250 Pharm Final
Which medication is prescribed to an infant with congenital syphilis? 1 Vidarabine 2 Intravenous (IV) penicillin (Pfizerpen) 3 Pyrimethamine 4 Trimethoprim-sulfamethoxazole
2 IV Pencillin (Pfizerpen) Rationale: IV penicillin destroys the cell wall of Treponema pallidum, the causative organism of syphilis.
Aspirin is prescribed for a client with rheumatoid arthritis. Which clinical indicators of aspirin toxicity should the nurse teach the client to report? Select all that apply. 1 Bradycardia 2 Joint pain 3 Blood in the stool 4 Ringing in the ears 5 Increased urine output
3 Blood in the stool 4 Ringing in the ears Rationale: Blood in the stool indicates gastrointestinal irritation and may have resulted from the anticoagulant effect of aspirin. Salicylates, such as aspirin, can cause ototoxicity (affects cranial nerve), which may manifest as ringing in the ears (tinnitus) or muffled hearing and it should be reported.
Levothyroxine 0.125 mg by mouth is prescribed for a client with hypothyroidism. The only tablets available contain 25 mcg per tablet. How many tablets should the nurse administer?
5 tablets 0.125 mg x 100 mcg/1 mg = 125 mcg 125 mcg x 1 tab/25 mcg = 125 mcg x 1 tab/25 mcg= 5 tablets
A nurse understands that after the administration of alprazolam (Xanax) it is important to assess the client for side effects. That will the nurse do INITIALLY? 1 Measure urine output 2 Check the blood pressure 3 Look for abdominal distention 4 Check the size of the pupils frequently
2 Check the blood pressure Rationale: Hypotension is a major side effect of Alprazolam (Xanax) that occurs early in therapy.
Acetaminophen 15 mg/kg is prescribed for a child with a temperature of 102 degree F (38.9 C). How much will the nurse tell the parent to administer if the child weighs 9.6 kg and the acetaminophen strength is 160mg/5 ml?
15 mg x 9.6 kg= 144 mg 144 mg/ 160 mg x 5 mL= 4.5 mL
A client who has been taking the prescribed dose of Zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement? 1 "I have less pain." 2 "I have been sleeping better." 3 "My blood glucose is under control." 4 "My blood pressure is coming down."
2 "I have been sleeping better." Rationale: Zolpidem is a sedative-hypnotic that produces central nervous system depression in the limbic, thalamic, and hypothalamic areas of the brain.
A nurse is administering hydroxyzine to a client. The nurse will monitor the client for which common side effects of this drug? 1 Ataxia and confusion 2 Drowsiness and dry mouth 3 Vertigo and impaired vision 4 Slurred speech and headache
2 Drowsiness and dry mouth Rationale: Hydroxyzine suppresses activity in key regions of the subcortical area of the central nervous system; it also has antihistaminic and anticholinergic affects.
Which medication used to treat urinary incontinence strengthens the urinary sphincters and has anticholinergic action? 1 Midorine 2 Duloxetine 3 Oxybutynin 4 Mirabegron
2 Duloxetine Rationale: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that strengthens urinary sphincters and has anticholinergic action.
Which information from the client's history does the nurse identify as a risk factor for developing osteoporosis? 1 Takes estrogen therapy 2 Receives long-term steroid therapy 3 Has a history of hypoparathyroidism 4 Engages in strenuous physical activity
2 Receives long-term steroid therapy Rationale: Increased levels of steroids will accelerate bone demineralization.
A health care provider prescribes Bisacodyl for a client with cardiac disease. The nurse explains to the client that this drug acts by what mechanism? 1 Producing bulk 2 Softening feces 3 Lubricating feces 4 Stimulating peristalsis
4 Stimulating peristalsis Rationale: Bisacodyl stimulates nerve endings in the intestinal mucosa, precipitating a bowel movement.
Which drug increase the risk of Reye syndrome in children? 1 Aspirin 2 Naloxone 3 Ibuprofen 4 Acetaminophen
1 Aspirin Rationale: Aspirin increases the risk of Reye syndrome in children.
A client with gastroesophageal reflux is to receive metoclopramide 15 mg orally before meals. The concentrated solution contains 10 mg/mL. How much solution should the nurse administer?
1.5 mL 15 mg/10 mg x 1 mL= 1.5 mL
Which medication should the nurse question when it is prescribed for a client with acute pancreatitis? 1 Ranitidine 2 Cimetidine 3 Meperidine 4 Promethazine
3 Meperidine Meperidine should be avoided because accumulation of its metabolites can cause CNS irritability and even tonic-clonic seizures.
A client's medication history includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse reclass that cholinergic medications are prescribed PRIMARILY for what type of urinary condition. 1 Kidney stones 2 Urine retention 3 Spastic bladder 4 Urinary tract infections
2 Urine retention Rationale: Cholinergics intensify and prolong the action of acetylcholine, which increases the tone in the genitourinary tract, preventing urinary retention.
A client is to receive metoclopramide intravenously 30 minutes before initiating chemotherapy for cancer of the colon. The nurse explains that metoclopramide is given for what purpose? 1 Stimulate production of gastrointestinal secretions 2 Enhance relaxation of the upper gastrointestinal tract 3 Prolong excretion of the chemotherapeutic medication 4 Increase absorption of the chemotherapeutic medication
2 Enhance relaxation of the upper gastrointestinal tract Rationale: The relaxation effect increases the passage of food through the gastrointestinal tract, limiting reverse peristalsis, gastroesophageal reflux, and vomiting, all of which are precipitated by chemotherapeutic agents.
A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which drug does the nurse expect the health care provider to prescribe? 1 Psyllium 2 Bisacodyl 3 Loperamide 4 Docusate Sodium
3 Loperamide Rationale: Loperamide inhibits peristalsis and prolongs transit time by its effect on the nerves in the muscle wall of the intestines.
A client who is postoperative hip replacement is receiving morphine by patient-controlled analgesia and has a respiratory rate of 6 breaths/min. What interventions should the nurse anticipate? 1 Nasotracheal suction 2 Mechanical ventilation 3 Naloxone administration 4 Cardiopulmonary resuscitation
3 Naloxone administration Rationale: Naloxone is an opioid antagonist and will reverse respiratory depression caused by opioids.
A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statement? 1 "I need to have my blood work checked periodically." 2 "I need to balance exercise with rest." 3 "I need to change positions slowly." 4 "I need to take the medication between meals."
1 "I need to have my blood work checked periodically." Rationale: If the client will be taking the medication long term, periodic diagnostic tests are necessary because ibuprofen is nephrotoxic, is hepatotoxic, and prolongs the bleeding time.
A nurse is reviewing a newly admitted client's medication administration record (MAR). Which element, if missing, make the record incomplete? 1 Height 2 Allergies 3 Vital signs 4 Body Weight
2 Allergies Rationale: Allergies should be listed on all MARs to prevent the administration of drugs to which the client is allergic.
A nurse administers an intramuscular injection of vitamin K to a newborn. What is the purpose of the injection? 1 It promotes formation of red blood cells 2 It prevents destruction of red blood cells 3 It promotes conjugation of bilirubin 4 It provides protection from hemorrhage
4 It provides protection from hemorrhage Rationale: Vitamin K prevents hemorrhagic disease of the newborn because it activates coagulation factors in the liver.
Which beta-adrenergic blocker is prescribed to clients with glaucoma? 1 Betaxolol 2 Carbachol 3 Brimonidine 4 Methazolamide
1 Betaxolol Rationale: Betaxolol is a beta-adrenergic blocker that is prescribed for glaucoma.
Which client statement indicates to the nurse that a client who is receiving cyanocobalamin (Vitamin B12) therapy for an intrinsic factor deficiency understands the treatment? 1 "I should have a vitamin B12 injection every month." 2 "I'll take my B12 vitamin every morning with my breakfast." 3 "I'll have a salad every day because vitamin B12 is in green vegetables." 4 "I should feel better because my vitamin B12 treatments will improve my aplastic anemia."
1 "I should have a vitamin B12 injection every month." Rationale: Vitamin B12 is administered via injection on a weekly or monthly basis. Vitamin B12 is destroyed by stomach acid and therefore cannot be taken in pill form.
What should the nurse keep in mind when administering a benzodiazepine to a client? 1 The medication can cause rebound insomnia if it is discontinued abruptly. 2 The medication should be administered cautiously for infants less than 6 months old. 3 The medication should be administered in higher dosage if the client becomes incontinent. 4 The medication can cause fewer problems with dependence and abuse than does a nonbenzodiazepine.
1 The medication can cause rebound insomnia if it is discontinued abruptly. Rationale: Benzodiazepine often leads to tolerance and withdrawal; therefore, it can cause rebound insomnia when discontinued abruptly.
A client has been taking levothyroxine for hypothyroidism for 3 months. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply. 1 Tremors 2 Bradycardia 3 Somnolence 4 Heat intolerance 5 Decrease blood pressure
1 Tremors 4 Heat intolerance Rationale: Excessive levothyroxine produces adaptations similar to hyperthyroidism, including tremors, tachycardia, hypertension, heat intolerance, and insomnia. These adaptations are related to the increase in the metabolic rate associated with hyperthyroidism.
A healthcare provider recently made the diagnosis that a client has glaucoma. The nurse is preparing to administer eyedrops to the client. which ophthalmic solution is contraindicated for this client? 1 Timolol 2 Atropine 3 Pilocarpine 4 Epinephrine
2 Atropine Rationale: Atropine, a mydriatic ophthalmic solution, is contraindicated for clients with glaucoma because it dilates the pupil, increasing intraocular pressure.
Nitrofurantoin used during the fifth week of pregnancy places the neonate at risk for which condition? 1 Cleft lip 2 Meromelia 3 Low set of malformed ears 4 Tooth and bone abnormalities
1 Cleft lip Rationale: Because the development of the upper and lower lips occurs during the fifth week of pregnancy, nitrofurantoin should be avoided because the drug may cause a cleft lip.
A pregnant women reports upper back pain and frequent and painful urination. Upon diagnosis, the client has a urinary tract infection and is treated with nitrofurantoin. Which teratogenic effect is likely to occur in the infant? 1 Cleft palate 2 Tooth anomalies 3 Neural tube defects 4 Ebstein anomaly
1 Cleft palate Rationale: Nitrofurantoin may cause cleft palate in fetuses.
A healthcare provider prescribes supplemental oral iron therapy for a child with iron-deficiency anemia. What side effect will the nurse tell the parents to anticipate. 1 Bloody stool 2 Orange Urine 3 Greenish-black stool 4 Staining of the mouth
3 Greenish-black stool Rationale: Iron is excreted in the feces, and the change in color results from the insoluble iron compound excreted in the stool.
A nurse has provided teaching to a client with a newly prescribed PPI. The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of which condition? 1 Diarrhea 2 Vomiting 3 Cardiac dysrhythmias 4 Gastroesophageal reflux disease (GERD)
4 Gastroesophageal reflux disease (GERD) Rationale: PPIs are effective in decreasing the secretion of gastric acid, helping to alleviate symptoms of GERD.
Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? 1 Increases gastric motility 2 Neutralizes gastric acidity 3 Facilitates histamine release 4 Inhibits gastric acid secretion
4 Inhibits gastric acid secretion Rationale: Famotidine decreases gastric secretion by inhibiting histamine at H2 receptors.
A health care provider prescribes daily docusate sodium for a client. The nurse explains to the client that this drug has what action? 1 Lubricates the feces 2 Creates an osmotic effect 3 Stimulates motor activity 4 Lowers the surface tension of feces
4 Lowers the surface tension of feces Rationale: The detergent action of docusate sodium promotes the drawing of fluid into the stool, which softens the feces
A nurse is evaluating a client who received intravenous morphine. Which life-threatening response indicates the potential need for naloxone administration? 1 Blurred vision 2 Urinary retention 3 Mental confusion 4 Respiratory depression
4 Respiratory depression Rationale: Because morphine is a central nervous system depressant, it affects the medulla, the respiratory center in the brain. Respiratory depression may progress to respiratory arrest and death. Naloxone will reverse the effects of an opioid.
A primary healthcare provider prescribes 0.25 mg of alprazolam (Xanax) by mouth three times a day for a client with anxiety and physical symptoms related to work pressure. For what MOST common side effect of this drug will the nurse monitor the client? 1 Drowsiness 2 Bradycardia 3 Agranulocytosis 4 Tardive dyskinesia
1 Drowsiness Rationale: Alprazolam (Xanax), a benzodiazepine, potentiates the actions of gamma-aminobutyric acid, enhances presympathetic inhibition, and inhibits spinal polysynaptic afferent pathways. Drowsiness, dizziness, and blurred vision are common side effects.
The nurse is caring for an adolescent with dysmenorrhea. What medication does the nurse anticipate to be prescribed as the first line of treatment? 1 Ibuprofen 2 Guanfacine 3 Medroxyprogesterone 4 Dextroamphetamine Sulfate
1 Ibuprofen Rationale: The client has dysmenorrhea, or increased discomfort during menstrual flow. The symptoms of dysmenorrhea can be effectively treated with nonsteroidal anti-inflammatory drugs like ibuprofen.
A nurse is teaching a client who has arthritis about the steroid medication prescribed by the healthcare provider. Which statement about why it is important to take the steroid medication at mealtime indicates that the teaching was effective? 1 "This will decrease gastric irritation" 2 "This will serve as a reminder to take the drug" 3 "The presence of food will enhance absorption" 4 "The medication is ineffective in an acid medium"
1 "This will decrease gastric irritation" Rationale: The presence of food limits the irritating effect of steroids on the gastric mucosa.
Which medications are associated commonly with upper gastrointestinal (GI) bleeding? Select all that apply. 1 Aspirin 2 Ibuprofen 3 Ciprofloxacin 4 Acetaminophen 5 Methylprednisolone
1 Acetylsalicylic acid (Aspirin) 2 Methylprednisolone (Solu-Medrol) 4 Ibuprofen (Advil) Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs), including acetylsalicylic acid and ibuprofen, and corticosteroids such as methylprednisolone, are known cases of drug-induced gastrointestinal (GI) bleeding by causing irritation and erosion of the gastric mucosal barrier.
After cataract surgery, a client reports feeling nauseated. How can the nurse help relieve the nausea? 1 Administer the prescribed antiemetic drug. 2 Provide some dry crackers for the client to eat. 3 Explain that this is expected following surgery. 4 Teach how to breathe deeply until the nausea subsides.
1 Administer the prescribed antiemetic drug Rationale: An antiemetic will prevent vomiting; vomiting increase intraocular pressure and should be avoided.
A nurse is caring for an older adult who is taking acetaminophen for the relief of chronic pain. Which substance is MOST important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen? 1 Alcohol 2 Caffeine 3 Saw palmetto 4 St. John's wort
1 Alcohol Rationale: Too much ingestion of alcohol can cause scarring and fibrosis of the liver. Eighty-five percent to 95% of acetaminophen is metabolized by the liver. Acetaminophen and alcohol are both hepatotoxic substances. Metabolites of acetaminophen, along with alcohol, can cause irreversible liver damage.
What is a nurse's responsibility when administering prescribed opioid analgesics? Select all that apply. 1 Count the client's respirations 2 Document the intensity of the client's pain. 3 Withhold the medication if the client reports pruritus 4 Verify the number of doses in the locked cabinet before administering the prescribed dose. 5 Discard the medication in the client's toilet before leaving the room id the medication is refused.
1 Count the client's respirations 2 Document the intensity of the client's pain 4 Verify the number of doses in the locked cabinet before administering the prescribed dose Rationale: Opioid analgesics can cause respiratory depression; the nurse must monitor respirations. The intensity of pain must be documented before and after administering an analgesic to evaluate its effectiveness. Because of the potential for abuse, the nurse is legally requited to verify an accurate count of doses before taking a dose from the locked source and at the change of the shift.
A client with rheumatoid arthritis has been taking a steroid medication for the past year. For which complication of prolonged use of this medication should the nurse assess the client? 1 Decreased white blood cells 2 Increased C-reactive protein 3 Increased sedimentation rate 4 Decreased serum glucose levels
1 Decreased white blood cells Rationale: Prolonged use of steroids may cause leukopenia as a result of bone marrow depression.
Trimethoprim-sulfamethoxazole is prescribed for a client with cystitis. When teaching about the medication, what does the nurse instruct the client to do? 1 Drink 8 to 10 glasses of water daily. 2 Drink 2 glasses of orange juice daily. 3 Take the medication with meals. 4 Take the medication until symptoms subside.
1 Drink 8 to 10 glasses of water daily Rationale: A urinary output of at least 1500 mL daily should be maintained to prevent crystalluria (crystals in the urine).
A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? 1 Increase the intake of fluids 2 Strain the urine for crystals and stones 3 Stop the drug if urinary output increases 4 Maintain the exact time schedule for taking the drug
1 Increase the intake of fluids Rationale: To prevent crystal formation, the client should have sufficient intake to produce 1000 to 1500 mL of urine daily while taking this drug.
The nurse provides care for a client with a long history of alcohol abuse. Which drug does the nurse anticipate will be prescribed for the client to prevent symptoms of withdrawal? 1 Lorazepam 2 Phenobarbital 3 Chlorpromazine 4 Methadone hydrochloride
1 Lorazepam Rationale: Lorazepam is most effective in preventing the signs and symptoms associated with withdrawal from alcohol. It depresses the CNS by potentiating gamma-aminobutyric acid, an inhibitory neurotransmitter.
A client is brought by ambulance to the emergency department. The client's signs and symptoms are indicative of opioid overdose. What does the nurse expect the primary healthcare provider to prescribe? 1 Naloxone 2 Methadone 3 Epinephrine 4 Amphetamine
1 Naloxone Rationale: This drug is an opioid antagonist that displaces opioids from receptors in the brain, reversing respiratory depression.
A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which medications are within the classification of an H2 receptor antagonist? Select all that apply. 1 Nizatidine 2 Ranitidine 3 Famotidine 4 Lansoprazole 5 Metoclopramide
1 Nizatidine 2 Ranitidine 3 Famotidine Rationale: Nizatidine is an H2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD. Ranitidine is an H2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD. Famotidine is an H2 receptor antagonist that reduces gastric acid secretion and provides for symptomatic improvement in GERD.
A client who takes daily megadoses of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver due to vitamin toxicity. What type of toxicity does the nurse suspect? 1 Retinol (Vitamin A) 2 Thiamine (Vitamin B1) 3 Pyridoxine (Vitamin B6) 4 Ascorbic acid (Vitamin C)
1 Retinol (Vitamin A) Rationale: Joint pain, hair loss, jaundice, anemia, irritability, pruritus, and enlarged liver and spleen are signs of vitamin A toxicity.
A client receiving morphine is being monitored by the nurse for adverse effects of the drug. Which clinical findings warrant immediate follow up by the nurse? Select all that apply. 1 Polyuria 2 Sedation 3 Bradycardia 4 Dilated pupils 5 Slow respirations
1 Sedation 2 Bradycardia 3 Slow respirations The central nervous system (CNS) depressant effect of morphine causes sedation. The CNS depressant effect of morphine causes bradycardia and bradypnea.
A client has received instructions to take 650 mg aspirin every 6 hours as needed for arthritic pain. What should the nurse include in the client's medication teaching? Select all that apply. 1 Take the aspirin with meals or a snack. 2 Make an appointment with a dentist if bleeding gums develop. 3 Do not chew enteric-coated tablets. 4 Switch to acetaminophen if tinnitus occurs. 5 Report persistent abdominal pain.
1 Take the aspirin with meals or a snack 3 Do not chew enteric-coated tablets 5 Report persistent abdominal pain. Aspirin is irritating to the stomach lining and can cause ulcerations; the presence of food, fluid, or antacids decreases this response. Enteric-coated tablets must not be crushed or chewed. Aspirin therapy may lead to gastrointestinal bleeding, which may be manifested by abdominal pain; if present, the prescriber must be notified immediately.
A healthcare provider prescribes aspirin to be continued at home for client with severe arthritis. What should the nurse teach the client about taking aspirin? 1 Take the medicine with meals 2 See a dentist if bleeding gums develop 3 Switch to acetaminophen if tinnitus occurs 4 Avoid spicy foods while taking the medication
1 Take the medicine with meals Rationale: Acetylsalicylic acid is irritating to the stomach lining and can cause ulceration; the presence of food, fluid, or antacids decreases this response.
A nurse is reviewing a list of current medications with a client who has developed gastrointestinal bleeding. Which medication prescription should the nurse discuss with the primary healthcare provider? 1 Digoxin 2 Ibuprofen 3 Famotidine 4 Atorvastatin
2 Ibuprofen Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause bleeding in the gastrointestinal (GI) tract; clients with a history of GI bleeding should not take NSAIDs
A client has had a total gastrectomy. What should the nurse include in the discharge teaching? 1 Daily use of a stool softener 2 Injections of vitamin B12 for life 3 Monthly injections of iron dextran 4 Replacement of pancreatic enzymes
2 Injections of vitamin B12 for life Rationale: Intrinsic factor is lost with removal of the stomach, and vitamin B12 is needed to maintain the hemoglobin level and prevent pernicious anemia.
After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with a gastric ulcer. The client receives a prescription for Ranitidine 150 mg twice a day. What concern prompts the nurse to contact the health care provider about the prescription? 1 Ranitidine can increase bleeding risk. 2 An administration route is not specified. 3 Ranitidine is contraindicated for gastric ulcers. 4 The recommended dose is higher then prescribed.
2 An administration route is not specified. Rationale: It is necessary to clarify the route of administration because Ranitidine can be given by mouth, intravenously, or intramuscularly; the health care provider's prescription is incomplete.
A health care provider prescribes vancomycin peak and trough levels for a client who is receiving vancomycin intravenous piggyback (IVPB). When should the nurse have the laboratory obtain a blood sample to determine a peak level of the antibiotic? 1 Halfway between two doses of the drug 2 Between 30 to 60 minutes after a dose 3 Immediately before the medication is administered 4 Anytime it is convenient for the client and the laboratory.
2 Between 30 and 60 minutes after a dose Rationale: Because the drug was administer IV, the blood level of the drug will be at its highest shortly after administration.
Which prostaglandin agonist is used in the treatment of clients with glaucoma? 1 Carteolol 2 Bimatoprost 3 Brinzolamide 4 Apraclonidine
2 Bimatoprost Rationale: Bimatoprost is the prostaglandin agonist used in the treatment of glaucoma.
A healthcare provider prescribes bed rest, loperamide, and esomeprazole for a client who just had major surgery. After several days of this regimen, a client complains of diarrhea. Which treatment strategy does the nurse conclude is the MOST likely cause of the diarrhea? 1 Loperamide 2 Esomeprazole 3 Bed Rest 4 Diet alteration
2 Esomeprazole Rationale: Esomeprazole, a PPI, may cause diarrhea related to a higher risk for Clostridium difficile intestinal infection.
What are the desired outcomes that the nurse expects when administering ibuprofen? Select all that apply. 1 Diuresis 2 Pain relief 3 Antipyresis 4 Bronchodilation 5 Anticoagulation 6 Reduced inflammation
2 Pain relief 3 Antipyresis 6 Reduced inflammation Rationale: Prostaglandins accumulate at the site of an injury, causing pain; nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit COX-1 and Cox-2 (both are isoforms of the enzyme cyclooxygenase), which inhibit the production of prostaglandins, thereby contributing to analgesia. NSAIDs inhibit COX-2, which is associated with fever, thereby causing antipyresis. NSAIDs inhibit COX-2, which is associated with inflammation, thereby reducing inflammation.
A health care provider prescribed ranitidine for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works? 1 Ranitidine increases GI peristalsis 2 Ranitidine reduces gastric acidity in the stomach 3 Ranitidine neutralizes the acid that is present in the stomach 4 Ranitidine stops production of hydrochloric acid in the stomach
2 Ranitidine reduces gastric acidity in the stomach Rationale: Ranitidine (Zantac) inhibits histamine at H2 receptor sites in the stomach, resulting in reduced gastric acid secretion.
Alprazolam is prescribed for a client who is anxious. For what therapeutic effect will the nurse monitor the client? 1 Reduced anger 2 Resting quietly 3 Sleeping soundly 4 Reduced blood
2 Resting quietly Rationale: Alprazolam, an anxiolytic, promotes muscle relaxation, reduces anxiety, and facilitates rest.
Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate? 1 Antacids should be taken 30 minutes before a meal. 2 Sucralfate should be taken on and empty stomach one hour before meals. 3 Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease. 4 Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects.
2 Sucralfate should be taken on and empty stomach one hour before meals. Rationale: Sucralfate works best in a low pH environment; therefore, it should be given on an empty stomach either one hour before or two hours after meals.
A nurse is caring for a client who reports urinary problems, and the healthcare provider prescribes a cholinergic medication. Which urinary problem will this medication correct? 1 Urinary frequency due to bladder spasticity 2 Urinary retention due to bladder atony 3 Pain due to urinary tract calculi 4 Urinary urgency due to urinary tract infections
2 Urinary retention due to bladder atony Rationale: Cholinergic intensity and prolong the action of acetylcholine, which increases tone in the genitourinary tract, preventing urinary retention.
Levothyroxine 12.5 mcg orally each day is prescribed for a client with hypothyroidism. The pharmacy dispensed 9- tablets with each tablet containing 12.5 mcg. Six weeks late, the healthcare provider increases the client's dose to 25 mcg daily and gives the client a prescription to be filled at the pharmacy. The client asks the nurse whether the tables in the original prescription can be used before filling the new prescription. How many of the original tablets should the nurse instruct the client to take daily?
2 tablets 25 mcg x 1 tab/12.5 mcg = 25 mcg x 1 tab/ 12.5 mcg = 2 tablets
A nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy? 1 Urinary calculi 2 Atrophy of the liver 3 Prolonged bleeding time 4 Premature erythrocyte destruction
3 Prolonged bleeding time Rationale: Aspirin interferes with platelet aggregation, thereby lengthening bleeding time.
Which drug impairs fertility when administered along with fertility drugs? 1 Clomiphene 2 Menotropins 3 Promethazine 4 Choriogonadotropin alfa
3 Promethazine Rationale: When taken with fertility drugs, promethazine increase prolactin concentration, which may impair fertility.
A client who has been taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted instead. What is the appropriate nursing response? 1 "Acetaminophen is the preferred treatment for rheumatoid arthritis." 2 "Acetaminophen irritates the stomach more than ibuprofen does." 3 "Ibuprofen has anti-inflammatory properties and acetaminophen does not." 4 "Yes, both are antipyretics have the same effect."
3 "Ibuprofen has anti-inflammatory properties and acetaminophen does not." Rationale: Ibuprofen has an anti-inflammatory action that relieves the inflammation and pain associated with arthritis. Acetaminophen is not a nonsteroidal anti-inflammatory drug (NSAID). NSAIDS are preferred for the treatment of rheumatoid arthritis.
A nurse is teaching a client about ampicillin that has been prescribed for a severe infection. Which statement indicates to the nurse that the client needs further teaching? 1 "I should report any problems with my hearing." 2 "I may be required to get additional blood tests." 3 "It is okay for me to stop taking this medication after I improve." 4 "If I develop a fever, I will notify my primary healthcare provider."
3 "It is okay for me to stop taking this medication after I improve." Rationale: It is most important for the client to complete the antibiotic prescription to prevent the development of antibiotic-resistant bacteria.
A nurse is teaching the parents of a child with iron-deficiency anemia how to administer liquid iron to their child. What instructions should be included in the lesson? Select all that apply. 1 Protect the child from sunlight 2 Administer the medication with food 3 Anticipate that stools tend to be blackish-green 4 Give the medication with a class of orange juice 5 Have the client drink it through a straw
3 Anticipate the stools tend to be blackish-green. 4 Give the medication with a glass of orange juice 5 Have the client drink it through a straw Rationale: Iron thickens the consistency of stools and may turn stools a blackish-green color. Citrus juices contain vitamin C and are acidic, meaning that they increase the absorption of iron. Direct contact with iron stains the teeth.
A client is receiving morphine sulfate for severe metastatic bone pain. What will the nurse do to assess for complications from a common serious side effect of morphine? 1 Monitor for diarrhea 2 Observe for an opioid addiction 3 Assess for altered breathing patterns 4 Check for a decreased urinary output
3 Assess for altered breathing patterns Rationale: Morphine Sulfate is a central nervous system depressant that commonly decreases the respiratory rate, which can lead to respiratory arrest.
A terminally ill client in a hospice unit for several weeks is receiving a morphine drip. The dose is now above the typical recommended dosage. The client's spouse tells the nurse that the client is again uncomfortable and needs the morphine increased. The prescription states to titrate the morphine to comfort level. What should the nurse do? 1 Add a placebo to the morphine to appease the spouse. 2 Discuss with the spouse the risk for morphine addiction. 3 Assess the client's pain before increasing the dose of morphine. 4 Check the client's heart rate before increasing the morphine to the next level.
3 Assess the client's pain before increasing the dose or the morphine Rationale: Over time clients receiving morphine develop tolerance and require increasing doses to relieve pain, thus requiring continuing reassessments.
A client is scheduled for discharge following surgery. The medical record indicates that the client has not had a bowel movement since before surgery, which was 4 days ago. During the hospital stay, the client received a stool softener daily and an oral laxative the day before discharge. Which one of the prescribed medications should the nurse administer to ensure a bowel movement prior to discharge? 1 Milk of magnesia 30 mL 2 Docusate sodium 100 mg 3 Bisacodyl 10-mg suppository 4 Bisacodyl two enteric-coated 5-mg tablets
3 Bisacodyl 10-mg suppository Rationale: *A Bisacodyl suppository should produce results before the client leaves the facility. oral laxative and stool softeners were already given with no results.
A client is treated with lorazepam for status epilepticus. What effect of lorazepam does the nurse consider therapeutic? 1 Slow cardiac contractions 2 Dilates tracheobronchial structures 3 Depresses the central nervous system 4 Provides amnesia for the convulsive episode
3 Depresses the CNS Rationale: Lorazepam, an anxiolytic and sedative, is used to treat status epilepticus because it depresses the CNS.
A client with irritable bowel syndrome has instructions to take Psyllium 2 rounded teaspoons full twice a day for constipation. What is MOST important for the nurse to include in the teaching plan? 1 Urine may be discolored. 2 Stop taking the laxative once a bowel movement occurs. 3 Each dose should be taken with a fill glass of water or juice 4 Daily use may inhibit the absorption of some fat-soluble vitamins.
3 Each dose should be taken with a full glass of water or juice. Rationale: This bulk-forming laxative works by absorbing water into the intestine, which increase bulk and distends the bowel to initiate reflex bowl activity, thus promoting a bowel movement. A full glass of fluid taken at the same time will help minimize the risk of esophageal obstruction or fecal impaction.
A client is started on tetracycline antibiotic therapy. What should the nurse do when administering this drug? 1 Administer the medication with meals or a snack. 2 Provide orange or other citrus fruit juice with the medication. 3 Give the medication an hour before milk products are ingested 4 Offer antacids 30 minutes after administration if gastrointestinal side effects occur.
3 Give the medication an hour before milk products are ingested. Rationale: Any product containing aluminum, magnesium, or calcium ions should not be taken in the hour before an oral dose of tetracyclines (with the exception of doxycycline) because it decreases absorption by as much as 25% to 50%.
A client receives a prescription for morphine via patient-controlled analgesia (PCA). Before beginning administration of this medication, what should the nurse assess first? 1 Temperature 2 Blood pressure 3 Respirations 4 Urinary output
3 Respirations Rationale: The nurse must be especially alert to any changes in respirations because morphine decreases the respiratory center function in the brain. An order for morphine should be questioned if the baseline respirations are less than 12 per minute.
A client has primary open-angle glaucoma. The nurse expects that the client will receive a prescription for which eyedrops? 1 Tetracaine (Pontocaine) 2 Cyclopentolate (Cyclogyl) 3 Timolol maleate (Timoptic) 4 Atropine sulfate (Atropisol Opthalmic)
3 Timolol maleate (Timoptic) Rationale: Timolol maleate is a beta-adrenergic antagonist that decreases aqueous humor production and increases outflow, thereby reducing intraocular pressure.
In addition to hydration during alcohol withdrawal delirium, parenteral administration of lorazepam is prescribed for a client. The nurse knows that this drug is given during detoxification PRIMARILY for what purpose? 1 To prevent injury when seizures occur 2 To enable the client to sleep better during periods of agitation 3 To reduce the anxiety tremor state and prevent more serious withdrawal symptoms 4 To quiet the client and encourage cooperation by promoting acceptance of the treatment plan
3 To reduce the anxiety tremor state and prevent more serious withdrawal symptoms Rationale: Lorazepam potentiates the actions of gamma-aminobutyric acid, which reduces the anxiety and irritability associated with withdrawal.
A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication may be prescribed because of its major role in wound healing? 1 Vitamin A (retinol) 2 Vitamin K (phytonadione) 3 Vitamin C (ascorbic acid) 4 Vitamin B12 (cyanocobalamin)
3 Vitamin C (ascorbic acid) Rationale: Vitamin C (ascorbic acid) plays a major role in wound healing. It is necessary for the maintenance and formation of collagen, the major protein of most connective tissues.
A nurse is teaching an older adult client about managing chronic pain with acetaminophen. Which client statement indicates that the teaching is effective? 1 "I can drink beer with this, but not wine." 2 "I need to limit my intake of acetaminophen to 650 mg a day." 3 "I should take an emetic if I accidentally overdose on the acetaminophen." 4 "I have to be careful about which over-the-counter cold preparations I take when I have a cold."
4 "I have to be careful about which over-the-counter cold preparations I take when I have a cold." Rationale: Many over-the-counter cold preparations contain acetaminophen; the amount of acetaminophen in cold preparations must be taken into consideration when the total amount of acetaminophen taken daily is calculated.
A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? 1 "Eliminating fluids with meals will prevent pain." 2 "I will increase my food intake to avoid an empty stomach." 3 "Taking an aspirin with milk will relieve my pain and coat my ulcer." 4 "Taking an antacid preparation will decrease pain due to gastric acid."
4 "Taking an antacid preparation will decrease pain due to gastric acid." Rationale: Over-the-counter antacid preparations neutralize gastric acid and relieve pain.
A Healthcare provider prescribes tolterodine for a client with an overactive bladder. What is MOST important for the nurse to teach the client to do? 1 Maintain a strict record of fluid intake and urinary output. 2 Chew the extended-release capsule thoroughly before swallowing. 3 Report episodes of diarrhea or any increase in respiratory secretions. 4 Avoid activities requiring alertness until the response to medication is known.
4 Avoid activities requiring alertness until the response to medication is known. Rationale: Tolterodine, a urinary tract anti-spacmotic, may cause dizziness and blurred vision, placing the client at risk for injury.
A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. What time of day is iron absorption MOST efficient? 1 Dinnertime 2 Bedtime 3 After Lunch 4 Before Breakfast
4 Before breakfast Rationale: Iron should be taken before breakfast, on an empty stomach, to permit maximal absorption
What information should the nurse include when teaching a client about antacid tablets? 1 Take them at 4-hour intervals 2 Take them 1 hour before meals 3 They are as effective as the liquid forms 4 They interfere with the absorption of other drugs
4 They interfere with the absorption of other drugs Rationale: Antacids interfere with absorption of drugs such as anticholinergics, barbiturates, some antibiotics, and cardiac drugs.
A client with chronic liver disease reports, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. The nurse concludes that the client needs which additional supplement? 1 Bile salts 2 Folic acid 3 Vitamin A 4 Vitamin K
4 Vitamin K Rationale: Fat-soluble vitamin K is essential for synthesis of prothrombin by the liver; a lack results in hypoprothrombinemia, inadequate coagulation, and hemorrhage.
A nurse administers vitamins as part of a client's medical regimen. Which prescribed vitamin is essential for they synthesis of prothrombin by the liver? 1 B12 2 C 3 D 4 K
4 Vitamin K Rationale: Prothrombin, which is present in the plasma, is synthesized in the liver in the presence of vitamin K from the amino acid glutamine; vitamin K initiates the vital process of coagulation.
