ATI Capstone Pharmacology
a nurse is providing teaching to a client who has a new prescription for levothyroxine, which statement indicates understanding of the teaching?
"i might not realize the full effect of the medication for several weeks" take on empty stomach with glass of water, first thing in the morning 30-60min prior to breakfast
a nurse is caring for a pt who has a prescription for HCTZ for the initial tx of hypertension, what should the nurse recognize as the action of this med?
HCTZ decreases the reabsorption of sodium and water in the distal renal tubule
a nurse is caring for a client who is receiving morphine, what assessment is priority
RR
a nurse is caring for 4 clients who have peptic ulcer disease, the nurse should recognize that misoprostol is contraindicated for which of the following clients?
a client who might be pregnant (category X, can cause spontaneous abortion)
a nurse is caring for a female client who has a new prescription for alosetron, what therapeutic effects should the nurse expect in this pt?
a decrease in the frequency of defecation
acetylcysteine is prescribed for what med
acetaminophen overdose
a nurse is caring for a client who has varicella zoster, what med should the nurse administer
acyclovir
a nurse is in the ICU and caring for a pt with sudden onset of sustained SVT, what med should the nurse prepare?
adenosine (decreases electrical conduction through the AV node)
a nurse is caring for a client who has a systemic fugal infection and is receiving IV amphotericin B deoxycholate, during previous infusions the pt developed a fever and chills, what should the nurse take
administer diphenhydramine prior to administration (admin an antipyretic, corticosteroid, antihistamine, or antiemetic prior to to minimize the effects)
a nurse is teaching the partner of a pt who has DM how to manage episodes of sever hypoglycemia, when the pt is unresponsive, what action should the nurse instruct the pt to do first?
administer glucagon IM to the client
a nurse is reviewing the medical record of a client who received his medications 1 hour ago, the pt reports chest pain, this can be an AE of what med?
albuterol (beta2agonist, controls bronchospasm for asthma--can cause tremors, chest pain, tachycardia, dysrhythmias)
a nurse is teaching a pt to use TD nitroglycerin patches to treat angina pectoris, what instructions should she include?
apply a new patch every morning (effects begin 30-60 min after application and last 14 hours)
a nurse is preparing to initiate a peripheral IV line on an OA client who has dehydration. which of the following actions should the nurse take? (SATA)
apply traction to the skin when inserting the catheter cleanse the insertion site with antiseptic swabs
a nurse is teaching a client who has a new prescription for alprazolam to treat an anxiety disorder, what should the nurse include?
avoid taking this med with GFJ (take with food to reduce gastric distress)
a nurse is caring for apt with difficulty voiding following surgery, nurse notes a palpable bladder distention, what med should the nurse administer
bethanechol (for nonobstructive urinary retention)
a nurse is providing teaching to a pt who is starting to take aspirin, instruct the pt to monitor for what AE
black, tarry stools (r/f bleeding)
a nurse is planning a staff education session on AE of meds, what info should the nurse discuss about anticholinergic adverse effects?
blurred vision tachycardia constipation
a nurse is administering timolol to a pt being treated for open-angle glaucoma, after administration the nurse should monitor what AE
blurred vision, bradycardia, conjuntivitis
a nurse is assessing a client after administering paclitaxel for the tx of ovarian cancer, the nurse should identify what findings as a priority
bradycardia (r/f 3rd deg HB, and MI)
a nurse is assessing a client who has been using beclomethasone for 2 weeks to manage her asthma, what is the priority to report to the provider
bronchospasms
a nurse is completing an admission assessment for a client who has been taking st. john's wort, the nurse should identify that which of the following meds can interact with St. John's wort?
citalopram (causing serotonin syndrome when combined with antidepressants, dec effect of BC, warfarin, cyclosporine, digoxin, CCB, steroids, HIV PI, and some chemo agents)
a nurse is caring for a pt with hyperlipidemia, a new prescription for colesevelam, the nurse should monitor what as an AE of colesevelam?
constipation (and dyspepsia)
a nurse is caring for a client who has a prescription for vancomycin 1g IV intermittent infusion over 30min every 12 hours, what should the nurse take?
contact the provider for prescription clarification (administer over 60min or more to reduce risk of infusion reaction--hypotension, flushing)
a nurse is reviewing the health history of a pt who has migraine headaches and asks about a prescription for sumatriptan, the nurse should identify what as a contraindication for the med
coronary artery disease (can cause coronary vasospasm, ECG changes, hypertension)
a nurse is caring for a client who has an infection and is starting to take gentamicin, what lab test should the nurse monitor to detect an AE of the med?
creatinine (Cr, BUN, U.O.)
a nurse in the PACU is caring for a client who has received GA and has a manifestations of malignant hyperthermia, the nurse should expect to administer which of the following meds?
dantrolene
a nurse in the PACU is caring for a pt who has received GA and has a manifestation of malignant hyperthermia, the nurse should expect to administer what med?
dantrolene
a nurse is preparing to administer verapamil to a client who is 2 days postmyocardial infarction. the nurse should monitor the client for which of the following outcomes as therapeutic response to the medication?
decreased anginal pain
a nurse is taching a pt who has prostate cancer and a new prescription for leuprolide, explain how it treats prostate cancer
decreases the production of testosterone (initial increase, then desensitization and decrease in testosterone production)
a nurse is assessing a pt who is in preterm labor and is receiving mg sulfate via continuous IV infusion, what findings should the nurse identify as the priority
deep tendon reflexes 1+ (indicates depressed CNS and possible mg sulf toxicity)
a nurse is providing teaching to a pt who has a new prescription for oral extended release potassium chloride tablets, what instructions should the nurse include in the teaching?
do not crush this medication
a nurse is preparing to administer a 2nd unit of PRBCs to a pt who is experiencing hemorrhagic shock, the nurse should monitor for the manifestations of what as circulatory overload?
dyspnea
a nurse is reviewing lab data for a pt who is taking niacin to correct plama lipid levels, what lab findings should inidcate the nurse an AE of this therapy?
elevated ALT (AE hepatotoxicity: incr ALT, AST, LDH)
a nurse is caring for a pt who has chemo induced anemia, the nurse should expect to administer which of the following meds to treat the anemia
epoetin alfa
a nurse is providing teaching to a pt who has a prescription for buspirone, what info should the nurse include in the teaching
expect to have a full response from buspirone after 3-4 weeks
a nurse is planning care for a client who has neutropenia, what meds should the nurse anticipate administering?
filgrastin (leukopoietic growth factor)
a nurse is caring for a pt who has a new diagnosis of adrenal insufficiency. which of the following prescriptions should the nurse anticipate?
fludrocortisone (mineralcorticoid replacement med used to treat adrenal insufficiency, monitor for hypertension and edema)
a nurse is providing teaching to a male client who has a new prescription for folic acid, the client tells the nurse he heard that the medication is prescribed for women during pregnancy, what statements should the nurse make?
folic acid is important for the building of blood cells for adults and children (tx megaloblastic and macrocytic anemias)
a nurse is preparing to administer topotecan IV, which of the following meds should the nurse expect to administer to control the adverse effects
granisetron (antiemetic to prevent n/v) for clients receiving chemo
a nurse is providing teaching to a client who has a new prescription for guaifenesin, what info regarding the action of guaifenesin should the nurse include in the teaching?
guaifenesin increases cough production
1 puff MDI, 2 puff albuterol, what is the correct order
have pt take one puff of albuterol pt rests for one min take 2nd puff of albuterol have pt rest for 5 min have pt take one puff of fluticasone
a nurse is caring for a client who has prescription for terazosin, the nurse should identify that this medication is indicated for which of the following disorders?
hypertension BPH
a nurse is assessing a pt who has open angle glaucoma and a new prescription for timolol, the nurse should monitor for what AE
hypoglycemia
a nurse is teaching a pt who has a new prescription for brimonidine to treat open-angle glaucoma, what indicates an understanding of the instructions?
i can expect to feel some irritation when i put these drops in my eyes
a nurse is providing teaching to a client who has a new prescription for oxybutynin, what statements by the client indicates an understanding of the teaching?
i need to avoid jogging on warm days (suppression of sweating by the anticholinergic effects by oxybutynin can result in hyperthermia)
a nurse is teaching a client who is starting to take benzonatate, which of the following statements by the pt indicates understanding?
i should not drive while taking this medication (AE is sedation and dizziness)
a nurse is providing discharge teaching to a pt who is starting to use an albuterol inhaler, what statement indicates understanding?
i should take this medication 15 minutes before exercising
the nurse is providing teaching to a female pt for ciprofloxacin, what statement indicates understanding of the teaching
i should wear protective clothing when I go outdoors (and sunscreen to prevent sunburn bc r/f photosensitivity)
a nurse is teaching a pt who will start methimazole for hyperthyroidism, what indicates understanding?
i will contact the provider if my throat becomes sore (potential for agranulocytosis, notify provider immediately if fever, sore throat, or other indications of infection)
a nurse is teaching a client who has a seizure disorder and is starting to take phenytoin, what statement should indicate understanding?
i will have my blood checked to monitor the med levels (10-20)
a nurse is providing teaching to a pt who has RA and is starting to take hydroxychloroquine, what indicates understanding?
i will need to have a baseline eye exam before starting this med (and every 6months , can cause possible retinal damage that can eventually lead to blindness)
a nurse is providing teaching to a pt who has hypertension and a new prescription for clonidine twice daily, the client understands when he says
i will stop drinking a glass of red wine at night (avoid due to the additive CNS effects)
a nurse is providing teaching to a pt who has a new prescription for montelukast, what statement by the pt indicates understanding
i will take the med every day to control my exercise-induced asthma
a nurse is providing teaching to a client who has T2D, and is starting to take immediate release exenatide, what statement is an understanding of the teaching
i will take this med 1 hour before morning and evening meals
a nurse is teaching a pt who is starting subq leuprolide for treatment of prostate cancer. what info should the nurse include?
increase calcium intake (can cause bone loss)
a nurse is providing teaching to a client who has a duodenal ulcer and is starting to take sucralfate, what instruction should the nurse include in the teaching?
increase fluid intake while taking med (incr fluid and dietary fiber to prevent constipation)
a nurse is providing teaching to a client who has a neuropathic pain and a new prescription for amitriptyline once per day, what should the nurse include?
increase fluids while on this med (urine turns blue/green, sedation is an AE)
a nurse is providing teaching to a pt who has a new prescription for allopurinol to treat gout, what should the nurse include?
increase your fluid intake
a nurse is caring for a pt who reports using the herbal med garlic along with his prescribed warfarin, the nurse should identify what is a potential AE of taking both of these products concurrently?
increased ecchymosis (antiplatelet effects can increase bleeding)
a nurse is administering bumetanide to a pt who has ascites, the nurse should monitor for what as an expected therapeutic effect of this med
increased urinary output (loop diuretic)
a nurse in ICU is monitoring a pt who has cardiogenic shock and is receiving a continuous IV infusion of dopamine. what requires an immediate intervention by the nurse?
infiltration of the peripheral IV
a nurse is providing teaching to a pt who has a new prescription for ranitidine for the tx of Zollinger-Ellison syndrome. the nurse should explain to the client that ranitidine treats ulcers by which of the following actions?
it reduces gastric acid production (H2 antagonist)
a nurse is caring for a pt who has hypertension and nephropathy due to T2D, the nurse should expect to administer what med to slow the progression of nephropathy?
losartan (angiotensin II receptor blocker)
a nurse is discussing AE with a pt who has non-Hodgkin's lymphoma and it is starting to take methotrexate, what should the nurse provide?
methotrexate can increase the risk for bleeding
a nurse is preparing to admin meds to a client who has type 1 diabetes mellitus, the client receives multiple oral meds, takes lispro insulin, he is starting to take pramlintide, what actions should the nurse take?
monitor for hypoglycemia for 3 hours after pramlintide administration (take before meals along with lispro insulin)
a nurse is providing teaching to the parents of a child who is starting to take liquid ferrous sulfate, what info should the nurse include in the teaching
monitor your child for constipation
a nurse is providing discharge instructions to a client who has a new prescription for codeine for cough suppression, what is the priority instruction?
move slowly when standing from a lying down position (r/f orthostatic hypotension)
a nurse is assessing a client who is receiving gemfibrozil, the nurse should identify what finding as an AE of this med?
muscle tenderness (--> myopathy, rhabdomyolysis)
a nurse is reviewing the lab findings for a client who is taking zidovudine to treat HIV, which should the nurse report to the provider
neutrophil count 650/mm3 (normal is 1500-8000)
a nurse is caring for a client who has recurrent lower UTIs which of the following meds should the nurse expect to administer?
nitrofuratoin ab for lower recurrent UTIs
a nurse is reviewing the med history of a pt who has MG and is asking about starting neostigmine, the nurse should identify what pt condition as a ptoential contraindication to cholinesterase inhibitor therapy
peptic ulcer disease (r/f erosion and perforation)
a nurse is caring for a female client who has osteoporosis and a new prescription for raloxifene, what should the nurse assess prior to initiating therapy?
pregnancy status (risk category X)
a nurse is caring for a pt who is receiving a continuous IV of heparin, the nurse should expect to administer which of the following meds if the client experiences a heparin overdose?
protamine sulfate
a nurse is caring for a pt who has HIV and a prescription for delavirdine, the nurse should monitor the pt for what manifestations as an AE of the med
rash (steven-Johnson sndrome)
a nurse is preparing to administer IV mannitol to a client, the nurse should monitor the client for which of the following manifestations as an expected outcome of this med
reduced intracranial pressure
a nurse is caring for a client who has a prescription for metoclopramide, what outcomes should the nurse use to evaluate the effectiveness of this med?
reduced nausea
a nurse is providing teaching to a client who has angina and a new prescription for sublingual nitroglycerin tablets, what info should the nurse include
store unused tablets at room temp (take one tablet every 5 mins, up to 3 tablets until pain resolves, call 911 after 1st tablet)
a nurse is caring for a client who has HF and a prescription for acetazolamide. prior to administration of the first dose, the nurse should ask the client if she has allergy to what meds?
sulfa-based meds
a nurse is assessing a pt who is taking ondansetron, what is a therapeutic effect?
suppressed emesis
a nurse is providing teaching to a client who has osteoporosis and is starting to take oral ibandronate, what instruction should the nurse include?
take one tablet of med on the same date each month (maintain med level)
a nurse is caring for a client who has HIV-1 and is starting therapy with ritonavir and zidovudine. the client asks why she has to take both medications, which explanation should the nurse provide?
taking the 2 meds together keeps you from becoming resistant to either of them
a nurse is assessing a pt who has DI and is starting intranasal desmopressin, what can indicate to the nurse that the med is effective?
the client's urine output is 1.256ml/24 hours
a nurse is teaching a pt who is taking methyldopa for the tx of htn, what info should the nurse include?
the med can cause dizziness
a nurse is providing teaching to a client who has a new prescription for calcitonin, what statements by the client indicates an understanding of the meds AE
the med can cause nausea
a nurse is providing teaching to a pt who is starting to take finasteride for the treatment of male pattern baldness, what indicates understanding
the med can increase my risk for impotence
a nurse is providing discharge instructions to a pt who has a prescription for omeprazole for the tx of GERD, what statement by the client indicates an understanding of the teaching?
the med reduces stomach acid (suppressing production of gastric acid, reduces baseline acid level and blocks production of all stimulated acid production within 2 hours of an oral dose)
a charge nurse is orienting a newly licensed nurse to the unit-dose med system, what info should the nurse include?
the pharmacist restocks the med drawer every day
a nurse is providing a teaching to a pt who is starting to take sulfasalazine for the treatment of ulcerative colitis, which of the following should the nurse include in the teaching
this med can cause your urine and skin to turn orange and can stain contact lenses
a nurse is teaching a pt who has ED and starting to take tadalafil, what statement by the pt indicates and understanding of the teaching?
this medication can decrease my BP
a nurse is assessing a client who has HF is taking digoxin. the nurse should monitor the client for which of the following manifestations as an indication of digoxin toxicity to report to the provider?
vomiting (n/v, anorexia, blurred vision)
a nurse is caring for a pt who has a prescription for ipratropium inhaler to control COPD bronchospasm, the nurse should monitor the client for which of the following manifestations as an AE of the med
xerostoma (anticholinergic)
a nurse is providing teaching to a client who has a new prescription for beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance, what should the nurse instruct?
you should gargle with water after each use of this inhaler
a nurse is providing teaching to a pt who has PD and has a new prescription for levodopa/carbidopa, what should the nurse include in the teaching
you should move slowly when you want to stand up
a nurse is providing teaching to a client who has fibromyalgia and a new prescription for pregabalin. which of the following instructions should the nurse include in the teaching?
you should notify your provider if you experience blurred vision (dizziness, difficulty with coordination, n, ha)
a nurse is providing teaching for a pt with a prescription for oral metronidazole, what is the priority teaching point?
you should report a rash to your provider (fatal disorder Stevens-Johnson syndrome)
a nurse is teaching a pt who has a new prescription for nitrofurantoin, what info should the nurse include in the teaching?
you should stop taking the med if you develop a cough (pulmonary reactions)
a nurse is caring for an OA client who is confirmed positive for HIV and will begin med therapy, what instruction should the nurse give the client
you will be prescribed more than one medication to fight the virus your medication plan can also include an antibiotic medication you will need to take the medication for the rest of your life
a nurse is teaching a client who has a new prescription for isoniazid to tx TB, what info should the nurse include?
you will have frequent sputum tests to monitor the effectiveness of this medication (sputum species every 2-4 weeks to monitor the effectiveness, 3 negative tests, continue for 6-12 mo)
a nurse is caring for a pt with T2D and began therapy with metformin 2 days ago the client reports experiencing n/d, what should the nurse say
your symptoms are common AE of metformin and should decrease with time (GI manifestations at onset of therapy)
