ATI exam 2 PHARM

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions? A. "Expect this medication to suppress your cough" B. "Expect this medication to smell like rotten eggs" C. "Expect this medication to cause euphoria" D. "Expect this medication to turn your urine orange"

B. "Expect this medication to smell like rotten eggs" It has a sulfur content that causes a rotten-egg odor

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I should use the spray every 4 hours while I am awake" B. "It can take as long as 3 weeks before the medication takes a maximum effect" C. "This medication can also be used to treat motion sickness" D. "I can use this medication when my nasal passages are blocked"

B. "It can take as long as 3 weeks before the medication takes a maximum effect"

A nursing is planning care for a client who is receiving Furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (SELECT ALL THAT APPLY) A. Assess for tinnitus. B. Report urine output 50 mL/hr. C. Monitor serum potassium levels. D. Elevate the head of bed slowly before ambulation. E. Recommend eating a banana daily

A. Assess for tinnitus- an adverse effect is ototoxicity C. Monitor serum potassium levels- could be decreased D. Elevate the head of bed slowly before ambulation- may prevent orthostatic hypotension secondary to hypovolemia E. Recommend eating a banana daily- eat foods high in potassium

A nurse is reviewing the health record of a client who asks about using propranolol to treat HTN. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia

A. Asthma Propranolol is a beta blocker which can cause bronchoconstriction

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than 60/min B. Check pulse rate for 30 seconds and multiply by 2 C. Increase intake of sodium D. Take with food if nausea occurs

A. Contact provider Digoxin is meant to increase heart rate. Nausea can be a sign of digoxin toxicity, and sodium should be reduced.

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (SELECT ALL THAT APPLY) A. Dry mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation

A. Dry mouth- due to an anti-cholinergic manifestation D. Drowsiness E. Urinary retention- due to an anti-cholinergic manifestation

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (SELECT ALL THAT APPLY) A. Fatigue B. Constipation C. Anorexia D. Rash E. Blurred vision

A. Fatigue- early CNS findings C. Anorexia- contributes to GI disturbances E. Blurred vision- and other visual changes such as yellow-tinged vision (yellow halo)

A nurse is teaching a client who has a new prescription for verapamil to control HTN. Which of the following instructions should the nurse include? A. Increase the amount of dietary fiber in the diet B. Drink grapefruit juice daily to increase vitamin C intake C. Decrease the amount of calcium in the diet D. Withhold food for 1 hour after the medication is taken

A. Increase the amount of dietary fiber in the diet can help prevent constipation

A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A. Take the medication with food B. Plan to take the medication at bedtime C. Expect increased swelling of the ankles D. Fluid intake should be limited in the morning

A. Take the medication with food prevents GI upset should be taken in the morning to prevent nocturia

A nurse is planning to administer a first dose of captopril to a client who has HTN. Which of the following medications can intensify first dose hypotension? (SELECT ALL THAT APPLY) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren

B. Hydrochlorothiazide- diuretics can intensify D. Clonidine- a centrally acting alpha agonist for HTN E. Aliskiren- a direct renin inhibitor for HTN

A nurse is planning caring for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following adverse reactions to the medication? (SELECT ALL THAT APPLY) A. Respiratory acidosis B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias

B. Hypokalemia (an adverse effect of loop diuretics) C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias- a manifestation of hypokalemia

A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased urine output C. Decreased conduction through AV node D. Vasoconstriction of the renal blood vessels

B. Increased urine output Occurs as a result of increased renal perfusion from vasodilation

A nurse is caring for a client who states she has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following adverse effects of this medication? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B. Nasal congestion When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications.

A nurse is caring for an older adult client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide

B. Verapamil A calcium channel blocker, can increase digoxin levels

A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

C. Delirium Mental status changes can occur in thiocyanate toxicity when IV Nitroprusside is infused at a high dosage. Monitor thiocyanate level, should remain below 10 mg/dL.

A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose 150 mg/dL B. Urine output 40 mL/hr C. Dyspnea D. Bilateral equal pupil size

C. Dyspnea a manifestation of heart failure, an adverse effect of mannitol

A nurse is caring for a client who has a new prescription for captopril for HTN. The nurse should monitor the client for which of the following adverse effects of this medication? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia

C. Neutropenia An adverse effect- A low number of neutrophils (a type of WBC) in the blood can increase risk for infection. Monitor the client's CBC and teach client to report indications of an infection.

A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/dL D. Potassium 4.8 mEq/dL

C. Potassium 3.4 mEq/dL Low potassium can cause fatal dysrhythmias and increases risk for digoxin toxicity

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Diarrhea B. Anxiety C. Sedation D. Palpitations

C. Sedation Advise client to avoid activities that require alertness.

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. Serum sodium 144 mEq/L B. Urine output 120 mL in 4 hr C. Serum potassium 5.2 mEq/L D. Blood pressure 140/90 mmHg

C. Serum potassium of 5.2 mEq/L indicative of hyperkalemia due to the medication having an adverse effect of potassium retention