ATI PHARM PT.2

A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider?

Decreased hemoglobin The nurse should apply the safety and risk-reduction priority-setting framework. which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. Therefore, the priority finding for the nurse to report to the provider is a decreased hemoglobin level. Zidovudine can cause severe anemia and neutropenia from bone marrow suppression, resulting in hematologic toxicity.

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

Electrocardiogram Rationale: Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects while using amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is caring for a client with benign prostatic hyperplasia who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxasozin?

Hypotension Rationale: Nonselective alpha1-adrenergic antagonists like doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased blood pressure.

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

Liver function Rationale: Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function.

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarfiy with the provider?

Lorazepam Rationale: The nurse should identify that lorazepam can cause central nervous system depression, which can result in increased respiratory depression and sedation when administered with an opioid. The nurse should clarify the prescription with the provider.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches Rationale: Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels

A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following findings is the nurse's priority?

Mood changes

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?

Orthostatic hypotension Rationale: Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensitivity.

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 experiencing an adverse effect of the medication?

Osteoporosis Rationale: 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 assessing a client who was recently admitted and has a history of alcohol use disorder. The client displays ataxia, an altered level of consciousness, and nystagmas. Which of the following medications should the nurse anticipate administering to the client?

Parenteral thiamine Rationale: The nurse should identify that a client who has a history of alcohol use disorder and displays ataxia, an altered level of consciousness, and nystagmus is exhibiting manifestations of Wernicke-Korsakoff syndrome due to a thiamine deficiency. Therefore, the nurse should anticipate administering parenteral thiamine.

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. A severe allergy to which of the following medications is a contraindication to ceftriaxone?

Piperacillin Rationale: Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross-sensitivity reaction to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for a client who has an allergy to cephalosporins or a severe allergy to penicillin.

A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching?

Pravastatin can be taken with grapefruit juice. Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP3A4 inhibitors. It is safe for the client to consume grapefruit juice if desired.

A nurse is reviewing the laboratory values of a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 sec. Which of the following actions should the nurse prepare to take?

Reduce the infusion rate Rationale: An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause anticoagulation. The nurse should contact the provider, reduce the infusion rate, and assess the client for bleeding.

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

Reduces ammonia levels Rationale: Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following pieces of information should the nurse include in the teaching?

Respiratory depression can occur 7 min after the morphine is administered. Rationale: Respiratory depression can occur within 7 minutes of the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine.

A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe urinary tract infection (UTI). The client asks why both medications are needed. Which of the following responses should the nurse make?

"Ciprofloxacin hydrochloride treats the infection, and phenazopyridine treats the pain." Rationale: Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic, and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation.

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching?

"I can develop lithium toxicity if I experience vomiting or diarrhea." Rationale: Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys, and the risk of lithium toxicity increases.

A nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. Which of the following client statements indicates an understanding of the teaching?

"I might feel dizzy at times while taking this medication." Rationale: Hypotension and dizziness are potential adverse effects of this medication. The nurse should monitor the client's blood pressure and instruct the client to change positions slowly.

A nurse is teaching about adverse effects of ergotamine with a client who has migraine headaches. Which of the following client statements should indicate an understanding of the teaching?

"If i overuse this medication, I might become addicted to it." Rationale: 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 providing teaching to a client who has chronic constipation and a new prescription for psyllium. Which of the following instructions should the nurse provide?

"Mix this medication with water and follow with an additional glass of liquid." Rationale: The nurse should direct the client to administer the medication mixed in a full glass of water or juice followed by an additional glass of liquid. The client should also be instructed to increase intake of fluids to help decrease constipation.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

"Rifampin can turn body fluids orange." Rationale: Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is teaching a client who has dyspepsia about prescribed antacids. Which of the following statements should the nurse include in the teaching?

"Take antacids 1 hour apart from other medications." Rationale: 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 medications.

A nurse is preparing to administer a hydromorphone IV infusion to a client for pain. Which of the following actions should the nurse take?

Administer the medication over 4 to 5 minutes Rationale: 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 new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

Anti-estrogenic Rationale: Tamoxifen is an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal woman. It is used to prevent breast cancer in women who are at an increased risk.