A_Q-Pharm 3
A nurse in a provider's office is collecting data from a client who has been taking black cohosh. Which of the following statements by the client indicates a therapeutic effect from the supplement? A. "I have not had a cold since I started taking black cohosh." B. "I am having fewer hot flashes now that I am taking black cohosh." C. "My memory has improved since I started taking black cohosh." D. "My urinary tract infection has cleared up since I started taking black cohosh."
"I am having fewer hot flashes now that I am taking black cohosh." *Black cohosh is used for treating symptoms of menopause such as hot flashes, vaginal dryness, irritability, and night sweats
A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following client statements indicates that the teaching was effective? A. "I should take the medication with a glass of orange juice." B. "I will allow the medication to dissolve in my mouth." C. "I will sit upright for 30 minutes after taking this medication." D. "I should take the medication right after eating breakfast."
"I will sit upright for 30 minutes after taking this medication." *The nurse should instruct the client to sit upright or stand for at least 30 minutes after taking the medication to prevent esophagitis
A nurse is assisting with preparing discharge teaching for a client who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of information should the nurse include? A. "Seizures can occur with this medication." B. "You should observe for manifestations of bleeding." C. "Check your hands and feet for sensory dysfunction." D. "This medication can increase the risk of ototoxicity."
"Seizures can occur with this medication." *The nurse should tell the client that seizures can occur when receiving imipenem. The client should notify the provider immediately if these occur
A nurse is reinforcing teaching with a client who has dyspepsia about prescribed antacids. Which of the following statements should the nurse include in the teaching? A. "Take antacids 1 hour apart from other medications." B. "Increase your sodium intake to avoid hyponatremia." C. "Avoid combining antacids due to an increased risk of adverse effects." D. "Antacids are take 3 times daily."
"Take antacids 1 hour apart from other medications." *The nurse should include in the teaching that antacids increase gastric pH, which causes an interference with the absorption of various medications. To help minimize these interactions, the client should take the antacids at least 1 hour apart from other medication
A nurse is preparing to administer epoetin 50 units/kg/dose 3 times weekly subcutaneously to a client who weighs 198 pounds. Epoetin solution is available for injection at 4,000 units/mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)
1.1
A nurse is reinforcing teaching with a cliet who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Arthralgia B. Constipation C. Stomatitis D. Sedation
Arthralgia *Suflasalazine can cause nausea, vmiting, and arthalgia
A nurse is caring for a client who is receiving sumatriptain for cluster headaches. Which of the following findings should the nurse expect as an adverse effect? A. Hypotension B. Tinnitus C. Urinary retention D. Chest pressure
Chest pressure *A client who takes sumatriptan can develop sensations of chest pressure and heavy arms. The nurse should monitor the client; of the chest pressure continues, the nurse should notify the provider. About 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve
A nurse is preparing to administer raloxifene to a client. Which of the following conditions is a contraindication for the administration of this medication? A. Osteoporosis B. Hyperthyroidism C. Myocardial infarction D. Deep-vein thrombosis
Deep-vein thrombosis *The nurse should identify that raloxifene, like estrogen, increases the risk of deep-vein thrombosis, pulmonary embolism, and stroke. Raloxifene is contraindicated for client who have a history of venous thrombotic events
A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? A. Potentiative interaction B. Detrimental inhibitory interaction C. Increased adverse reaction D. Toxicity-reducing inhibitory interaction
Detrimental inhibitory interaction *A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects
A nurse is assisting with the admission of a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin
Diltiazem *The nurse should anticipate the provider to prescribed diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation
A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? A. Blood pressure 180/70 mmHg B. Oxygen saturation 94% C. Heart rate 51/min D. Respiratory rate 21/min
Heart rate 51/min *The nurse should identify that if the client's heart rate is less than 60.min, the medication should be withheld, and the provider should be notified
A nurse is reinforcing teaching with a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure
Intestinal obstruction *Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation
A nurse is assisting with the care of a client who has been in the PACU for more than 1 hour. He has a respiratory rate of 9/min and is difficult to arouse. The nurse should expect a prescription for which of the following medications? A. Pentazocine B. Naloxone C. Naltrexone D. Butophanol
Naloxone *The nurse should expect a prescriptio for naloxone. This medication displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia that opiates cause
A nurse is preparing to administer medication to a client. Which of the following abbreviations indicates the greatest frequency of medication administration? A. BID B. TID C. QID D. Q8h
QID *BID=2x daily; TID= 3x daily; BID=4x daily; Q8h=every 8 hours
A nurse is reinforcing teachng with a client who has tuberculosis and a prescription for rifampin. The nurse should identify which of the following findings as a harmless and expected adverse effect of rifampin? A. Red-orange discoloration or urine B. Increased ecchymosis C. Yellow appearance of the sclerae D. Lack of energy
Red-orange discoloration or urine *The nurse should instruct the client that rifampin commonly causes a red-orange discoloration of body fluids. This adverse effect is considered harmless and does not need to be reported to the provider
A nurse is caring for a client who has tuberculosis and is taking rifampin. The nurse should monitor the client for which of the following findings as an adverse effect of rifampin? A. Red-tinged urine B. Tinnitus C. Blurred vision D. Dry mouth
Red-tinged urine *The nurse should identify that red-tinged urine, saliva and tears are adverse effects of rifampin
A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed gabapentin. Which of the following therapeutic effects should the nurse identidy for the client when taking this medication? A. Reduced cancer-related bone pain B. Decreased anxiety and isomnia C. Decreased inflammatory response to cancer tumors D. Reduced cramping, aching, and burning neuropathic pain
Reduced cramping, aching, and burning neuropathic pain *The nurse should identify that gabapentin is administed to treat neuropathic pain that is sharp and darting. The medication can also decrease cramping, aching, and burning pain and suppress spontaneous neuronal firing that causes pain
A nurse is contributing to the plan of care for a client who is receiving phenyton to treat seizures. Which of the following recommendations should the nurse make to counteract potential adverse effects of the medication? A. Administer an antidiarrheal agent to the client as needed B. Encourage the client to increase dietary intake of foods high in potassium C. Reinforce teaching with the client about how to perform gum massage D. Offer hard candy for the client to suck
Reinforce teaching with the client about how to perform gum massage *Phenytoin can cause gingival hyperplasia (overgrowth of gum tissue). The nurse should instruct the client about proper brushing and flossing techniques as well as gum massage to decrease the risk of damage and discomfort
A nurse is reinforcing teaching with a group of new parents about medications. The nurse should include that aspirin is contraindicated in children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's syndrome B. Visual disturbances C. Diabetes mellitus D. Wilms' tumor
Reye's syndrome *Aspirin should not be given to children or adolescents who have a viral infection such as chickenpox or influenza due to the risk of developing Reye's syndrome
A nurse manager is instructing a newly licensed nurse about routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue? A. Oral B. Topical C. Parenteral D. Sublingual
Sublingual *Absorption through the sublingual route occurs by placing the medication under the tongue
A nurse suspects that a client is having an allergic reaction to a medication. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to the medication? A. This is the client's initial dose of the current prescription B. The client received a larger dose C. The route of administration was oral D. The client has had previous exposure to the medication
The client has had previous exposure to the medication *Once the immune system has developed sensitization to a medication, a subsequent exposure to the client has to have the medication, the more intense the reaction will likely be
A nurse is collecting data from a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement? A. The client is having 1-2 bowel movements per day B. The client's glucose is elevated C. The client has experienced weight loss D. The client has abdominal distention
The client is having 1-2 bowel movements per day *Having 1-2 bowel movements per day indicates adequate absorption of food and a therapeutic response to pancreatic enzyme replacement for clients who have cystic fibrosis. Frequent stooling, defined as more than 1-2 bowel movements per day, indicates inadequate replacement
A nurse is collecting data from a client who is taking theophylline. The client's dose was decreased due to concurrent use with cimetidine. Which of the following findings should the nurse expect? A. Theophylline level 15 mcg/mL B. Decreased urine output C. Decreased urine output D. Creatinine 1.4 mg/dL
Theophylline level 15 mcg/mL *The nurse should identify that a theophyline level of 15 mcg/mL is within the expected reference range of 10 to 20 mcg/mL and indicates the dose is appropriate for this client
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs? A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache
Tinnitus *Loop diuretics such as furosemide can cause ototoxicity. The client should be taugh to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs
A nurse is planning care for a client who took an overdose of acetaminophen. Which of the following laboratory values should the nurse plan to monitor for adverse effects of the overdose? A. Hematocrit B. High-density lipoproteins (HDL) C. Pancreatic enzymes D. Liver enzymes
Liver enzymes *The nurse should monitor the liver enzymes alanine transainase (ALT and aspartate transaminase (AST) for indication of liver injury. Acetaminophen overdose can cause severe liver injury as high doses of the medication produce a toxic metabolite. It takes 42 to 72 hours after ingestion for indications of liver failure to appear
A nurse is reinforcing medication teaching to a client who has a new diagnosis of rheumatoid arthritis. Which of the following medications in the therapy regimen will take weeks to months to be effective? A. Ibuprofen B. Methotrexate C. Prednisone D. Celecoxib
Methotrexate *Methotrexate is a disease-modifying anti-rheumatic drug (DMARD) that is prescribed to control symptoms and slow the progression of the disease. It can take weeks to months for DMARDs to show effectiveness, so clients are also placed on NSAID therapy for the control of pain. After the DMARD takes effect, the NSAID therapy can be withdrawn
A nurse is caring for a client who has unstable angina. The nurse should anticipate a prescription from the provider for which of the following medications? A. Epineprine B. Nitroglycerin C. Lidocaine D. Atropine
Nitroglycerin *The nurse should anticipate a prescription for nitroglycerin, which is indicated for a client who has unstable angine. Nitroglycerin is an organic nitrate and a vasodilator that acts by relaxaing or preventing spasms in the coronary arteries, thereby decreasing the oxygen demand of the heart along with ventricular filling
A nurse is administering a prescription for nifedipine to a client who is pregnant. Which of the following pieces of information related to nifedipine should the nurse monitor and document? A. Hypoglycemia B. Uterine ripening C. Increased blood pressure D. Number of uterine contractions
Number of uterine contractions *A client who is going into preterm labor can have a prescription for nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into myometrial cells, which can delay labor
A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication? A. Weight loss B. Hypotension C. Lethargy D. Osteoporosis
Osteoporisis *Long-term use of steroid medications such as glucocorticoid medication can inhibit bone growth and result in the adverse effect of osteoporosis with long-term treatment
A nurse is caring for an adolescent who has cystic fibrosis (CF) and has a prescription for high-dose ibuprofen daily. The nurse should identify that which of the following is an expected outcome for the client receiving this medication? A. Thinned pulmonary secretions that are retained in the airways B. Slowed progression of pulmonary damage C. Potentiated action of bronchodilator therapy D. Decreased risk of fevers associated with CF
Slowed progression of pulmonary damage *The nurse should identify that clients who have CF are prescribed high-dose ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands
A nurse is reinforcing teaching with a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse must give the client? A. Take the medication and herbal supplement B. Stop taking the herbal supplement while taking this medication C. Take the herbal supplement and the medication at least 2 hours apart D. Take an antacid with both the herbal supplement and the medication
Stop taking the herbal supplement while taking this medication *Taking the antidepressant sertraline and the herbal supplement St. John's wort together puts the client at risk for serotonin syndrome
A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? A. Gingival ulcerations B. Orthostatic hypotension C. Stress fractures D. Weight loss
Stress fractures *Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures
A nurse is collecting data from a client who has heart falure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? A. Suppression of dysrhythmias B. Increase in atrioventricular (AV) conduction C. Visual disturbances D. Weight gain
Visual disturbances *The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate that the client is experiencing digoxin toxicity
A nurse is reinforcing teaching with the guardian of a school-aged child about growth hormone therapy. Which of the following statements should the nurse include in the teaching? A. "Your child will grow an extra 4 to 6 inches while receiving hormone therapy." B. "Hormone injection therapy will occur for 2 to 3 years." C. "Your child will receive hormone injections no more often than 1 to 2 times each week." D. "The hormone injections are administered subcutaneously."
"The hormone injections are administered subcutaneously." *The nurse should include in the teaching that the growth hormone therapy is administered subcutaneously, which is the preferred route of administration since the injections are more painful when administered intramuscularly.
A nurse is a provider's office is reinforcing teaching with a female client who has a new diagnosis of seizures and a prescription for valproic acid. Which of the following pieces of information should the nurse provide? A. "This medication can cause changes in your mood and behavior." B. "Valproic acid is one of the few seizure medications that can be taken during pregnancy." C. "You can expect this medication to cause you to lose weight." D. "Valproic acid should be taken every morning on an empty stomach."
"This medication can cause changes in your mood and behavior." *All anti-seizure medications can cause an increased risk of suicidal thoughts and behavior. The nurse should inform the client of this adverse effect and instruct her to notify the provider if depression, anxiety, panic, or thoughts of dying occur
A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia
Orthostatic hypotension *Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensivity
A nurse is an acute care facility is preparing a reconciled list of medications for a client who is being discharged home. Which of the following actions should the nurse take? A. Give the client a handwritten medication list to take to the next care provider following discharge B. Include a list of medications the client received during care at the facility C. Inform the client that he can get a complete list of his medications from the provider who will be caring for him after discharge D. Provde the client and the next care provider with a list of medications the client will take after discharge
Provde the client and the next care provider with a list of medications the client will take after discharge *The nurse should provide a reconciled medication list that includes any medications the provider prescribes at the time of discharge for the client to take after discharge. The list also includes any other medications the client will be taking, including over-the-counter medications before admission to the acute-care facility and did not receive them during treatment in the facility, the provider should confirm whether the client should resume taking them after discharge
A nurse is collecting data from a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates that the client is experiencing acute levothyroxine overdose? A. Bradycardia B. Cold intolerance C. Tremor D. Hypothermia
Tremor *Tremor and anxiety are expected findings in a cute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism
A nurse in a provider's office is collecting data from a client who has hypothyroidism and has been taking levothyroxine for 3 months. Which of the following statements by the client indicates that a decrease in the dosage of levothyroxine might be needed? A. "I have to take a laxative for constipation." B. "I don't feel cold all the time anymore." C. "I am having trouble getting to sleep at night." D. "I am dieting but still not losing any weight."
"I am having trouble getting to sleep at night." *Difficulty sleeping is a manifestation of hyperthyroidism. This statement by the client can indicate the dosage of levothyroxine needs to be reduced
A nurse is reinforcing teaching with a client who has new prescription for nitroglycerin via a transdermal patch. Which of the following client statements indicates an understanding of the teaching? A. "I need to wear the patch continuously for it to be effective." B. "I will stop using the patch immediately if it gives me a headache." C. "I should change the patch whenever I have chest pain." D. "I need to rotate the location of my patch every few days."
"I need to rotate the location of my patch every few days." *The nitroglycerin patch should be rotated to different hairless areas of the body every few days to avoid local skin irritation
A nurse is reinforcing discharge teaching with a client who has heart falure ad a prescription for digoxin 0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching? A. "Blurred vision is something I will expect to happen while taking digoxin." B. "I will measure my urine output each day and document it in my diary." C. "I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute." D. "I will eat fruits and vegetables that have a high potassium content every day."
"I will eat fruits and vegetables that have a high potassium content every day." *Hypokalemia is an adverse effect of diuretic therapy. because this client is taking digoxin, the client will need to maintain a potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity
A nurse is reinforcing teaching with a client who is about to start taking propylthiouracil to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective? A. "I will need laboratory tests to check my liver function." B. "I should take this medication once daily." C. "If I get a rash, I am probably having an allergic reaction." D. "If I have difficulty sleeping, it is probably because of this medication."
"I will need laboratory tests to check my liver function." *Propylthiouracil is hepatotoxic and can cause severe liver injury. The nurse should instruct the client to report dark urine and yellowing of the eyes, which can indicate an injury to the liver
A nurse is reinforcing teaching with a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching? A. "Take this medication on a full stomach." B. "Limit your consumption of dairy products while taking this medicine." C. "Take the medication with your regular iron supplement." D. "Take antacids if you have an upset stomach from using tetracycline."
"Limit your consumption of dairy products while taking this medicine." *The nurse should tell the client to avoid or limit the consumption of dairy products while taking tetracycline. An interval of at least 2 hours should separate tetracycline ingestion and the ingestion of products that can chelate this medication such as milk or calcium
A nurse is reinforcing teaching with a client who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of information should the nurse include in the teaching? A. "Report gastrintesinal disturbances immediately." B. "You might find that you develop a dry mouth." C. "You should not experience any central nervous system alterations." D. "Increased urinary frequency is an expected effect."
"You might find that you develop a dry mouth." *A client who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid or sucking on a hard, sugarless cady can help relieve dry mouth
A nurse is prepraing to administer albuterol syrup 0.1 mg/kg/day to a school-aged child. The amount available is albuteril syrup 2 mg/5 mL. How many mL should the nurse administer? Round your answer to the nearest tenth
5
A charge nurse is discussing medication administration policy with a newly licensed nurse. The newly licensed nurse shows an understanding of the policy by identifying situations as requiring the completion of an incident report? A. A nurse obtained a client's blood for culture testing prior to beginning antibiotic therapy B. A client refuses to take her morning medication C. A nurse used a client's telephone number as a client identifier prior to medication administration D. A stat prescription for a medication administration was initiated 2 hours after it was received
A stat prescription for a medication administration was initiated 2 hours after it was received *Stat prescriptions are often written for emergencies and should be initiated immediately. This situation requires the completion of an incident report because this medication error violates the right of "right time."
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Naproxen B. Acetaminophen C. Aspirin D. Ibuprofen
Acetaminophen *Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastroinstinal bleeding
A nurse is reinforcing teaching with a newly licensed nurse about the care of a client who is receiving patient-controlled analgesia (PCA). Which of the following actions by the newly licensed nurse indicates an understanding of the teaching? A. Assessing the client's vital signs every 6 hours B. Instructing the client's family to press the PCA button when the client is asleep C. Asking a second nurse to check the PCA setting D. Administering the PCA through a free-flow
Asking a second nurse to check the PCA setting *The nurse should have a second check the PCA settings to ensure the correct amount of medication is being administered to the client
A nurse is caring for a client who is taking an agonist medication. The nurse should expect which of the following actions from this type of medication? A. Acts with a partial agonist molecule to block receptors fully B. Temporarily occupies receptors instead of other competitive molecules C. Blocks receptors and prevents them from activating with a regulatory molecule D. Binds to receptors and mimics regulatory molecules
Binds to receptors and mimics regulatory molecules *Full agonist medications act by binding to receptors and mimicking the actions of the body's regulatory molecules. Agonists activate receptors to produce the expected effects. Hormones are an example of agonists
A nurse is caring for a client and realized after administering the 0900 medications that she gave digoxin 0.25 mg PO to the client instead of the prescribed dose of digoxin 0.125 mg PO. Which of the following actions should the nurse take first? A. Notify the provider B. Contact the nursing supervisor C. Check the client's apical pulse D. Complete an incident report
Check the client's apical pulse *The first action the nurse should take is to assess the client
A nurse is preparing to administer the influenza vaccine to a client. Which of the following allergies should the nurse identify as a contraindication to the clent receiving this vaccine? A. Gelatin B. Chicken eggs C. Neomycin D. Prednisone
Chicken eggs *The nurse should identify that an allergy to chicken eggs is a contraindication to receiving the influenza vaccine. Clients who have this allergy can experience angioedema and severe respiratory distress if this vaccine is administered
A nurse is reviewing the laboratory data of a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings places the client at risk for decreased clearance of the medication? A. Alanine aminotransferase (ALT) 60 international units/L B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31
Creatinine clearance 35 mL/min *Creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidneys' ability to filter waste. A creatinine clearance of 35 mL/min is below the expected reference range of 87 to 139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs with moderate renal impairment
A nurse is caring for a client who has multiple medication allergies. During which of the following steps of the nursing process should the nurse idenify the client's allergies? A. planning B. Evaluation C. Data collection D. Implementation
Data collection *The data collection step of the nursing process involves collecting pertinent information, which includes the identification of the client's allergies
A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? A. Decreased blood glucose B. Increased potassium C. Increased prostaglandin synthesis D. Decreased inflammation
Decreased inflammation *For a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budeseonide is a glucocorticoid that words by suppressing the immune system. Glucocortocoids inhibit the actions of prostaglandins and leukotrienes
A nurse is caring for a male client who has been taking cimetidine for the treatment of a duodenal ulcer. Which of the following manifestations related to the medication should the nurse report to the provider? A. Emesis that looks like coffee grounds B. Erectile dysfunction C. Muscle pain D. Gynecomastia
Emesis that looks like coffee grounds *The nurse should identify that coffee-ground emesis is a manifestation of a gastrointestinal bleed asa result of the duodenal ulver and can indicate that treatment with cimetidine has been effective. Therefore, the nurse should report this finding to the provider immediately
A nurse is reviewing the medication administration record of a client who has a new prescription for levothyroxine. Which of the following medications should the nurse identify as needing to be administered 4 hours after levothyroxine administration? A. Metaxalone B. Ferrous sulfate C. Spironolactone D. Ibuprofen
Ferrous sulfate *The nurse should identify that ferrous sulfate can reduce the absorption of levothyroxine. The nurse should administer the ferrous sulfate 5 hours later to ensure adequate absorption
A nurse is caring for a client who is taking streptomycin. Which of the following medications should the nurse identify as increasing the risk of developing ototoxicity when taken with streptomycin? A. Celoxitin B. Furosemide C. Naproxen D. Amphortericin B
Furosemide *Furosemide, a high-ceiling (loop) diuretic, increases the risk of developing ototoxicity when taken with streptomycin, an aminoglycoside
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0
INR 3.0 *Warfarin is an anticoagulant that prevents thrombus formation in susceptible clients. The INR measures its effectiveness. For most clients taking warfarin, an INR of 3.0 indicates effective therapy
A nurse is reinforcing teaching about immunopressive medications with a client who had kidney transplant surgery. Which of the following adverse effecs of these medications should the nurse include in the teaching? A. Increased urinary output B. Increased susceptibility to infection C. Increased hair loss D. Increased risk for autoimmune disorders
Increased susceptibility to infection *Immunosuppressive medications such as cyclosporine increase the risk of infection. As the medication classification indicates, these medications impair immunity and adversely affect the client's ability to resist and fight infection
A nurse in a provider's office is reinforcing teaching with a client who has an elevated prostate-specific antigen level and a new prescription for finasteride. Which of the following statements by the client indicates an understanding of the teaching? A. "I should expect my urinary problems to improve within a couple of weeks." B. "It will be great to have a stronger sex drive." C. "I will skip donating blood while I am taking this medication." D. "I wont have to worry about getting cancer while taking this medication."
"I will skip donating blood while I am taking this medication." *The nurse should reinforce with the client that finasteride is teratogenic to male fetuses and carries an FDA pregancy Risk catergory X. Pregnant women should not handle the medication, and men who are taking it should not donate blood until it has been discontinued for at least 1 month
A nurse is reinforcing teaching about the adverse effects of ergotamine with a client who has migraine headaches. Which of the following client statements should indicate an understanding of the teaching? A. "If I overuse this medication, I might become addicted to it." B. "This medication is okay to use during pregnancy." C. "Tingling in my fingers and toes is an adverse effect that goes away with continued use." D. "I will experience restlessness as an adverse effect when I begin taking this medication."
"If I overuse this medication, I might become addicted to it." *The client should take the ergotamine according to the prescribed dose and should only take the medication when needed to avoid developing a physical dependence
A nurse is reinforcing teaching with a client who has urethritis and a new prescription for oral erythromycin. Which of the following statements should the nurse include in the teaching? A. "Report persistent diarrhea to the provider." B. "Take this medication with a full glass of milk." C. "Some people who take erythromycin experience vision loss." D. "Antacids will reduce the extent of absorption of this medication."
"Report persistent diarrhea to the provider." *Although gastrointestinal distrubances are the most common adverse effects of erythromycin, clients should report persistent or severe gastrointestinal reactions to the provider. Erythromycin can cause superinfection of the bowel because it destroys some sensitive flora in the gastroinstinal system
A nurse is preparing to administer the first injection of the diptheria, tetanus, and pertussis (DTaP) vaccine to an infant. Which of the following pieces of information should the nurse tell the guardian prior to administering the immunization? A. "Your chid might develop diarrhea or vomiting withing 24 hours of receiving this vaccine." B. "I can either give you child all of the injectons in this series at once or individually." C. "The vaccine will be injected into the infant's thigh." D. "This injection contains a live virus."
"The vaccine will be injected into the infant's thigh." *The DTaP vaccine is administered intramuscularly (IM) in the detloid or mediolateral thigh because these are larger muscles that can better diffuse inflammation. Therefore, the nurse should prepare to administer the IM injection in the mediolateral thigh
A nurse is reinforcing teaching with a client who has been taking an NSAID to treat rheumatoid arthritis. During the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen. Which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication? A. "Your current medication was not strong enough to manage this condition." B. "Once your blood levels of methotrexate are withing the therapeutic range, the NSAID will be discontinued." C. "This medication was added to delay the disease progression." D. "Treating this disease with 2 medications will help protect you from becoming treatment-resistant."
"This medication was added to delay the disease progression." *The nurse should inform the client that the provider prescribed methotrexate to be added to the medication regimen along with an NSAID to delay the prgoression of the disease and to delay joint damage or deformity that can result from the disease
A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication? A. 1/2 inch B. 1 1/2 inch C. 2 1/2 inch D. 3 inch
1 1/2 inch *In general, needle length for IM injections are 1 to 1/2 inches, unless the client is obese. A BMI is considered to be an optimal weight
A nurse is assisting with preparing to administer a hydromorphone IV infusion to a client for pain. Which of the following actions should the nurse take? A. Administer the medication over 4 to 5 minutes B. Place the client in high-Fowler's position C. Assess the client's pain level after administering the medication D. Review the client's last set of vital signs
Administer the medication over 4 to 5 minutes *The nurse should administer the IV injection of this opioid medication over 4 to 5 minutes to prevent the adverse effects of the medication such as respiratory depression and cardiac arrest
A nurse is caring for a client who has a postive tuberculin skin test and a new prescription for isoniazid. For which of the following laboratory values should the nurse monitor? A. Thyroid Stimulating Hormone level (TSH) B. Asparte aminotransferase (AST) C. Potassium D. Sodium
Asparte aminotransferase (AST) *Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider about jaundice, nausea, dark-colored urine, or other findings indicating hepatitis
A nurse is assisting with the care of a client who had a myocardial infarction 2 hours ago and is receiving alteplase. Which of the following findings should the nurse identify as an adverse effect of receiving this medication? A. Bleeding B. Increased clot C. Shortness of breath D. Blockage of the central venous catheter
Bleeding *The nurse should identify that an adverse effect of alteplase is bleeding. Severe bleeding can occur as aresult of the alteplase-plasminogen complex, which catalyzes the conversion of other plasminogen molecules that digest fibrin cloths. This action of the medication can contribute to hemorrhage.
A nurse is caring for a client who has a prescription for a QT interval medication. Which of the following conditions should the nurse identify as an adverse effect of this medication? A. Bradycardia B. Jaundice C. Low blood pressure D. Dark urine
Bradycardia *The nurse should identify that an adverse effect of a QT interval medication is bradycardia. This medication should be used with caution for clients who have hypotension or heart failure, older adult clients, or clients who have low potassium or magnesium levels
A nurse is caring for a client who has alcohol use disorder and was admitted wth lower-extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first? A. Acamprosate B. Naltrexone C. Chlordiazepoxide D. Disulfiram
Chlordiazepoxide *Chlordiazepoxide, a long-acting oral benzodiazepine, is a first-line medication for manifestations of acute alcohol withdrawal. For clients who are nauseated or vomiting, another benzodiazepine such as lorazepam can be administered via IV. The nurse should apply the acute versus chronic priority-setting framework when caring for this client. In ths framework, acute needs (i.e. manifestations of acute withdrawal) are typically the priority because they pose more of a threat to the client. Since chronic needs usually develop over a period of time, the client has more of an opportunity to adapt to the alteration in health
A nurse discovers that a client received an incorrect dosage of a morning medication. Which of the following actions should the nurse take first? A. Collect data from the client to determine the client's condition B. Report the incident to the nursing supervisor C. Complete and file a facility incident report D. Notify the client's provider of the incident
Collect data from the client to determine the client's condition *The first action the nurse should take when using the nursing process is to collect data from the client to determine the client's condition and safety
A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following laboratory values related to this medication should indicate to the nurse that the treatment is effective? A. Increased aspartate aminotransferase (AST) B. Decreased alanine aminotransferase (ALT) C. Increased prothrombin time (PT) D. Decreased serum ammonia
Decreased serum ammonia *The nurse should identify that lactulose is a laxative that can be used for chronic liver disorders such as cirrhosis. Lactulose improves the client's condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that is can be eliminated from the body
A nurse is assisting with a client's laceration repair in which the provider will use both lidocaine and epinephrine. The nurse should inform the client that the epinephrine will perform which of the following actions? A. Act as a catalyst for the anesthetic properties of lidocaine B. Delay systemic absorption of the anesthetic properties of lidocaine C. Open the blood vessels for rapid anesthesia from the lidocaine D. Prevent medication toxicity during the procedure
Delay systemic absorption of the anesthetic properties of lidocaine *The nurse should inform the client that medications such as lidocaine are often administered in combination with a vasoconstrictor such as epinephrine. Epinephrine decreases local blood flow and delays systemic absorption of the anesthetic property of lidocaine
A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? A. Ecchymosis B. Decreased urine output C. Increased blood pressure D. Dizziness
Dizziness *Zolpidem can cause dizziness and daytie drowsiness. It can cause confusion in an older adult client
A nurse is reinforcing teaching with a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long-term therapy. The nurse should instruct the client to report which of the following as an adverse effect of prednisone? A. Thrombosis B. Immunosuppression C. Gastric ulceration D. Liver toxicity
Gastric ulceration *The nurse should instruct the client to monitor for gastric ulceration as an adverse effect of the long-term use of prednisone. Other adverse effects of this medication include osteoporosis and adrenal suppression
A nurse is preparing to administer the varicella vaccine to a 12-month-old infant. The nurse asks the infant's guardian if the infant has any allergies. Which of the following allergies is a contraindication to the infant receiving the vaccine? A. Gelatin B. Milk C. Eggs D. Peanuts
Gelatin *An allergy to gelatin is a contraindication to receiving the varicella vaccine; therefore, the nurse should contact the infant's provider
A nurse is caring for a client who is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room? A. Grapefruit juice B. Hardboiled eggs C. Coffee D. Oatmeal
Grapefruit juice *Grapefruit juice is contraindicated for a client which is taking simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism
A nurse is reinforcing teaching with a client who has atrial fibrillation and a new prescription for amiodarone. Which of the following items should the nurse instruct the client to avoid while taking this medication? A. Green leafy vegetables B. Grapefruit juice C. Garlic D. Salt substitutes
Grapefruit juice *The nurse should instruct the client to avoid grapefruit juice while taking amiodarone. Grapefruit juice can prevent amiodarone from being metabolized in the gastrointestinal tract, increasing the risk of toxicity
A nurse is planning care for a client who has gout and a new prescription for allopurinol. Which of the following actions should the nurse plan to take? A. Instruct the client to increase fluid intake to 2 to 3 L daily B. Ensure the client increases vitamin C C. Increase the client's dosage during an acute D. Explain to the client that a harmless rash can occur
Instruct the client to increase fluid intake to 2 to 3 L daily *The nurse should instruct the client to increase fluid intake to 2 to 3 L to prevent the risk of kidney stone formations and renal injury to the kidneys
A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? A. Aspirin EC 80 mg PO daily B. Levothyroxine 75 mcg PO q AM brefore breakfast C. Metormin XR 500 mg PO daily D. Nitroglycerin 0.3 mg SL PRN chest pain, can repeat q 5 min for 2 additional doses
Levothyroxine 75 mcg PO q AM brefore breakfast *Levothyroxine can be crushed because it is not extended-release, sublingual, or enteric-coated. If crushed, the medication should be mixed with 5 to 10 mL of water
A nurse is caring for a client who takes a combination oral contraceptive (OC). Which of the following findings should indicate to the nurse that the client is experiencing a deficiency of estrogen in the OC? A. Mid-cycle breakthrough bleeding or spotting B. Breast tenderness C. Migraine headaches D. Nausea
Mid-cycle breakthrough bleeding or spotting *If a client has mid-cycle breakthrough bleeding or spotting while taking a combination OC, the nurse should recognize that the OC is deficient in the amount of estrogen for the client
A nurse is caring for a client who has been receiving medication through a transdermal patch. The client is experiencing therapeutic benefits from the medication even though the medication in the patch is no longer active. The nurse should recognize that this is an example of which of the following? A. Pharmacodynamic tolerance B. Placebo effect C. Metabolic tolerance D. Tachyphylaxis
Placebo effect *The nurse should identify that the client is experiencing a placebo effect from the medication in the transdermal patch. This occurs when a medication response is caused by psychosocial factors and not by the biochemical or physiological properties of the medication
A nurse is reinforcing teaching about the adverse effects of baclofen with a client who has multiple sclerosis with spasms. Which of the following statements should the nurse identify as an indication that the client understands the information? A. "Adverse effects include urinary frequency." B. "I should increase my fiber intake to counteract the adverse effect of diarrhea." C. "This medication can cause addiction." D. "I should not stop taking this medication suddenly."
"I should not stop taking this medication suddenly." *The nurse should inform the client about the adverse effects associated with abrupt withdrawal of baclofen such as visual hallucinations, paranoid ideations, and seizures
A nurse is caring for a client at 39 weeks of gestation who has gestational hypertension. The client has a new prescription for misoprostol for cervical ripening and induction of labor. Which of the following findings in the client's history should the nurse identify as increasing the client's risk of complications due to the use of this medication? A. Positive bacterial vaginosis culture B. History of failure to progress C. Previous cesarean delivery D. Positive serum Rh sensitization
Previous cesarean delivery *The nurse should identify that misoprostol is a prostaglandin that promotes cervical ripening. An adverse effect of misoprostol is uterine tachysystole (excessively frequent uterine contractions). Therefore, this medication should be used with extreme caution and is contraindicated in clients who have experiences a previous cesarean delivery
A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? A. Dextromethorphan B. Montelukast C. Ciprofloxacin D. Propranolol
Propranolol *The nurse should identify that a client who is experiencing an acute exacerbation requires the use of beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol
A nurse is caring for a client who takes gentamicin IM and has a prescription to obtain a blood sample to measure a trough level. At which of the following times should the nurse draw the blood sample? A. Within 15 minutes prior to the next medication dose B. 3 hours prior to administering a dose C. Within 15 minutes following the next medication dose D. 2 hours after administering a dose
Within 15 minutes prior to the next medication dose *The nurse should obtain the blood sample for a trough medication level immediately before or within 15 minutes of giving a dose of the medication, regardless of the route of administration
A nurse is reinforcing teaching with a client who has a new prescription for alosetron. Which of the following client statements indicates an understanding of the teaching? A. "Nausea is a common adverse effect of this medication." B. "I should contact my provider immediately if I experience constipation." C. "If I do not respond to treatment at my lowest dosage, my provider may continue to increase the dosage at weekly intervals." D. "Abdominal pain with diarrhea can indicate a serious complication."
"I should contact my provider immediately if I experience constipation." *The nurse should identify that constipation is an adverse effect of this medication and requires the provider to be notified. The provider may adjust the dose or withhold the medication and then instruct the client to resume taking it once the constipation has resolved
A nurse is reinforcing teaching with a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? A. "If phenazopyridine upsets my stomach, I can take it with meals." B. "Phenazopyridine will receive my discomfort, but ciprofloxacin will get rid of the infection." C. "I need to drink 2 liters of fluid per day while taking ciprofloxacin." D. "I should notify my provider immediately if my urine turns orange."
"I should notify my provider immediately if my urine turns orange." *Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. The medication can cause the client's urine to turn a reddish-orange color. Although this coloration can stain clothing, this finding does not need to be reported to the provider
A nurse is reinforcing discharge teaching with a client who has a new prescription for cyclosporine following a kidney transplant. Which of the following client statements indicates an understanding of the teaching? A. "I can expect this medication to cause my blood pressure to drop." B. "I should take this medication with grapefruit juice." C. "I will need to take a stool softener now that I am taking this medication." D. "I should schedule an appointment with my dentist every 3 months."
"I should schedule an appointment with my dentist every 3 months." *The nurse should reinforce with the client that gingival hyperplasia is a potential adverse effect of cyclosporine. The client should maintain proper oral hygiene and a schedule a dental examination for teeth cleaning for teeth cleaning and plaque control every 3 months to help decrease gingival inflammation and hyperplasia
A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL infused over 10 hours. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? Round to the nearest whole number
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A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? A. Use a 22-gauge needle to administer the medication B. Inject the medication into a muscle C. Massage the site after administering the medication D. Administer the medication into the client's abdomen
Administer the medication into the client's abdomen *The heparin should be administered into the client's abdomen
A nurse is reinforcing discharge teaching with a client who has major depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? A. Broiled beef steak B. Macaroni and cheese C. Pepperoni pizza D. Smoked salmon
Broiled beef steak *Phenelzine is an MAOI antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume
A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications? A. Disulfiram B. Chlordiazepoxide C. Methadone D. Varenicline
Chlordiazepoxide *Chlordiazepoxide is a benzodiazepine, which is a type of medication often used to facilitate withdrawal. It assists with decreasing withdrawal manifestations, stabilizing vital signs, and prevent seizures and delirium tremens.
A nurse is caring for a client with Alzheimer's disease who has a prescription for memantine. Which of the following laboratory results should the nurse identify as increasing the client's risk for decreased clearance of the medication? A. Alanine aminotransferase (ALT) 30 units.L B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31
Creatinine clearance 35 mL/min *Creatinine clearance is an estimate of the glomerular filtration rate and the kidney's ability to filter waste. A creatinine clearance of 35 mL/min indicates moderate renal impairment. The kidney's excrete memantine, and decreased clearance occurs with moderate renal impairment
A nurse prepares is collecting data preoperatively from a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? A. Soy B. Garlic C. Black cohosh D. Green tea
Garlic *Many dietary supplements can affect clotting or interact with other medications that affect clotting, increasing the client's risk of bleeding. Examples of these dietary supplements include garlic, echinacea, feverfew, ginger, glucosamine, and ginkgo biloba. The nurse should notify the provider immediately about this potential risk
The nurse is caring for a client who has had a levonorgestrel-releasing intrauterine device (IUD) in place for 1 year. Which of the following findings should indicate that the client is experiencing an adverse effect? A. Developed sensitivity to copper B. Vaginal irritation or inflammation C. Decreased menstrual bleeding D. Spotting between menstrual cycles
Spotting between menstrual cycles *Light spotting and amenorrhea are common adverse effects for clients who use a levonorgestrel-releasing IUD. IUDs can alter menses, prompting spotting between menstruation periods
A nurse is reviewing the medical record of a client who has been taking a vitamin D supplement. Which of the following findings from the client's record should the nurse identify as a risk factor for developing vitamin D deficiency? A. Middle-age B. Obesity C. Dark-colored eyes D. Light-pigmented skin
Obesity *The nurse should identify that a client who is obese is at risk for vitamin D deficiency. A screening can be prescribed to determine of a deficiency is present
A nurse is assigned to care for several clients who postoperative. The nurse should identify that the client taking which of the following medications is at risk for delayed wound healing? A. Nefedipine to treat hypertension B. Prednisone to treat persistent arthritis exacerbations C. Albuterol to treat asthma D. Chlorpromazine to treat schizophrenia
Prednisone to treat persistent arthritis exacerbations *Prednisone is a corticosteroid that is associated with delayed wound healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations
A nurse is evaluatig a 20-month-old child who received a hepatitis A immunization 3 days ago. The parent reports that the child has exhibited a loss of appetite following the immunization. Which of the following actions should the nurse take? A. Tell the parent that this reaciton should only last for a couple of days B. Notify the provider immediately C. Prepare an antidote to administer to the child D. Request that the provider order a serum titer level
Tell the parent that this reaciton should only last for a couple of days *The nurse should tell the parent that a loss of appetite is a mild reaction in response to the hepatitis A vaccine and will usually last 1 to 2 days
A nurse is caring for a client who was recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe methotrexate at which of the following times? A. Within 3 months of the initial diagnosis B. When NSAIDs have not provided pain relief C. During an exacerbation of symptoms D. Once bone degeneration progresses
Within 3 months of the initial diagnosis *The nurse should identify that current guidelines recommend starting a disease-modifying antirheumatic drug (DMARD) such as methotrexate within 3 month of a diagnosis of rheumatoid arthritis to prevent or delay joint degeneration
