ATI Pharm

A nurse is reinforcing discharge teaching with a client who has a prescription for a meter-dose inhaler. which of the following information should the nurse include in the teaching? 1. "wait 15 seconds between each puff of the same medication" 2. "hold your breath for 5 seconds after inhaling the medication" 3. "take a slow deep breath for3- 5 seconds after relasing the medication" 4. "roll the canster between your hands for 10-15 seconds to mix the medication"

"take a slow deep breath lasting 3-5 seconds after releasing the medication" doing this allows the medication to be disturbed deeper into the lungs

The nurse assesses the client with metastatic breast cancer for which nontherapeutic effect of docetaxel? Select all that apply. One, some, or all responses may be correct. Correct1 Alopecia 2 Constipation Correct3 Febrile neutropenia 4 Increased blood pressure Correct5 Hypersensitivity reaction

Alopecia, Febrile neutropenia, hypersensitivity reaction

Which medication does the nurse suspect causes a client who is hypokalemic to experience nausea, vomiting, and seeing a yellow light around objects? Digoxin Furosemide Propranolol Spironolactone

Digoxin These are signs of digitalis toxicity, which is more likely to occur in the presence of hypokalemia. Although furosemide most likely contributed to the hypokalemia, the client's symptoms are consistent with digitalis toxicity. Although propranolol can cause nausea, vomiting, and blurred vision, the presence of hypokalemia and yellow vision are more suggestive of digitalis toxicity. A side effect of spironolactone is hyperkalemia, not hypokalemia.

A client with a mental illness reports weakness and fatigue. During assessment, the primary health care provider notes hoarseness, esophagitis, dental erosion, and palate lacerations. Which medication will the nurse expect to be prescribed to treat these symptoms? 1 Clozapine Correct2 Fluoxetine 3 Olanzapine 4 Risperidone

Fluoxetine The symptoms of bulimia nervosa are hoarseness, esophagitis, dental erosion, and palate lacerations; this disorder can be treated with fluoxetine. Bulimia nervosa is a mental health disorder classified as an eating disorder. The client with bulimia nervosa voluntarily vomits food immediately after eating. Clozapine, olanzapine, and risperidone are used to treat schizophrenia.

Which medication would cause a client to appear pale and report fatigue and dyspnea? 1 Famotidine Correct2 Methyldopa 3 Levothyroxine 4 Ferrous sulfate

Methyldopa Methyldopa is associated with acquired hemolytic anemia and should be discontinued to prevent progression and complications. Famotidine will not cause these symptoms; it decreases gastric acid secretion, which will decrease the risk of gastrointestinal bleeding. Ferrous sulfate is an iron supplement to correct, not cause, symptoms of anemia. Levothyroxine is not associated with red blood cell destruction.

A nurse is collecting data from a client who is taking tobramycin. Which of the following should the nurse report to the provider immediately? 1. Report of nausea 2. fever 3. Oliguria 4. Report of headache

Oliguria oliguria indicated the client is at greatest risk for nephrotoxicity.

The nurse is caring for a client who is being given intravenous magnesium sulfate to treat preeclampsia. Which adverse side effect alerts the nurse to notify the health care provider? Respiratory rate of 18 breaths/min 2+ patellar reflex response Magnesium blood level of 5 mEq/L Urine output of less than 100 mL in 4 hours

urine output of less than 100mL in 4 hours A decreased urine output of less than 25 mL/hr may be indicative of kidney damage, a result of the preeclampsia, and impending renal failure. Magnesium sulfate is excreted by the kidneys, and magnesium toxicity may occur. Respirations at this rate are within the expected range; a rate of at least 16 breaths/min should be present before each dose of magnesium sulfate. Loss of the patellar reflex is suggestive of magnesium sulfate toxicity; a 2+ reflex is within the expected range. A magnesium blood level of 5 mEq/L is within the therapeutic magnesium blood range of 2.5 to 7.5 mEq/L.

A nurse is reinforcing teaching about nicotine polacrilex gum with a client who smokes 3 packs of cigarettes per day. which of the following statements should the nurse include in the teaching? 1. "you can drink caffeinated drinks while chewing gum" 2. "you can chew 2 pieces of gum when you have the urge to smoke 3. " you should chew the gum for a full 30 mins before discarding 4. "you should wait 5 mins after eating to chew the gum"

"you should chew the gum for a full 30 mins before discarding" the full dose of nicotine from the gum occurs within 15-30 mins

Which medication would the nurse anticipate the health care provider to prescribe to relieve the pain experienced by a client with rheumatoid arthritis? Correct1 Acetylsalicylic acid 2 Hydromorphone 3 Meperidine 4 Alprazolam

acetylsalicylic acid

Which common side effects of hydroxyzine would the nurse expect? Ataxia and confusion Drowsiness and dry mouth 3 Vertigo and impaired vision 4 Slurred speech and headache

drowsiness, and dry mouth Hydroxyzine suppresses activity in key regions of the subcortical area of the central nervous system; it also has antihistaminic and anticholinergic effects. Ataxia and confusion, vertigo and impaired vision, and slurred speech and headache are not associated with hydroxyzine.

Which medication would the nurse expect to be prescribed as first line of treatment for an adolescent with dysmenorrhea? 1 Ibuprofen 2 Guanfacine 3 Medroxyprogesterone 4 Dextroamphetamine sulfate

ibuprofen Nonsteroidal antiinflammatory drugs like ibuprofen can effectively treat dysmenorrhea (increased discomfort during menstrual flow). Guanfacine is an alpha-adrenergic agonist, which helps in the treatment of attention deficit hyperactivity disorder (ADHD). Medroxyprogesterone is a contraceptive that helps prevent pregnancy. Dextroamphetamine sulfate is a potent stimulant of the central nervous system, which helps in the treatment of ADHD.

Which deficiency would the nurse conclude is occurring when a client with chronic liver disease reports, "My gums have been bleeding spontaneously," and the nurse identifies small hemorrhagic lesions on the client's face? 1 Bile salts 2 Folic acid 3 Vitamin A Correct4 Vitamin K

vitamin K Fat-soluble vitamin K is essential for synthesis of prothrombin by the liver; a lack results in hypoprothrombinemia, inadequate coagulation, and hemorrhage. Although cirrhosis may interfere with production of bile, which contains the bilirubin needed for optimum absorption of vitamin K, the best and quickest manner to counteract the bleeding is to provide vitamin K intramuscularly. Folic acid is a coenzyme with vitamins B12 and C in the formation of nucleic acids and heme; thus, a deficiency may lead to anemia, not bleeding. Vitamin A deficiency contributes to development of polyneuritis and beriberi, not hemorrhage.

Which responsibility is the nurse's when administering prescribed opioid analgesics? Select all that apply. One, some, or all responses may be correct. 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 if the medication is refused.

A,B,D 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 required to verify an accurate count of doses before taking a dose from the locked source and at the change of the shift. Pruritus is a common side effect that can be managed with antihistamines. It is not an allergic response, so it does not preclude administration. The nurse should not discard an opioid in a client's room. Any waste of an opioid must be witnessed by another nurse.

Which medication requires the nurse to monitor the client for signs of hyperkalemia? 1 Furosemide 2 Metolazone Correct3 Spironolactone 4 Hydrochlorothiazide

spironolactone Spironolactone is a potassium-sparing diuretic; hyperkalemia is an adverse effect. Furosemide, metolazone, and hydrochlorothiazide generally cause hypokalemia

A client in labor who is prepared and plans to participate in the labor and birth process states that she is in severe discomfort. The nurse administers the prescribed butorphanol. Which phase of labor is the safest time for the nurse to administer this medication? Early phase Active phase 3 Transition phase 4 Expulsion phase

active phase Respiratory depression of the newborn will not occur if butorphanol is given during the active phase, and it should not be given when birth is expected to occur within 2 hours. The level of pain during the early phase can usually be managed with other strategies such as breathing techniques or diversion. Giving an opioid early in labor may slow the progress of labor. An opioid should be avoided in the 2 hours preceding birth as giving it to a client in the transition phase can cause respiratory depression in the newborn. Giving the medication when birth is imminent is contraindicated because it may cause respiratory depression in the newborn. The mother's level of consciousness will be altered as well, and this may make it difficult for her to cooperate with requests to push.

A preschooler is to have a peripheral intravenous catheter inserted. How would the nurse make the experience minimally traumatic for the child? By applying a topical analgesic before the procedure 2 By telling the child that the procedure will not cause pain 3 By having the parents leave the room during the procedure 4 By describing the procedure several hours before the catheter is inserted

by applying a tropical analgesic before the procudure Topical analgesics are used to make catheter insertion less uncomfortable. Telling the child that the procedure will not cause pain is not truthful; even with the application of a topical analgesic there may be some discomfort. The presence of the parents may provide a sense of security and help the child cope with the procedure. Although a brief explanation is necessary to prepare the child for the procedure, it should be given just before the procedure is performed; several hours is too long for the child to wait.

A nurse assesses a client whose fetal heart rate tracing is reassuring. Contractions, which are of mild intensity, are lasting 30 seconds and are 3 to 5 minutes apart. An oxytocin infusion is prescribed. Which intervention would the nurse take at this time? Checking cervical dilation every hour 2 Keeping the labor environment dark and quiet Correct3 Infusing oxytocin by piggybacking into the primary line 4 Positioning the client on the left side throughout the infusion

infusing oxytocin by piggybacking into the primary line Piggybacking the oxytocin infusion allows it to be discontinued, if necessary, while permitting the vein to remain open by way of the primary intravenous line. Cervical dilation is checked when there is believed to be a change, not on a regular basis. Unless specifically requested by the client, there is no reason to maintain a dark, quiet labor environment. Although positioning the client on her left side is recommended, it is not the primary concern at this time; there are no data to indicate maternal hypotension.

Which statement by a client prescribed paroxetine indicates to the nurse that more medication education is needed? I'll be a little drowsy in the mornings." 2 "I'm expecting to feel somewhat better, but I may need other therapy." Correct3 "I've been on the medication for 8 days now, and I don't feel any better." 4 "I know that I'll probably have to take this medication for several months."

ive been on medication for 8 days now, and i dont feel any better The response "I've been on the medication for 8 days now, and I don't feel any better" indicates that the client has not been taking the drug long enough to expect a therapeutic response; clients who begin taking antidepressants usually begin to feel a lightening of depression in approximately 14 to 20 days, with the full antidepressant effects being felt between 3 and 4 weeks. Drowsiness, fatigue, and insomnia are common side effects. Medication alone may not be effective; some form of psychotherapy often is needed. Clients usually remain on these medications for several months.

A nurse is assisting with the admission of a client who reports muscle aches and pains associated with construction work. the provider suggests taking acetaminophen. the nurse should notify the provider about which of the following? 1. History of hepatitis B 2. Cigarette smoker 3. History of hypertension 4. allergy to sulfonamides

History of hepatitis B Acetaminophen can cause hepatotoxicity, clients who have a history of liver damage are at risk for further damage and can require a lower dose.

Which nursing intervention is most important for a client with severe preeclampsia who is receiving intravenous (IV) magnesium sulfate? Increasing IV fluid intake 2 Preparing for a possible precipitous birth Correct3 Maintaining a quiet, darkened environment 4 Obtaining magnesium gluconate as an antagonist

Maintaining a quiet, darken enviroment A quiet, darkened room reduces stimuli, which is essential for limiting or preventing eclamptic seizures. Due to oliguria with severe preeclampsia, IV fluids should generally be limited due to the possibility of pulmonary edema. Precipitous birth is not a usual side effect of magnesium therapy. Calcium gluconate, not magnesium gluconate, is the antagonist for magnesium sulfate toxicity.

The nurse is administering the prescribed regular insulin to a client in diabetic ketoacidosis. In addition, an intravenous (IV) solution with potassium is prescribed. Which rationale would the nurse recognize as the reason for potassium administration? 1 Potassium loss occurs rapidly from diaphoresis present during coma. 2 Potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts. 3 Potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose. Correct4 Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment. Insulin stimulates cellular uptake of glucose and stimulates the sodium/potassium pump, leading to the influx of potassium into cells. The resulting hypokalemia is offset by parenteral administration of potassium. Potassium is not lost from the body by profuse diaphoresis. Potassium moves from the extracellular to the intracellular compartment rather than being excreted in the urine. Anabolic reactions are stimulated by insulin and glucose administration; potassium is drawn into the intracellular compartment, necessitating a replenishment of extracellular potassium.

Which aspect of blood transfusions would the nurse consider about O-negative blood that allows it to be the universal donor? It does not have any of the antigens that can cause a reaction. 2 The donor can donate blood more frequently than other people. 3 The antibodies to human immunodeficiency virus (HIV) can develop more quickly than in other blood types. 4 It is more frequently administered when compared with other blood types

it does not have any antigens that can cause a reaction

a nurse us reinforcing dietary teaching with a client who has a prescription for phenazine. Which of the following foods should the nurse include in the teaching as an appropriate food choice? 1. yogurt 2. avocado 3. smoked salmon 4. pepperoni

yogurt clients need to avoid tyramine, which can cause high blood pressure. yogurt contains litter or no tyramine.