribe the administration of oxytocin in 10 minute pulsed infusions rather than a continuous infusion. This pulse method which is more like endogenous secretion of oxytocin is reported to be effective for labor induction and require significantly less oxytocin use. Drowsiness and fatigue may be caused by the labor experience. Early deceleration of the fetal heart rate are a reassuring sign and do not indicate fetal distress.

An opioid analgesic is administered to a client in labor. The nurse assigned to take care of the client ensures that which medication is readily available should respiration distress occur? Naloxone, morphine sulfate, betamethasone, hydromorphone hydrochloride

naloxone Opioid analgesics may be prescribed to relieve moderate to severe pain associate with labor. Opioid toxicity can occur and cause respiration depression. Naloxone is an opioid antagonist which reverses the effects of opioids and is given for respiratory distress

The nurse determines the client needs further instruction on cimetidine if which statements were made? Select all that apply 1. "i will take the cimetidine with my meals" 2. "i'll know the medication is working if my diarrhea stops" 3. "my episodes of heartburn will decrease if the medication is effective" 4. "taking the cimetidine with an antacid will increase its effectiveness" 5. "i will notify my HCP if i become depressed or anxious" 6. "some of my blood levels will need to be monitored closely since i also take warfarin for atrial fibrillation"

1. "i will take the cimetidine with my meals" 2. "i'll know the medication is working if my diarrhea stops" 4. "taking the cimetidine with an antacid will increase its effectiveness" Cimetidine, a Histamine (h2) receptor antagonist, helps alleviate the symptom of heartburn, not diarrhea. Because Cimetidine crosses the blood-brain barrier, CNS side and adverse effects, such as mental confusion, agitation, depression, and anxiety can occur. Food reduces the rate of absorption, so if cimetidine is taken with meals, absorption will be slowed. Antacids decrease the absorption of cimetidine and should be taken a t least 1 hour apart. If cimetidine is concomitantly administered with warfarin Therapy, warfarin dose may need to be reduced, so prothrombin and INR results must be followed.

A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action? 1. use alcohol in small amounts only. 2. report yellow eyes or skin immediately 3. increase intake of swiss and aged cheeses 4. avoid vitamin supplements during therapy.

2. report yellow eyes and skin immediately med is hepatotoxic ..

The nurse is caring for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client should the nurse note as an expected side effect of this combination medication? 1. I feel like my heart is racing 2. I feel more bloated than usual 3. My eyes have been watering lately 4. I haven't had a bowel movement in 4 days.

1. I feel like my heart is racing. Albuterol/ipratropium is a combination agent- one is b2-adrenergic agonist and the other is an anticholinergic medication, in combination they produce an overall bronchodilation effect. common side effects include headache, dizziness, dry mouth, tremors, nervousness and tachycardia.

The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? 1. I must take the medication exactly as prescribed 2 Once I start the medication, I will no longer be contagious 3. I will not get any colds or infections while taking this medication 4. This medication has minimal side effects and I can return to normal activities.

1. I must take the medication exactly as prescribed. Antiviral Medications for influenza must be taken exactly as prescribed. these medications do not prevent the spread of influenza, and clients are usually contagious for up to 2 days after the initiation of antiviral meds. Secondary Bacterial infections may occur despite antiviral treatments. side effects occur with these meds and may necessitate change in activities

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. 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 are 20-36 seconds. Because the activated partial thromboplastin time should be 1.5-2.5 times the normal value, the client's activated partial thromboplastin time would be considered therapeutic if it was 60 seconds.

A client with Valvular heart Disease who has a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hr and warfarin 7.5mg at 5pm daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT) = 32 seconds; internationalized normalized ratio (INR) = 1.3. The nurse should plan to 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 (Coumadin) for clot prevention due to atrial fibrillation, an INR of 2-3 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 60-80 seconds. Therefore, the nurse should collaborate with the health care provider to obtain a prescription to increase the heparin infusion and to administer the warfarin as prescribed.

A client who uses NSAIDs has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted? 1. resolved diarrhea 2. relief of epigastric painterm-30 3. decreased platelet count 4. decreased WBC count

2. Relief of epigastric pain Clients who use NSAIDs are prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence in clients taken NSAIDs frequently. Diarrhea can be a side effect of the medication but is not an intended effect.

the nurse teaches a client about the effects of diphenhydramine, which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement? 1. i will take the medication on an empty stomach 2. i wont drink alcohol while taking this medication 3. i wont do activities that require mental alertness while taking this medication 4. i will us sugarless gum, candy, or oral rinses to decrease dryness in my mouth

2. i will take this medication on an empty stomach

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 then the salmeterol 2. salmeterol first 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 then the beclomethasone salmeterol is an adrenergic type of bronchodilator, and beclomethasone dipropionate is a glucocorticoid. bronchodilators are always administered before glucocorticoids when both are given on the same time schedule. this allows widening of the airs passages by the bronchodilator which then makes the glucocorticoid to work more effective.

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen? 1. "my ulcer will heal because these medications will kill the bacteria" 2. "these medications are only taken when I have pain from my ulcer" 3. "the medications will kill the bacteria and stop the acid production" 4. "these medications will coat the ulcer and decrease the acid production in my stomach"

3. "the medication will kill the bacteria and stop the acid production" Triple therapy for H. Pylori infection usually includes 2 antibacterial meds and a proton pump inhibitor. They will kill the bacteria and decrease acid production.

An older client recently has been taking cimetidine. The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1. tremors 2. dizziness 3. confusion 4. hallucinations

3. Confusion Cimetidine is an Histamine (h2)-receptor antagonist. Older clients are especially susceptible to CNS side effects from cimetidine. Most frequently Confusion. . less common CNS side effects include headaches, dizziness, drowsiness and hallucinations.

A client is diagnosed with a ST-segment elevation myocardial infarction (STEMI) and is receiving 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 psychological 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.

A client has been started on long-term therapy with rifampin. The nurse should provide which information to the client about the medication? 1.should always be taken with food or antacids 2. should be dosed if 1 dose is forgot 3. causes orange discoloration of sweat, tears, urine and feces 4. may be discontinued independently if symptoms are gone in 3 months.

3. causes orange discoloration of sweat, tears, urine and feces rifampin causes orange-red discoloration of body secretions and will stain soft contacts lenses permanently.

Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. platelet count 2. neutrophil count 3. liver function test 4. complete blood count

3. liver function test zafirlukast is a leukotriene receptor antagonist used in the prophylaxis and long term treatment of bronchial asthma. zafirlukast should with caution in clients with impaired hepatic function.

A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. weight loss 2. relief of heartburn 3. reduction of steatorrhea 4. absence of abdominal pain

3. reduction of steatorrhea Pancrelipase is a pancreatic enzyme use in clients with pancreatitis as an digestive aid. This medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. Its use could result in weight gain.

A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action? 1. take an extra dose if fever develops 2. take the medication with meals only 3. take the table with a full glass of water 4. decrease the amount of daily fluids

3. take with full glass of water Guaifenesin is an expectorant and should be taken with full glass of water to decrease the viscosity of secretions . client should call pcp if cough is longer than a week.

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take FIRST? 1. Obtain a 12-lead EKG immediately rhythm strip 2. Check patients fingerstick blood glucose level 3. Auscultate the client's apical pulse and obtain a BP 4. measure QRS interval duration on the rhythm strip

3.Auscultate the clients apical pulse and obtain a bp Rationale: Signs of toxicity from procainamide include confusion, dizziness, drowsiness, decreased urination, nausea, vomiting, and tachydysrhythmias. If the client complains of dizziness, the nurse should assess the vital signs first. Although measuring the heart rate on the rhythm strip and obtaining a 12-lead EKG may be interventions, these would be done after the vital signs are taken. Nitroglycerin is a vasodilator and will lower the BP.

The nurse provides discharge instructions to a client who is taking warfarin sodium (Coumadin). 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 Medic-Alert bracelet" 4. " I will take coated Aspirin for my headache because it will coat my stomach"

4. " I will take coated Aspirin for my headache because it will coat my stomach" Rationale: Ecotrin is an aspirin-containing product and should be avoided. Alcohol consumption should be avoided by a client taking warfarin sodium. Taking prescribed medication at the same time each day increases client compliance. The Medic-Alert bracelet provides health care personnel emergency information.

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3mEq/L and is complaining of anorexia. The health care provider prescribes determination of the serum digoxin level to rule out digoxin toxicity. The nurse checks the results and should recognize which level is outside the therapeutic range? 1. 0.5ng/mL (0.63nmol/L) 2. 0.8ng/mL (1.02nmol/L) 3. 0.9ng/mL (1.14nmol/L) 4. 2.2ng/mL ( 2.8nmol/L)

4. 2.2ng/mL The optimal therapeutic range for digoxin is 0.5-2.0ng/Ml. if the client is experiencing symptoms such as anorexia and is experiencing hypokalemia as evidence by a low potassium level, digoxin toxicity is a concern.

The nurse has just administered the first dose of omalizumab to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect? 1. I have a severe headache 2. My feet are quite swollen 3. I am nauseated and may vomit 4. My lips and tongue are swollen

4. My lips and tongue are swollen Omalizumab is an anti-inflammatory and monoclonal antibody used for long term control of asthma. anaphylactic reactions can occur with the administration of Omalizumab. nurse should monitor for signs of adverse reactions of the medication. .

The nurse provides instructions to a client about nicotinic acid prescribe for hyper lipidemia. Which statement by the client indicates understanding of the instructions? The medication should be taken with meals to decrease flushing. It is not necessary to avoid the use of alcohol when taking nicotinic acid Clay colored stools are a common side effect and should not be of concern. Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing.

Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing. Flushing is an adverse effect of the medication. Aspirin or an NSAID as prescribed 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 sign of hepatic dysfunction and should be reported to the primary healthcare provider immediately.

Methylgonovine is prescribed for a client with postpartum hemorrhage. Before administering the medication the nurse should contact the obstetrician who prescribed this medication if which condition is documented in the clients medical history? Hypotension, hypothyroidism, diabetes, peripheral vascular disease

Peripheral vascular disease. Methylergonovine is an ergot alkaloid used to treat postpartum hemorrhage. Ergot alkaloids are contraindicated in clients with significant cardiovascular disease, peripheral vascular disease, hypertension, preeclampsia, or eclampsia. These conditions are worsened by vasoconstrictive effects of the ergo alkaloids.

Late deceleration caused by

Placental insufficiency

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines the client is experiencing toxicity from the medication if which of the following findings are noted on the assessment? Select all that apply Proteinuria of 3+ Respirations of 10 breaths per minute Presence of deep tendon reflexes Urine output of 20 mL in an hour Serum magnesium of 4

Respirations of 10 breaths per minute Urine output of 20 mL in an hour Magnesium toxicity can occur from magnesium sulfate therapy. Signs of magnesium sulfate toxicity relate to the central nervous system depressant effects of the medication and include respiratory distress loss of deep tendon reflexes and a sudden decline in fetal heart rate and maternal heart rate and blood pressure. Respirations below 12 breaths per minute is a sign of toxicity. Urine output should be at least 25 to 30 mL per hour proteinuria of 3+ is an expected finding in a client with preeclampsia. Presence of deep tendon reflexes is a normal and expected finding. Therapeutic levels of magnesium are between 4 to7.5.

The nurse administered iv bumetanide to a client being treated for heart failure. Which outcome indicates that the medication has achieved the expected effect? 1. cough becomes productive of frothy pink sputum 2. urine output increases from 10ml/hr to greater than 50ml/hour 3. the serum potassium level changes from 3.8 to 3.1 4. b-type natriuretic peptide BNP factor increases from 200 to 262

2. urine output increases from 10ml/hr to greater than 50ml/hour Bumetanide is a diuretic and expected outcomes include increased UO, decreased crackles, and decreased weight. Potassium loss is a side effect rather than an expected effect of the diuretic. Frothy pink sputum indicates progression to pulmonary edema. a BNP greater than 100 is indicative of heart failure thus a rise from a previous level indicates worsening of the condition.

The nurse has given instructions to a client who has just been prescribed cholestyramine. Which statement by the client indicates a need for further instruction? 1. "I will continue taking vitamin supplements" 2. "this medication will help to lower my cholesterol" 3. "this medication should only be taken with water" 4. "a high fiber diet is important while taking this medication"

3. "this medication should only be taken with water" Cholestyramine is a bile acid sequestrant used to lower the cholesterol level and client compliance is a problem because of its taste and palatability. . The use of flavored products or fruit juices can improve the states. Some of the side effects of bile acid sequestrants include constipation and decreased vitamin absorption.

Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium 9.8mg/dl; serum magnesium 1.2mg/d; serum potassium 4.1mg/dl; serum creatinine 0.9mg/dl. Which result should alert the nurse that the client is at risk for digoxin toxicity? 1. Serum calcium level 2. Serum potassium level 3. Serum creatinine level 4. Serum magnesium level Rationale: An increased risk of toxicity exists in clients with hypercalcemia, hypokalemia, hypomagnesemia, hypothyroidism, and impaired renal function. The calcium, creatinine, and potassium levels are all within normal limits. The normal range for magnesium is 1.6-2.6mg/dl and the results in the correct option are reflective of hypomagnesemia.

4. Serum Magnesium level Rationale: An increased risk of toxicity exists in clients with hypercalcemia, hypokalemia, hypomagnesemia, hypothyroidism, and impaired renal function. The calcium, creatinine, and potassium levels are all within normal limits. The normal range for magnesium is 1.6-2.6mg/dl and the results in the correct option are reflective of hypomagnesemia.

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which finding? 1.impaired sense of hearing 2. gastrointestinal side effects 3. orange-red discoloration of body secretions 4. difficulty in discriminating the color red from green

4. difficultly in discriminating the color red from green ethambutol causes optic neuritis, which decreases visual acuity and the ability to discriminate between the colors red and green. this poses a potential safety hazard when a client is driving. client needs to report symptom to the doctor ASAP. impaired hearing is from streptomycin not ethambutol.

Rh immune globulin is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines if a woman understands the purpose if the woman states that it will protect her next baby from which condition? Having Rh positive blood Developing a rubella infection Developing physiological jaundice Being affected by Rh incompatibility

Being affected by Rh incompatibility Rh incompatibility can occur when Rh negative mother become sensitized to Rh antigen. Sensitization may develop when Rh negative woman becomes pregnant with a fetus who is Rh positive. During pregnancy and at delivery some of the fetus is Rh positive blood can enter the maternal circulation causing the mothers immune system to form antibodies against Rh positive blood. Administration of Rh immune globulin prevents the mother from developing antibodies against Rh positive blood by providing passive antibody protection against the Rh antigen

A client in preterm labor at 31 weeks who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the clients labor can be inhibited for the next 48 hours the nurse anticipate a prescription for which medication? Nalbuphine Betamethasone Rh immune globulin Dinoprostone vaginal insert

Betamethasone Betamethasone a glucocorticoid is given to increase the production of surfactant to stimulate fetal lung maturity. It is ministered to client in preterm labor at 28 to 32 weeks of gestation of labor can be inhibited for 48 hours.

Methlergonovine is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine what is the priority assessment? Uterine tone Blood pressure Amount of lochia Deep tendon reflexes

Blood pressure methylgonovine an ergot alkaloid is used to prevent or control postpartum hemorrhage by contracting the uterus. It causes continuous uterine contractions and may elevate the blood pressure. A priority assessment before the administration of this medication is to check the blood pressure. The doctor needs to be notified if hypertension is present

The nurse should report which assessment finding to the primary healthcare provider before initiating thrombolytic therapy in a client with pulmonary embolism Adventitious breath sounds Temperature of 99.4° orally Blood pressure of 198/110 Respiratory rate of 28 breaths per minute

Blood pressure of 198/110 Thrombolytic therapy is contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage. Therefore the nurse should report the results of the blood pressure to the healthcare provider before initiating therapy

the nurse is preparing to administer a dose of naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed? 1. nasogastric tube 2. paracentesis tray 3. resuscitation equipment 4. central line insertion tray.

Resuscitation equipment the nurse administering naloxone for suspected opioid overdose should have the resuscitation equipment readily available to support naloxone therapy if needed.