ATI Pharm Review

A nurse is teaching a client who is starting to take ketorolac. Which of the following information should the nurse include in the teaching? "Check for bruising while taking this medication." "Take the medication on an empty stomach." "The medication can cause anxiety." "Increase iron intake with this medication."

"Check for bruising while taking this medication." The nurse should instruct the client to check for bruising because ketorolac can increase the risk of bleeding by interfering with platelet aggregation.

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? "This medication increases your risk for hypertension." "Avoid potassium-rich foods in your diet." "Take each dose of medication in the evening before bed." "Drink a glass of milk with each dose of medication."

"Drink a glass of milk with each dose of medication." The client should take furosemide with food or milk to reduce gastric irritation

A nurse is providing teaching to a client who just started taking lithium (Eskalith). Which of the following statements indicates that the client understand the teaching? "I should inject this medication subcutaneously" "I should expect to feel better in just a few days" "I should call my doctor if I develop hand tremors" "I should take this medication on an empty stomach"

"I should call my doctor if I develop hand tremors"

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? "I will apply the patch once a week for 2 weeks." "I will leave the existing patch on for 4 hours after applying the new patch." "I will fold the sticky sides of the old patch together before disposing it." "I will apply the patch within 14 days of menses."

"I will fold the sticky sides of the old patch together before disposing it." The client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe disposal of the patch.

A nurse is providing teaching to a client who had a total gastrectomy. The client has anew prescription for Cyanocobalamin (Vitamin B12). Which of the following client statements indicates understanding of the teaching? "I will have to take this medication for the rest of my life." "After I receive injections for a week, I will be able to switch to a pill." "I need to have my vitamin B12 levels measured once a month." "Increasing my intake of green, leafy vegetables will increase my vitamin B12 levels."

"I will have to take this medication for the rest of my life."

A nurse is caring for a client who has anew prescription of zolipidem (Ambien) 10 mg by mouth. Which comments by the client indicates understanding regarding this medication? "I will take my medication at bedtime" "I will take this medication with food" "I will stop taking this medication in 1 week, so I don't get addicted" "I will take vitamin C to increase the effectiveness of this medication"

"I will take my medication at bedtime"

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? "I will have increased saliva production." "I will continue taking the medication until the rash disappears." "I will taper off the medication before discontinuing it." "I will report any urinary incontinence."

"I will taper off the medication before discontinuing it." The client should taper off cyclobenzaprine before discontinuing it to prevent the return of the musculoskeletal condition.

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? "I will need to get laboratory testing prior to a refill of this medication." Laboratory testing is not needed when taking this medication for sleep. "I will use this medication for a short period of time." "I will need to take this medication for 1 week before results are seen." The client who takes zolpidem should have improved sleep within 2 days of starting this medication. "I will need to change the medications to prevent building up a tolerance." The client who takes zolpidem should not build up a tolerance with short-term use.

"I will use this medication for a short period of time." Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.

A nurse is teaching a client who has an upper respiratory infection about guaifenesin. Which of the following statements should the nurse include in the teaching? "Constipation is an expected adverse effect of this medication." "Increase your fluid intake to at least 2 liters each day while taking this medication." "Store your medication in the refrigerator." "You can expect to experience insomnia while taking this medication."

"Increase your fluid intake to at least 2 liters each day while taking this medication." The nurse should instruct the client to increase fluid intake to at least 2 L per day while taking guaifenesin. An increase in fluid intake facilitates the removal of secretions and helps to create a more productive cough.

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? 1000 0900 0830 1200

0830 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

A nurse is preparing to administer to a client 0.9% sodium chloride 1,000 mL IV over 8 hr. 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 the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

31 gtt/min

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

6.2 mL

A client with diabetes mellitus is admitted to the medical unit. The client has routine before breakfast prescription for 8 unites of regular insulin and 18 unites of NPH. The primary care provider adds on additional dose of regular insulin based on the following blood glucose regular insulin dose: 121 to 150 2 unites 151 to 180 4 units 201 to 200 6 units 201 to 250 8 units > 250 call provider The clients pre-breakfast glucose is 192 mg/dl. Which dosage of insulin should the nurse administer? 8 unites of regular, 18 units of NPH 8 unites of regular, 24 units of NPH 14 unites of regular, 18 units of NPH 14 units of regular, 24 units of NPH

8 unites of regular, 24 units of NPH

A nurse is caring for four older adult clients who are taking digoxin (Lanoxin). Which of the following clients is at greatest risk for developing digoxin toxicity? A client taking furosemide (Lasix) for edema A client taking allopurinol (Zyloprim) forgout A client taking fluoxetine (Prozac) for depression A client taking pramipexole (Mirapex) for Parkinson's disease

A client taking furosemide (Lasix) for edema

A nurse is administering verapramil (Calan) to a client via IV bolus. The nurse should monitor for which outcome? A rapid increase in aPTT A sudden increase in heart rate A sudden decrease in heart rate A rapid decrease of aPTT

A sudden decrease in heart rate

A nurse is preparing to administer a medication to a client who states, "That looks different from the pill I usually take." Which of the following responses should the nurse make? A. "Describe what the pill looks like." B. "This is the medication prescribed by your provider." C. "This pill is probably from a different lot number than yours at home." D. "This hospital might use a different manufacturer, but the medication is the same."

A. "Describe what the pill looks like." Rationale: The nurse must collect more data prior to administering the medication. There is a chance that this is not the correct dose or medication. The nurse should clarify the prescription with the provider in order to ensure safe and effective administration of therapy.

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? A. "I have started taking ginger root to treat my joint stiffness." B. "I take this medication at the same time each day." C. "I eat a green salad every night with dinner." D. "I had my INR checked three weeks ago."

A. "I have started taking ginger root to treat my joint stiffness." Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching.

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching? A. "I will avoid drinking grapefruit juice." B. "I should take this medication without food." C. "I should expect my stools to turn clay-colored." D. "It is not necessary to have routine lab tests done."

A. "I will avoid drinking grapefruit juice." Rationale: Grapefruits and grapefruit juice can reduce metabolism of atorvastatin, which increases the risk for toxicity.

A nurse is caring for a client who has a prescription for 3,000 mL of dextrose 5% in 0.45% sodium chloride to infuse IV over 24 hr. The nurse initiates an IV infusion of 1,000 mL of this fluid at 0800. At what time should the nurse prepare to initiate the second 1,000 mL bag? A. 1600 B. 2400 C. 1200 D. 1800

A. 1600 Rationale: 3000 mL is going to be infused over 24 hr. Each 1000 mL will hang for 8 hr. The first 1000 mL bag was initiated at 0800, so the second 1000 mL bag will be initiated in 8 hr, or at 1600.

A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction? A. Client report of low back pain B. Client report of tinnitus C. A productive cough D. Distended neck veins

A. Client report of low back pain Rationale: Manifestations of an acute hemolytic reaction include apprehension, tachypnea, hypotension, chest pain, and lower back pain.

A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? A. Heart rate 46/min B. Oxygen saturation 95% C. Respiratory rate 18/min D. Blood pressure 160/94 mm Hg

A. Heart rate 46/min Rationale: The nurse should check the client's heart rate prior to administering a beta-blocker. If the client's heart rate is less than 50/min, the nurse should hold the medication and contact the provider. Atenolol is a beta-blocker and is used in the treatment of hypertension and angina, and following a myocardial infarction. This medication works by slowing the heart rate, decreasing the speed of electrical impulses through the atrioventricular node, and decreasing the force of contraction.

A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take? A. Infuse the medication with an IV pump. B. Cover the IV container with dark paper. C. Administer a test dose first. D. Infuse the medication at 35 mg/min.

A. Infuse the medication with an IV pump. Rationale: Theophylline should be administered slowly on an infusion pump. Rapid administration may cause hypotension and death.

A nurse is planning care for a client who has a detached retina and is preoperative for a surgical repair. The nurse should prepare to administer which of the following medications? A. Phenylephrine B. Latanoprost C. Pilocarpine D. Timolol

A. Phenylephrine Rationale: Mydriatic medications, such as phenylephrine, are used preoperatively to dilate pupils to facilitate intraocular surgery.

A nurse is assessing a client prior to administering a seasonal influenza vaccine. The client says he read about an influenza vaccine that is given as a nasal spray and wants to receive it. The nurse should recognize that which of the following findings is a contraindication for the client receiving the live attenuated influenza vaccine (LAIV)? A. The client's age is 62. B. The client smokes one pack of cigarettes a day C. The client has a history of myocardial infarction D. The client has recently traveled to Europe

A. The client's age is 62. Rationale: Clients must be between the ages of 2 and 49 to receive the LIAV; therefore, it is contraindicated for this client. Pregnancy and immunocompromised status are also contraindications.

A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? A. Tinnitus B. Constipation C. Hyperkalemia D. Weight gain

A. Tinnitus Rationale: Tinnitus and hearing loss are adverse effects of cisplatin.

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? Administer the medication outside the 5-cm (2-in) radius of the umbilicus. Aspirate for blood return before injecting Rub vigorously after the injection to promote absorption. Place a pressure dressing on the injection site to prevent bleeding.

Administer the medication outside the 5-cm (2-in) radius of the umbilicus. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 2 inches away from the umbilicus.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol? Cholelithiasis Asthma Angina pectoris Tachycardia

Asthma Asthma is a contraindication to receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.

The nurse is caring for a client who is receiving muromonab-CD3 (orthoclode OKT3) and is experiencing fever and 3+ pitting edema in the lower extremities. Which of the following actions should the nurse take for the client? Administer corticosteroids as prescribed. Obtain a prescription for a WBC count Auscultate the client's lungs for adventitious sounds. Maintain strict fluid intake and output measurements.

Auscultate the client's lungs for adventitious sounds.

A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take? A. Administer the medication at 100 mg/min. B. Administer a saline solution after injection. C. Hold the injection if seizure activity is present. D. Dilute the medication with dextrose 5% in water.

B. Administer a saline solution after injection. Rationale: The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation.

A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately? A. Diarrhea B. Blurred vision C. Pruritus D. Fatigue

B. Blurred vision Rationale: When using the urgent vs non-urgent approach to client care, the nurse should determine that the priority finding to report to the provider is blurred vision, as this is a manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.

nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication? A. Reduces risk of infection B. Decreases inflammation C. Improves peripheral blood flow D. Increases bone density

B. Decreases inflammation Rationale: Prednisone is used to treat rheumatoid arthritis because it produces anti-inflammatory and immunosuppressive effects, which reduces inflammation, decreases pain, and increases mobility.

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? A. Take aspirin if headaches develop B. Eat foods that contain plenty of potassium. C. Expect some swelling in the hands and feet D. Take the medication at bedtime.

B. Eat foods that contain plenty of potassium. Rationale: Furosemide, a high-ceiling (loop) diuretic, can cause potassium loss. The client should add potassium-rich foods to his diet, such as nuts, dried fruits, bananas, and citrus fruits.

nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? A. Radioactive iodine B. Levothyroxine C. Sumatriptan D. Levofloxacin

B. Levothyroxine Rationale: Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on the use of this medication.

A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

B. Metabolic alkalosis Rationale: Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects? A. Vitamin K B. Protamine sulfate C. Acetylcysteine D. Deferasirox

B. Protamine sulfate Rationale: Protamine sulfate reverses the effects of heparin by binding with heparin to form a heparin-protamine complex that has no anticoagulant properties.

nurse is caring for a client who is taking sucralfate. Which of the following outcomes indicates a therapeutic effect of the medication? A. Alleviate Helicobacter pylori B. Relief of gastrointestinal pain C. Prevention of opportunistic infections D. Improvement of impaired vision

B. Relief of gastrointestinal pain Rationale: Sucralfate, an antiulcer medication, is prescribed for acute or maintenance therapy of duodenal ulcers. A therapeutic effect of the medication is relief of gastrointestinal pain associated with gastric ulcers. Sucralfate also promotes ulcer healing.

nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.) A. The medication will stimulate flow of mucus. B. The medication will prevent wheezing. C. The medication will open the airways. D. The medication will reduce inflammation. E. The medication will decrease coughing episodes.

B. The medication will prevent wheezing. C. The medication will open the airways. E. The medication will decrease coughing episodes. Rationale: The medication will stimulate flow of mucus is incorrect. Expectorants, such as guaifenesin, stimulate the flow of mucous to produce a productive cough. Asthma is characterized by bronchoconstriction, airway edema, and increased mucus production. Albuterol relaxes the airways, allowing for expectoration of mucus.The medication will prevent wheezing is correct. Albuterol is used to prevent or treat wheezing.The medication will open the airways is correct. Albuterol promotes bronchodilation. The primary purpose is to provide rapid relief of bronchoconstriction, thus opening the airway and improving oxygenation.The medication will reduce inflammation is incorrect. Albuterol does not reduce inflammation. Glucocorticoid medications reduce inflammation.The medication will decrease coughing episodes is correct. Coughing is often an early indicator of bronchospasm. Albuterol provides a rapid response to relax smooth muscle and reduce bronchoconstriction, which will decrease coughing.

A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? Hypertension Low INR Constipation Bleeding gums

Bleeding gums The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) Blood glucose levels will be monitored during therapy. Avoid contact with people who have known infections. Take the medication 1 hr before breakfast. Decrease dietary intake of foods containing potassium. Grapefruit juice can increase the effects of the medication.

Blood glucose levels will be monitored during therapy. Avoid contact with people who have known infections. Grapefruit juice can increase the effects of the medication Blood glucose levels will be monitored during therapy is correct. The nurse should monitor the client for hyperglycemia while providing this medication to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. Avoid contact with people who have known infections is correct. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. Grapefruit juice can increase the effects of the medication is correct.The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? Difficulty seeing in the dark Pinpoint pupils Blurred vision Excessive tearing

Blurred vision Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause distant objects to appear blurry to the client

A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for long-term complications of prednisone? Pulmonary function tests Electrocardiograms Liver function studies Bone density scans

Bone density scans The client who is taking prednisone, which is a glucocorticoid, should have regularly scheduled bone density scans to monitor for the adverse effects of osteoporosis.

nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching? A. "I will take the antiemetic as soon as the chemotherapy infusion is complete." B. "I will run my toothbrush in the dishwasher every month." C. "I'll call my doctor if I notice any unusual menstrual bleeding." D. "I will avoid crowds to keep from infecting others."

C. "I'll call my doctor if I notice any unusual menstrual bleeding." Rationale: Clients should be taught bleeding precautions and to report bruising or excessive bleeding.

A nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention by the nurse? A. Glass of whole milk B. Celery sticks C. Bologna sandwich D. Sliced apples

C. Bologna sandwich Rationale: Clients who are receiving an MAOI should avoid foods containing a high tyramine content.Bologna has a high tyramine content and should be avoided.

A nurse is caring for a client who has a prescription for potassium chloride (KCL) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results and finds the client's potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? A. Give the ordered KCL as prescribed. B. Omit the KCL dose and document it was not given. C. Call the prescribing physician and inform her of the client's serum potassium level results. D. Call the lab to verify the client's results.

C. Call the prescribing physician and inform her of the client's serum potassium level results. Rationale: As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication and notify the provider of the client's serum potassium level.

A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of the following actions should the plan to nurse take? A. Leave the client 5 min after beginning the transfusion. B. Infuse the transfusion at a rate of 200 mL/hr C. Check the client's vital signs every hour during the transfusion. D. Flush the blood tubing with dextrose 5% in water.

C. Check the client's vital signs every hour during the transfusion. Rationale: The nurse should check the client's vital signs every 15 min at the start of the transfusion, then every 1 hr to monitor for a transfusion reaction.

nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication? A. Pepperoni B. Orange juice C. Grapefruit juice D. Smoked salmon

C. Grapefruit juice Rationale: Clients taking cyclosporine should avoid drinking grapefruit juice because it can increase the therapeutic effect leading to renal and hepatic toxicity.

A nurse is caring for a client who has heart failure and a new prescription for furosemide. For which of the following adverse effects should the nurse monitor? A. Hypervolemia B. Hypertension C. Hypokalemia D. Hypoglycemia

C. Hypokalemia Rationale: Hypokalemia is an adverse effect of furosemide.

nurse is monitoring a client who is receiving a unit of packed RBCs following surgery. Which of the following assessments is an indication the client might be experiencing a hemolytic reaction? A. Flushing B. Dyspnea C. Hypotension D. Vomiting

C. Hypotension Rationale: A hemolytic reaction causes hypotension, headache, apprehension, chest pain, and low-back pain.

nurse is assessing a client who is receiving liothyronine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication? A. Decrease in appetite B. Increase in weight C. Increase in energy D. Decrease in body temperature

C. Increase in energy Rationale: An increase in energy is a therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations.

A nurse is caring for a client who is receiving a transfusion of packed red blood cells and suspects that the client is experiencing a hemolytic reaction. Which of the following interventions is the priority? A. Collect a urine specimen. B. Administer 0.9% sodium chloride through the IV line. C. Stop the transfusion. D. Notify the blood bank.

C. Stop the transfusion. Rationale: The greatest risk to the client is injury due to further hemolysis; therefore, the priority action is to stop the transfusion. When suspecting a hemolytic reaction, the priority action by the nurse is to immediately stop the transfusion to prevent further hemolysis.

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? Carbamazepine Sumatriptan Atenolol Glipizide

Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

A nurse is monitoring a client who is taking fosinopril (Monopril). The nurse should understand that this has a beneficial effect on which of the body systems? Gastrointestinal Cardovascular Pulmonary Reproductive

Cardovascular

A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instructions should the nurse plan to include? Take the medication on an empty stomach. Avoid crowds. Discontinue the medication if palpitations occur. Change positions slowly.

Change positions slowly. The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope

A nurse is caring for four clients. After administering morning medications, she realized that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? Notify the clients provider Check the client's vital signs Fill out an occurrence form Administer the medication to the correct client

Check the client's vital signs

A nurse is caring for a client who has a prescription for levadopa carbidopa(Sinemet-CR). Which of the following should the nurse recognize as an adverse effect of this medication? Constipation Weightgain Hirsultism Dyskinesia

Constipation

A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching? A. "It might take up to 3 days for the medication to work." B. "I will take the medication for diarrhea." C. "I should drink 4 ounces of water when I take the medication." D. "I can take this medication along with mineral oil."

D. "I can take this medication along with mineral oil." Rationale: The client's statement indicates the need for further teaching. Docusate sodium may lead to toxicity if taken with mineral oil.

A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching? A. "I will take this medication as needed to reduce pain." B. "I will reduce my fluid intake with this medication." C. "I will take this medication with an antacid." D. "I will take this medication 1 hour before meals and at bedtime."

D. "I will take this medication 1 hour before meals and at bedtime." Rationale: The client should take sucralfate on an empty stomach, 1 hr before each meal and at bedtime to create a protective coating over the ulcer.

A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching? A. "I should expect to feel better after 24 hours of starting this medication." B. "I should not take this medicine with grapefruit juice." C. "I'll take this medicine with food." D. "I'll take this medicine first thing in the morning."

D. "I'll take this medicine first thing in the morning." Rationale: The client should take fluoxetine in the morning to reduce the risk for insomnia.

nurse is caring for a client who has a central venous catheter and reports hearing a gurgling sound on the side of the catheter insertion. Which of the following complications should the nurse suspect? A. Catheter occlusion B. Catheter rupture C. Catheter dislodgment D. Catheter migration

D. Catheter migration Rationale: A client report of hearing a gurgling sound on the side of the catheter insertion is a manifestation of catheter migration.

A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider? A. Blurred vision B. Palpitations C. Constipation D. Depression

D. Depression Rationale: Montelukast can cause neuropsychiatric effects such as depression, behavior changes, hallucinations, and suicide ideation. The nurse should instruct the client to report such adverse effects. A change in medication might be prescribed.

A nurse is preparing to administer medications to a client who states, "I don't want to take those drugs." Which of the following actions should the nurse take? A. Tell the client the physician wants him to take the medications. B. Ask the client why he is refusing to take the medications. C. Explain the purpose for the medications. D. Document that the client refuses the medications.

D. Document that the client refuses the medications. Rationale: The client has the right to refuse the medication. It is appropriate for the nurse to document the client's refusal of the medications. The nurse should then inform the provider of the client's refusal.

nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? A. Withholding the medication if the heart rate is above 100/min B. Instructing the client to eat foods that are low in potassium C. Measuring apical pulse rate for 30 seconds before administration D. Evaluating the client for nausea, vomiting, and anorexia

D. Evaluating the client for nausea, vomiting, and anorexia Rationale: Loss of appetite, nausea, vomiting, and blurred or yellow vision may be signs of digoxin toxicity.

A nurse is assessing a client prior to the administration of morphine. The nurse should recognize that which of the following assessments is the priority? A. Pupil reaction B. Urine output C. Bowel sounds D. Respiratory rate

D. Respiratory rate Rationale: When using the airway, breathing, circulation approach to client care, the nurse should determine the priority assessment is respiratory rate. Morphine can cause respiratory depression. The nurse should withhold the medication and notify the prescriber if the client has a respiratory rate less than 12/min.

The nurse is preparing a medication for a client and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take? A. Give the medication. B. Discard the medication. C. Notify the provider. D. Return the medication to the pharmacy.

D. Return the medication to the pharmacy. Rationale: The nurse should return the medication to pharmacy. Laws require that all medication include an expiration date.

nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? A. Furosemide B. Hydrochlorothiazide C. Metolazone D. Spironolactone

D. Spironolactone Rationale: Spironolactone is a potassium-sparing diuretic. It blocks the effects of aldosterone in the renal tubules, causing a loss of sodium and water and the retention of potassium. The possible adverse reactions include hyperkalemia and hyponatremia.

A nurse is teaching a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication has which of the following actions? A. Reduces inflammation B. Suppresses the urge to cough C. Dries mucous membranes D. Stimulates secretions

D. Stimulates secretions Rationale: A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

A nurse is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include? A. Take 1 capsule at the onset of anginal pain. B. Stop taking the medication if side effects are troublesome. C. Take the medication with meals D. Swallow the capsules whole

D. Swallow the capsules whole Rationale: The client should swallow the capsules whole and not chew or crush them or place them under the tongue.

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? A. Drowsiness B. Constipation C. Oliguria D. Tachycardia

D. Tachycardia Rationale: Theophylline can increase cardiac stimulation and cause tachycardia.

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome? Increase in seizure threshold Decrease in flexor and extensor spasticity Increase in cognitive function Decrease in paralysis of the extremities

Decrease in flexor and extensor spasticity The client who has a spinal cord injury and takes baclofen can experience a decrease in the frequency and severity of muscle spasms and in flexor and extensor spasticity.

A client who has supraventricular tachycardia (SVT) is receiving procainamide. The nurse recognizes that the primary pharmacological action of this medication is to: Decrease cardiac preload Promote systemic vasoconstriction Decrease sinoatrial node conduction. Control the rate of cardiac contraction.

Decrease sinoatrial node conduction.

A nurse is planning teaching for a client who has leukemia and is receiving chemotherapy. The client is taking Allopurinal (Zyloprim). The nurse should instruct the client that this medication will? Decrease blood glucose levels Prevent cardiac toxicity. Prevent urinary tract infections. Decrease uric acid levels.

Decrease uric acid levels.

A child with cerebral palsy is prescribed Baclorfen (Lioresol). Which of the following therapeutic effects should the nurse monitor? Increased urine output Increased energy Decreased anxiety Decreased Spacity

Decreased Spacity

A client has a new prescription for oral nitroglycerin sustained-release capsules once a day. During the nursing history the client reveals his usual medications. Which of the following medications should the nurse question at this time? Diazepam(Valium) Lansoprazole(Prevacid) Gemfibrozil(Lopid) Sildenafil(Viagra)

Diazepam(Valium)

A nurse is caring for a client who is to receive a series of allergy tests. The nurse should instruct the client to avoid which medications for up to 4 weeks before the procedure? Acetemetaphen (Tylenol) Diphenhydramine (Benadryl) Albuterol (Accuneb) Psuedoephendrine hydrocholroide (Sudafed)

Diphenhydramine (Benadryl)

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? Administer epinephrine 0.5 mL via IV bolus. Discontinue the medication IV infusion. Elevate the client's legs above the level of the heart. Collect a blood specimen for ABGs.

Discontinue the medication IV infusion. The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion.

A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to receiving which of the following medications? Acetaminophen Ipratropium Benzonatate Doxycycline

Doxycycline Doxycycline is a tetracycline antibiotic and is contraindicated for a client who is pregnant because the medication is a category D medication of the FDA pregnancy risk categories, which indicates the medication has fetal risks that can cause fetal damage. The client should only take doxycycline for a life-threatening condition.

A nurse is preparing to administer insulin to a client with diabetes mellitus. The client is to receive insulin aspart (NovoLog) 5 units and NPH insulin (Humulin N) 15 unites subcutaneously in the morning. Which of the following actions should the nurse take first? Inject 5 unites of air into the insulin aspart vial Inject 15 unites of air into the NPH insulin vial Draw up 5 units of insulin aspart from the vial Draw up 15 unites of NPH insulin from the vial

Draw up 5 units of insulin aspart from the vial

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? Take the medication with food. Expect a fine, red rash as a transient effect. Drink 8 to 10 glasses of water daily. Store the medication in the refrigerator

Drink 8 to 10 glasses of water daily. The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (64 to 80 oz) a day to decrease the chance of kidney damage from crystallization.

A nurse is providing teaching to a client who is to start taking lisinopril. Which of the following findings is an adverse effect that the nurse should instruct the client to monitor and report to the provider? Hair loss Ringing in the ears Facial flushing Dry cough

Dry cough A buildup of bradykinin from taking lisinopril can cause a client to have a dry cough and lead to life-threatening consequences. The client should report the finding

A nurse is caring for a school age child who has been prescribed diphenhydramine (Benadryl). Which of the following adverse effects has highest priority? Sedation Dry mucous membranes Ataxia Diarrhea

Dry mucous membranes

A nurse is caring for a client with Parkinson‟s disease. The client is taking carbidopa levadopa (Sinemet) and reports nausea. Which of the following instructions should the nurse include to reduce nausea? Give medication 1 hr before meals. Give medication with meals Give medication 1 hr after meals Give medication with high-protein snacks

Give medication with meals

A nurse receives a phone call from a client who has heart failure and reports a dry cough for the last week. After reviewing the client‟s medical record, the nurse asks the client to come to the provider‟s office. The nurse should then instruct the client to stop taking which of the following daily medications until he sees his provider? Isosorbide(Imdur) Hydroclorothiazide(Hydrodiuril) Nifedipine(Procardia) Lisinopril(Zestril)

Hydroclorothiazide(Hydrodiuril)

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? Hyperventilation Heartburn Anorexia Swollen ankles

Hyperventilation When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

A nurse is caring for a client who is receiving anticoagulant therapy withWarfarin (Coumadin). The client is prescribed Cefotetan (Cefotan) by intermittent IV bolusfor pneumonia. The nurse should monitor the client for which of thefollowing? Hemorrhage Hypoglycemia Hyperkalemia Paresthesias

Hypoglycemia

A client who has been taking atenolol (Tenormin) receives a new prescription for nifedipine (Procardia). For which of the following interactions should the nurse monitor? Tachycardia Hypotension Bleeding Angina

Hypotension

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? Decreased blood pressure Increased heart rate Increased cardiac output Decreased serum potassium

Increased cardiac output Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect? Tachycardia Oliguria Xerostomia Miosis

Miosis Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? Infuse 0.9% sodium chloride 1,000 mL IV fluid bolus. Schedule the client for an electroencephalogram. Obtain WBC with absolute neutrophil count. Place the client on a tyramine-free diet.

Obtain WBC with absolute neutrophil count. The client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytopenia. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can be changed to occur every 2 weeks up to 1 year.

A nurse is providing care to a client who has heart failure. While verifying the orders with the medication administration record the nurse notes that the prescription for digoxin (Lanoxin) was transcribed incorrectly. As a result, the client received and extra dose of the medication yesterday. Which of the following actions should the nurse take first. Complete an incident report Notify the charge nurse Obtain a set of vital signs Withhold the next does

Obtain a set of vital signs

A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? Obtain the client's blood pressure. Contact the client's provider. Inform the charge nurse. Complete an incident report.

Obtain the client's blood pressure. The first action the nurse should take to prevent injury to the client when using the nursing process is to assess the client for adverse effects of atenolol, such as hypotension.

A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? Vitamin E Orange juice Milk Antacids

Orange juice The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice. However, increasing the dosage of ferrous sulfate can provide the same benefit to increase the amount of iron uptake.

A nurse is assessing a client who is taking enalapril (Vasotec) for congestive heart failure. Which of the following indicates an expected finding? Activity tolerance Orthostatic hypotension Loss of strenth Increase in blood pressure

Orthostatic hypotension

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? Perform a capillary blood glucose test. Provide the client with a protein-rich snack Give the client 120 mL (4 oz) of orange juice. Schedule an early meal tray.

Perform a capillary blood glucose test. The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? Schedule the client for the last surgery of the day. Place monitoring cords and tubes in a stockinet. Choose rubber injection ports for fluid administration. Ensure phenytoin IV is readily available.

Place monitoring cords and tubes in a stockinet. The circulating nurse should place monitoring devices in a stockinet to prevent direct contact with the client's skin.

A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? Serum calcium Pregnancy test 24 hr urine collection for protein Aspartate aminotransferase level

Pregnancy test The client who is pregnant or might become pregnant must not take isotretinoin because this medication has teratogenic effects. Pregnancy testing is mandatory before the initial prescription (two tests) and before monthly refills (one test).

A nurse is caring for a client who is receiving therapy with the clonidine (Catapres) transdermal patch. The client reports light-headedness and drowsiness. Which of the following actions should the nurse take? Administer a prescribed antiemetic Remove the Patch Elevate the head of the bed Measure Blood pressure

Remove the Patch

A nurse is teaching a client who is to start taking diltiazem. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? Blurred vision Shortness of breath Muscle twitching Dry cough

Shortness of breath

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) Report muscle pain to the provider. Avoid taking the medication with grapefruit juice. Take the medication in the early morning. Expect a flushing of the skin as a reaction to the medication. Expect therapy with this medication to be lifelong.

Report muscle pain to the provider. Avoid taking the medication with grapefruit juice. Expect therapy with this medication to be lifelong. Report muscle pain to the provider is correct. Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis, so it should be reported to the provider. Avoid taking the medication with grapefruit juice is correct. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. Expect therapy with this medication to be lifelong is correct. If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months

A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication? Smoked sausage Cottage cheese Green beans Apple pie

Smoked sausage The nurse should instruct the client to avoid eating smoked sausage because it contains tyramine. Tyramine can interact with MAOIs and result in hypertensive crisis.

A nurse is caring for a client who has rheumatoid arthritis. The client is prescribed methotrexate (Rheuamtarex). Which of the following should the nurse instruct the client to monitor and report to the provider? Sore throat Urinary retention Constipation Insomnia

Sore throat

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family? A) The provider will prescribe naloxone at home for respiratory depression. B) Remove the patch to reverse the adverse effects immediately. C) Expect an increase in urinary output. D) Take a stool softener on a daily basis.

Take a stool softener on a daily basis. Constipation is an adverse effect of opioid use and stool softeners can decrease the severity of this adverse effect

A nurse is caring for a client who is taking atenolol. Which of the following findings should indicate to the nurse that the medication is effective? The client has an increase in urinary output The client report an improvement in memory The client has a decrease in blood pressure The client reports having an increase in libido

The client has a decrease in blood pressure

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? Tingling of fingers Constipation Weight gain Oliguria

Tingling of fingers The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? Troponin Total cholesterol Creatinine Thyroid stimulating hormone

Total cholesterol The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.

A nurse is caring for a client with a urinary tract infection. Her past history reveals an allergy to thiazide diuretics. Which of the following medications is contraindicated? Nitrofurantoin(Macrodantin) Ciprofloxacin(Cipro) Amoxicillin/ clavulanate(Augmentin) Trimethoprim/ sulfamethoxazole(Bactrim)

Trimethoprim/ sulfamethoxazole(Bactrim)

A nurse is assessing a client who takes diphenoxylate with atropine (Lomotil) for inflammatory bowel disease. For which of the following should the nurse monitor? Hearing loss Increased oral secretions Bradycardia Urinary retention

Urinary retention

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? Diarrhea Cough Urinary retention Increased libido

Urinary retention The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.

A nurse is caring for a client who has a new prescription for sucraflate (Carafate). The client also takes several other medications and herbal supplements. Which of the following requires that the nurse provide additional teaching for this client? Phentoin(Dilantin) Burpropion(Wellbutrin) Ginko biloba Valerianroot

Valerianroot

A nurse is providing teaching about adverse effects of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider? Orange urine Watery diarrhea Weight gain Headache

Watery diarrhea The client who takes clindamycin can have an adverse effect of watery diarrhea that can lead to Clostridium difficile-associated diarrhea or pseudomembranous colitis. The client should report these findings immediately to the provider.

A nurse is assessing a client who is taking naproxem (Naprosyn). Which of the following is an expected outcome for this client? Increased appetite Reduced bleeding Improved breathing reduced pain

reduced pain

A female adult client is scheduled to start a prescription for azathioprine (Imuran) foractive Rheumatoid Arthritis. The nurse should inform the client about the need for which ofthe following diagnostic tests priormedication? Erythrosedimentation rate Bone densityscan Electrocardiogram PregnancyTest

Erythrosedimentation rate

A nurse is providing teaching to a school-age child and his parents. The child has anew prescription for methylphenidate (Concerta). For which of the following adverse effects should the nurse monitor? (Select all that apply.) Nosebleed Oliguria Weightloss Palpitations Insomnia

Nosebleed Palpitations Insomnia

A nurse is completing discharge teaching for a client who has hypertension. The cline has a new prescription for spironolactone (aldactone). Which of the following statement by the client indicates an understand of the teaching? "I'll increase y dietary fiber, because this medication causes constipation" "I'm aware that this medication can cause heart palpitations" "I'll take aspirin every day, because it makes this medication more effective" "I realize that I should use sugar substitutes when taking this medication"

"I'm aware that this medication can cause heart palpitations"

A nurse is caring for a client who is taking amoxicillin (Amoxil) and is experiencing adverse effects. Which of the following instructions should the nurse give to this client? "Stand up slowly after taking this medication" "Monitor for increased urine output" "Take this medication with a snack" "Administer the medication at bed time"

"Monitor for increased urine output"

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? "Take beclomethasone to avoid an acute attack." "Use beclomethasone 5 minutes before using albuterol." "Limit your calcium and vitamin D intake when taking beclomethasone." "Rinse your mouth after inhaling the beclomethasone."

"Rinse your mouth after inhaling the beclomethasone." The client should rinse her mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? Birth 2 months 6 months 15 months

2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

A client has an IV infusion of nitroprusside (Nitropress) at 2 mcg/kg/min. The order reads to titrate the nitroprusside by 0.5 mcg/kg/min to maintain mean arterial pressure (MAP) to 70to 110 mm HG. The client has a MAP of 120 mm Hg. The nurse should next titrate the nitroprusside to which of the following dosages? (Round to the nearest tenth.)

2.5 mcg

A nurse is teaching a client who has a new prescription for colesevelam to lower his low-density lipoprotein level. Which of the following instructions should the nurse include? A. "Take this medication 4 hr after other medications." B. "Reduce fluid intake." C. "Take this medication on an empty stomach." D. "Chew tablets before swallowing."

A. "Take this medication 4 hr after other medications." Rationale: The client should take this medication 4 hours after other medications to increase absorption of the medication.

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? A. Anorexia B. Ataxia C. Photosensitivity D. Jaundice

A. Anorexia Rationale: Anorexia, vomiting, confusion, headache, and vision changes are manifestations of digoxin toxicity.

A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.) A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily. D. Apply the patch to dry skin and cover the area with plastic wrap. E. Apply a new patch at the onset of anginal pain.

A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily. Apply the patch to a hairless area and rotate sites is correct. Hair can interfere with the adhesion of the patch. Rotating sites helps prevent skin irritation. Apply a new patch each morning is correct. Therapeutic preventive effects of transdermal nitroglycerin patches begin 30 to 60 min after application and last up to 14 hr. Remove the patch for 10 to 12 hr daily is correct. Removing the patches for 10 to 12 hr each day helps prevent tolerance to the medication.

A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include? A. Avoid activities that require alertness such as driving. B. Increase caffeine intake. C. Take this medication before bedtime. D. Reduce calorie intake.

A. Avoid activities that require alertness such as driving. Rationale: The client should avoid driving and other activities that require alertness until the effects of this medication are known.

A nurse is caring for a client who has a central venous catheter and develops acute shortness of breath. Which of the following actions should the nurse take first? A. Clamp the catheter. B. Position the client in left lateral Trendelenburg. C. Initiate oxygen therapy. D. Auscultate breath sounds.

A. Clamp the catheter. Rationale: The greatest risk to this client is injury from further air entering the central venous catheter; therefore, the first action the nurse should take is to clamp the catheter.

A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions? A. Constipation B. Flatulence C. Palpitations D. Headache

A. Constipation Rationale: Aluminum hydroxide can cause constipation. The nurse should tell the client to increase fluid and fiber intake to reduce the risk for constipation.

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? A. Decreased sodium level B. Decreased phosphate level C. Decreased potassium level D. Decreased chloride level

A. Decreased sodium level Rationale: The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.

A nurse is assessing a client who has a peripheral IV with a continuous infusion. Which of the following findings is a manifestation of phlebitis? (Select all that apply.) A. Erythema B. Damp dressing C. Throbbing D. Warmth at insertion site E. Streak formation

A. Erythema C. Throbbing D. Warmth at insertion site E. Streak formation Rationale: Erythema is correct. Erythema is a reddened area at the insertion site and is a manifestation of phlebitis. Other manifestations can include throbbing, burning, and increased skin temperature.Damp dressing is incorrect. A damp dressing is a manifestation of infiltration. Other manifestations include pallor, local swelling, and decreased skin temperature. Throbbing is correct. Throbbing and pain at the insertion site are manifestations of vein inflammation and phlebitis. Warmth at insertion site is correct. Responses to inflammation include warmth and redness of the affected tissue. Streak formation is correct. Streak formation is a classic indicator of advanced phlebitis.

A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer? A. Fab antibody fragments B. Flumazenil C. Acetylcysteine D. Naloxone

A. Fab antibody fragments Rationale: Fab antibody fragments, also called digoxin immune Fab, bind to digoxin and block its action. The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity.

A nurse is obtaining a medical history from a client who is to start warfarin therapy and currently uses herbal supplements at home. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin? A. Feverfew B. Black cohosh C. Echinacea D. Flaxseed

A. Feverfew Rationale: The nurse should instruct the client to avoid taking feverfew while taking warfarin because it will increase the anticoagulant effect.

A nurse is preparing to administer nalbuphine to a postoperative client who is experiencing pain. The nurse should monitor the client for which of the following potential adverse effects of this medication? A. Miosis B. Joint pain C. Diarrhea D. Oliguria

A. Miosis Rationale: Adverse effects of nalbuphine include visual disturbances such as miosis, blurred vision, and diplopia.

A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching? A. Monitor for a cough. B. Hold medication for heart rate less than 60/min. C. Take this medication with food. D. Avoid grapefruit juice.

A. Monitor for a cough. Rationale: Captopril is an ACE inhibitor used to treat hypertension. The client should monitor and report a cough and dyspnea.

A nurse is teaching a client who has a new prescription for dimenhydrinate. Which of the following instructions should the nurse include in the teaching? A. Monitor for dizziness B. Observe for diarrhea. C. Administer 24 hr before effects are desired. D. Expect an increase in salivation.

A. Monitor for dizziness. Rationale: The client should monitor for dizziness and avoid activities that require alertness because dimenhydrinate can cause dizziness and drowsiness.

A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication? A. Potassium B. Albumin C. Cortisol D. Bicarbonate

A. Potassium Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium. The nurse should monitor the client's potassium level to watch for hypokalemia.

A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls? A. The client takes alprazolam. B. The client has a nonslip bath mat in his shower. C. The client uses a raised toilet seat. D. The client wears fitted slippers.

A. The client takes alprazolam. Rationale: Alprazolam is a CNS depressant that can cause dizziness and orthostatic hypotension, which can cause the client to lose his balance and fall.

A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses? A. Urticaria B. Fever C. Fluid overload D. Hemolysis

A. Urticaria Rationale: For clients who have previously had allergic reactions to blood transfusions, administering an antihistamine such as diphenhydramine prior to the transfusion might prevent future reactions. Allergic reactions typically include urticaria (hives).

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer? A. Vitamin K B. Heparin C. Warfarin D. Ferrous sulfate

A. Vitamin K Rationale: A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k.

A nurse is caring for a client who has acute angina and has prescription for nitroglycerin. Which of the following is an appropriate intervention for the nurse to take when administering this medication? Massage the nitroglycerin ointment completely into the skin Replace the nitroglycerin transdermal patch every 4 hours Administer a sustained nitroglycerin tablet orally Administer a nitroglycerin tablet sublingually every 5 minutes

Administer a nitroglycerin tablet sublingually every 5 minutes

A nurse is teaching a client who has decided to quit smoking about using a nicotine transdermal system (Nicotorl). Which of the following instructions should the nurse include? Cleanse the skin with alcohol before applying the patch Moisten the patch and hold it against the skin until it adheres Apply the patch first thing int he morning and remove at bedtime Place the patch in the same skin areas for the duration of the treatment

Apply the patch first thing int he morning and remove at bedtime

A nurse administered meperidine (Demerol) Intramuscularly to a client with an ankle fracture. Which of the following action should the nurse take next? Asses the clients respiratory status Document on the clients medication recored Reassesses the clients pain level Check the clients blood pressure

Asses the clients respiratory status

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. "A headache is an indication of an allergy to the medication." B. "A headache is an expected adverse effect of the medication." C. "A headache indicates tolerance to the medication." D. "A headache is likely due to the anxiety about the chest pain."

B. "A headache is an expected adverse effect of the medication." Rationale: The vasodilation nitroglycerin induces increases blood flow to the head and typically results in a headache.

A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? A. Apply a new transdermal patch once a week. B. Apply the transdermal patch in the morning. C. Apply the transdermal patch in the same location as the previous patch. D. Apply a new transdermal patch when chest pain is experienced

B. Apply the transdermal patch in the morning. Rationale: The client should apply the patch every morning and leave it in place for a 12 to 14 hr, then remove it in the evening.

nurse is monitoring a client who is receiving a unit of packed RBCs following surgery. Which of the following assessments is an indication that the client might be experiencing circulatory overload? A. Flushing B. Dyspnea C. Bradycardia D. Vomiting

B. Dyspnea Rationale: Circulatory overload causes dyspnea, cough, rales, tachycardia, and jugular vein distention.

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances? A. Hypernatremia B. Hyperuricemia C. Hypercalcemia D. Hyperchloremia

B. Hyperuricemia Rationale: The nurse should monitor the client who is receiving IV furosemide for hyperuricemia. The nurse should instruct the client to notify the provider for any tenderness or swelling of the joints.

nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? A. Bicarbonate B. Carbon dioxide C. Potassium D. Phosphate

C. Potassium Rationale: Furosemide is a loop diuretic and therefore promotes excretion of potassium. The nurse should monitor the client's serum potassium level before administering it to prevent hypokalemia.

nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication? A. Dry mouth B. Vomiting C. Headache D. Peripheral edema

B. Vomiting Rationale: The nurse will monitor for vomiting as an adverse effect of lactulose.

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? A. Discard the NPH solution if it appears cloudy. B. Shake the insulin vigorously before loading the syringe. C. Expect the NPH insulin to peak in 6 to 14 hr D. Freeze unopened insulin vials.

C. Expect the NPH insulin to peak in 6 to 14 hr. Rationale: NPH insulin is an intermediate-acting insulin. Its onset of action is 1 to 2 hr, peaking at 6 to 14 hr. Its duration of action is 16 to 24 hr. The client is at risk for hypoglycemia during the peak time.

A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions? A. Excessive bleeding B. Ecchymosis C. Infection D. Hyperglycemia

C. Infection Rationale: Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.

A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take? A. Use a 22-gauge needle to inject the medication. B. Use a 1-inch needle to inject the medication. C. Inject the medication into the abdomen above the level of the iliac crest. D. Massage the injection site after administration of the medication.

C. Inject the medication into the abdomen above the level of the iliac crest. Rationale: The nurse should inject the medication into the abdomen above the level of the iliac crest, at least 2 inches from the umbilicus.

nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client? A. Piperacillin/tazobactam B. Levothyroxine C. Levodopa/carbidopa D. Carbamazepine

C. Levodopa/carbidopa Rationale: Levodopa/carbidopa is the cornerstone of Parkinson's treatment. The nurse should prepare to instruct the client on the use of this medication.

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack B. Measure the client's blood pressure. C. Measure the client's apical pulse D. Weigh the client.

C. Measure the client's apical pulse. Rationale: Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min before administering. The nurse should hold the medication and notify the provider if the client's heart rate is below 60/min or if a change in heart rhythm is detected.

A nurse is reviewing discharge instructions with a client who has bipolar disorder and is taking lithium. Which of the following manifestations should the nurse include as an indication of mild toxicity? A. Constipation B. Urinary retention C. Muscle weakness D. Hyperactivity

C. Muscle weakness Rationale: The nurse should instruct the client that muscle weakness is a manifestation of mild toxicity.

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? A. Ranitidine B. Guaifenesin C. Prednisone D. Atorvastatin

C. Prednisone Rationale: Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.

nurse is caring for a client who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose? A. Iron B. Glucagon C. Protamine D. Vitamin K

C. Protamine Rationale: Protamine reverses the effects of heparin and is used in the event of an overdose

nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication? A. Tinnitus B. Muscle pain C. Hyperglycemia D. Jaundice

D. Jaundice Rationale: Acetaminophen can cause hepatotoxicity. The client should monitor and report jaundice, abdominal pain, clay colored stools, and fever.

A nurse is caring for a client who is experiencing Cushing's Triad following a subdural hematoma. Which of the following medications should the nurse plan to administer? A. Albumin 25% B. Dextran 70 C. Hydroxyethyl glucose D. Mannitol 25%

D. Mannitol 25% Rationale: Cushing's Triad is an indication that the client is experiencing increased intracranial pressure. The nurse should administer mannitol 25%, an osmotic diuretic that promotes diuresis to treat cerebral edema.

nurse is caring for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Which of the following medications should the nurse plan to administer? A. Albumin 25% B. Dextran 70 C. Hydroxyethyl glucose D. Mannitol 25%

D. Mannitol 25% Rationale: The nurse should plan to administer mannitol 25%, an osmotic diuretic that lowers intracranial pressure by promoting diuresis.

nurse is teaching a client who has a new prescription for aspirin to prevent cardiovascular disease. Which of the following instructions should the nurse include in the teaching? A. Take the tablets on an empty stomach. B. Expect stools to turn black. C. Anticipate the tablets to smell like vinegar. D. Monitor for tinnitus.

D. Monitor for tinnitus. Rationale: Tinnitus is a manifestation of salicylism, or aspirin toxicity. Other manifestations include sweating, headache, and dizziness.

A nurse is planning to administer butorphanol to a client who is in labor. Which of the following medications should the nurse plan to have available to reverse the action of this medication? A. Protamine B. Diphenhydramine C. Atropine D. Naloxone

D. Naloxone Rationale: Butorphanol is an opioid analgesic. The nurse should have the opioid reversal agent naloxone and resuscitation equipment available in the event that the client develops respiratory depression.

nurse is caring for a client who has hemophilia A and hemarthrosis of the left knee. Which of the following actions should the nurse take? A. Administer low dose aspirin B. Apply heat to the knee C. Prepare for autologous blood transfusion. D. Obtain a stool specimen.

D. Obtain a stool specimen. Rationale: The nurse should obtain a stool specimen, as the client is at risk for bleeding

A nurse is caring for a postoperative client with PCA containing IV morphine. A nurse should recognize which is the following priority assessment? Hypotension Bradypnea Drowsiness Urticaria

Drowsiness

nurse is teaching a class about medication reconciliation. Which of the following information should the nurse include in the teaching? A. Do not include over-the-counter medications in the medication reconciliation report. B. Provide a list of the client's current medications during the change of shift report. C. Do not perform reconciliation for a client at discharge from a health care facility. D. Provide a list of the client's current medications during admission to a health care facility.

D. Provide a list of the client's current medications during admission to a health care facility. Rationale: The nurse should create a list of current medications including the name, indication, route, dosage, and dosing interval upon admission to a health care facility. The list consists of all medications, including vitamins, herbal products, and prescription and nonprescription medications.

nurse is preparing to instill eardrops to a 5-year-old child. Which of the following techniques should the nurse use? A. Pull the auricle down and back B. Pull the auricle down and out. C. Pull the auricle up and back. D. Pull the auricle up and out.

D. Pull the auricle up and out. Rationale: The nurse should pull the auricle up and out to instill eardrops to a 5-year-old child. This technique is used for children 4 years of age and older, and adults.

A nurse is assessing a client who is on long term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective? A. Increased appetite B. Regular bowel movements C. Absence of headache D. Reduced dyspepsia

D. Reduced dyspepsia Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.

A nurse is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the nurse plan to take? A. Check the unit of blood with an assistant personal (AP). B. Premedicate the client with an antiemetic. C. Plan to infuse the unit of blood over 6 hr. D. Remain with the client for the first 15 minutes of the transfusion.

D. Remain with the client for the first 15 minutes of the transfusion. Rationale: The nurse should remain with the client for the first 15 to 30 minutes of the transfusion to monitor for a transfusion reaction, which occurs often during the first 50 mL of the transfusion.

nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer? A. Epinephrine B. Atropine C. Protamine D. Vitamin K

D. Vitamin K Rationale: Vitamin K reverses the effects of warfarin.

The nurse is caring for a client who has tuberculosis and is being treated with combination medication therapy. To test the effectiveness of the treatment, the nurse should periodically monitor which of the following laboratory results. TT ESD rate Sputumculture INR

ESD rate

A nurse is assessing a client who is receiving chloramphenioc (Chloromycetin). Which of the following finding is an adverse effect of this medication? Ecchymosis Ototoxicity Hypertension Anxiety

Ecchymosis

A nurse is caring for a client who is receiving penicillin by intermittent IV bolus. The client develops cyanosis and tachycardia. A nurse should administer which of the following medications first? Epinephrine(Adrenalin) Prednisone(Deltasone) Hydrocortisone sodium succinate(Solu-Cortef) Isoproterenol(Isuprel)

Epinephrine(Adrenalin)

A client is receiving extended-release morphine sulfate (Avinza) 30mg PO every 12hr. Three hours after the last dose, the client requests pain medication. Which of the following assessment finding is the best indicator of the patient‟s need for more pain medication? Facial grimacing Elevated blood pressure Flushed skin Self report

Facial grimacing

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? Ondansetron Magnesium sulfate Flumazenil Protamine sulfate

Flumazenil Flumazenil is an antidote and the nurse should administer the medication to reverse benzodiazepines, such as diazepam.

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (Select all that apply.) Hemoglobin 7.0 g/dL Creatinine 1 mg/dL RBC 4.7 million/mm3 Platelets 75,000/mm3 Potassium 5.2 mEq/L

Hemoglobin 7.0 g/dL Platelets 75,000/mm3 Potassium 5.2 mEq/L Hemoglobin 7.0 g/dL is correct. A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider. Platelets 75,000/mm3 is correct. A platelet level of 75,000/mm3 indicates hydroxyurea toxicity, and the nurse should report it to the provider. Potassium 5.2 mEq/L is correct. A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it to the provider.

A nurse is caring for a client who has a prescription for Metformin (Glucophage) twice daily. Which of the following lab results projects the expected outcome? Hemoglobin A1C6.4% Pre-meal plasma glucose135mg/dl Bedtime blood glucose 150mg/dl Systolic blood pressure 146 mmHg

Hemoglobin A1C6.4%

A nurse is caring for a client who has been taking ferrous sulfate for the past 2 months.Which of the following findings is expected? Increased energy Reduced frequency of coughing Increased vision Decreased inflammation

Increased energy

A nurse is admitting a client who has chest pain to the emergency department.What medication should the nurse anticipate administering to reduce cardiac demand? Heparin Pentazocine(Talwin) Morphine Butorphanol(Stadol)

Morphine

A nurse is providing teaching to a client who was recently diagnosed as HIV positive. The client is beginning medication therapy with zidovudine (Retrovir). Which of the following statements should the nurse include in the teaching? (select all that apply) Must be taken with other retroviral medicines Has few adverse effects Cures an HIV infection Prevents you from transmitting the HIV infection Increases CD4+ cll count

Must be taken with other retroviral medicines Has few adverse effects Increases CD4+ cll count

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? Methadone Naloxone Diazepam Bupropion

Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

A nurse is caring or a client who is receiving haloperidol (Haldol). The nurse should document which of the following findings are dystonia. Neckspasms Lip smacking Tremors Pacing

Neckspasms

A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication? Tachycardia Oliguria Hyperkalemia Weight gain

Oliguria Oliguria can indicate renal compromise in a client who is taking amphotericin B. The nurse should report this finding to the provider.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? Hypoglycemia Orthostatic hypotension Bradycardia Xanthopsia

Orthostatic hypotension The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness in clients who are taking the medication. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position.

A nurse is caring for a 4 year old client, who is taking amoxicillin (Amoxil) 50 mg/kg/day PO in three divided doses. Which of the following resources should the nurse consult to verify that the dose is safe for the client? Medication administration record The client's health history Physician's desk reference The client's BMI record

Physician's desk reference

A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include? Limit continuous use to 7 to 10 weeks. Schedule doses for early morning before breakfast. Expect that it will take 4 nights before benefits are noticed. Plan to withdraw from the medication gradually.

Plan to withdraw from the medication gradually. The nurse should include in the teaching to have the client plan to withdraw from taking temazepam gradually to avoid mild withdrawal syndrome

A nurse is caring for a client who has been taking furosemide (Lasix) for 3 days to treat heart failure. Which of the following findings indicate that the medication sis effective? Reduced levels of HDL Potassium within the expected reference range Clear lung sounds Increased level of consciousness

Potassium within the expected reference range

A nurse is teaching about IV betamethasone (CelestoneSoluspan) with a client who is at31 weeks of gestation and is in premature labor. Which of the following information should the nurse include in the teaching? Prevents contractions of the uterus to avoid premature birth Promotes the production of surfactant in the fetal lung Decreases inflammation associated with an allergic reaction Suppresses the immune system to prevent fetal respiratory distress.

Promotes the production of surfactant in the fetal lung

A nurse is caring for a client who is receiving a fentanyl transermal system (Duragesic). What is important to document in the client's record? Fluid intake Skin integrity Respiratory rate Pulse rate

Respiratory rate

A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used to treat tuberculosis? (Select all that apply.) Rifampin Mirtazapine Temazepam Infliximab Isoniazid

Rifampin Isoniazid Rifampin is correct. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria. Isoniazid is correct. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria

A nurse is caring for a client who has open angle glaucoma and was prescribed pilocarpine (Pilocar) 1 gtt of 3% solution. The nurse should recognize that which of the following findings indicates the client is developing systemic cholinergic toxicity? Stinging and burning sensation in her eye Hypertension Tachycardia Salivation and sweating

Salivation and sweating

A nurse is caring for a client who has a new prescription for buproion (Welbutrin). What should the nurse recognize as a contraindication for the use of this medication? Xerostomia GERD Seizure Bradycardia

Seizure

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? Chew on the medication stick to release the medication. Leave the medication stick in one location of the mouth until melted. Allow the medication 1 hr for analgesia effects to begin. Store unused medication sticks in a storage container.

Store unused medication sticks in a storage container. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? Turn the client to a side-lying position. Disconnect the client's oxytocin from the maintenance IV. Apply oxygen to the client by face mask. Increase the client's maintenance IV infusion rate

Turn the client to a side-lying position The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority intervention the nurse should take is to place the client in a lateral position.

nurse is collecting data on a client who has a new prescription for ampicillin. The nurse should recognize which of the following findings is a priority? A. Nausea B. Vomiting C. Wheezing D. Moniliasis

C. Wheezing Rationale: When using the airway, breathing, circulation approach to client care, the nurse should determine the priority finding is wheezing. Wheezing is a manifestation of an anaphylactic allergic reaction due to bronchospasm and edema in the airway. Wheezing indicates a constriction of the airway and requires immediate intervention to support respiratory function. The nurse should advise the client to wear identification to indicate an allergy to this medication.

A nurse is caring for a client who has an order for clozapine (Clozaril) 350 mg PO daily. The muse should recognize that which of the following findings is a side effect of this medication? WBC 8,000 mm3 Serum sodium 136 mg/dL Fasting blood glucose of 220 mg/dL Weight loss of 2.26 kg (5lb in 2 weeks)

WBC 8,000 mm3

A nurse is planning discharge teaching for a client who is to start therapy with repaglinide (Prandin). Which of the following should the nurse include in theteaching? "Take the medication 1 hour before mealtime." "Hold the medication if your blood glucose is less than120mg/dL." "Monitor for irritability anddiaphoresis." "Increase your protein intake."

"Hold the medication if your blood glucose is less than120mg/dL."

A nurse is caring for a client with PCA Morphine Sulfate. Which of the following statements is not true? "I will not receive any pain medications during the lock out period" "I should push the button when the pain becomes severe" "I will be asked to rate my pain occasionally" "I don't have to worry about getting an overdose of the medication"

"I don't have to worry about getting an overdose of the medication"

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? "I have tendonitis, so I haven't been able to exercise." "I take a stool softener for chronic constipation." "I take medicine for my thyroid." "I am allergic to sulfa."

"I have tendonitis, so I haven't been able to exercise." The nurse should identify tendonitis is a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching? "I should take my medication with antacids to minimize gastric upset." "This type of medication does not require blood monitoring." "I should let my dentist know I'm taking this medication." "I should expect to experience some unusual eye movement when taking this medication."

"I should let my dentist know I'm taking this medication." Phenytoin commonly causes gingival hyperplasia. As a result, the client should notify his dentist.

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? "I can apply the patch to a chest area that has hair." "I can take this medication if using an erectile dysfunction product." "I will remove the patch after 14 hours." "I need to apply a new patch to the same area every day."

"I will remove the patch after 14 hours." The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? "I should avoid getting rid of the air bubble in the syringe." "I should inject the insulin into my thigh for the fastest absorption." "I will store my unopened bottles of insulin in the refrigerator." "I need to shake the insulin before using it to make sure it is well mixed."

"I will store my unopened bottles of insulin in the refrigerator." The client should store unopened vials of insulin in the refrigerator to maintain medication viability. Once opened, the insulin may remain at room temperature for up to 1 month.

A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching? A. "Do not take antihistamines with this medication." B. "Take the medication on an empty stomach." C. "Stop taking the medication immediately for a headache." D. "Expect to develop diarrhea initially."

A. "Do not take antihistamines with this medication." Rationale: The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen.

A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications? A. Senna B. Ibuprofen C. Omeprazole D. Zolpidem

A. Senna Rationale: Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort.

A nurse is caring for a client who is to receive 1,500 mL of 0.9% sodium chloride IV over 8 hours. The nurse plans to us IV tubing with a drop factor of 10gtt/mL. How many gtt/min of IV fluid should the client receive? (round to the nearest whole number)

31 gtt/min

A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication? A. Sedation B. Constipation C. Hypertension D. Bradycardia

A. Sedation Rationale: Diphenhydramine can cause sedation. It is used to treat rhinitis, allergies, and insomnia.

A nurse is teaching a client who has a new prescription for bumetanide. Which of the following instructions should the nurse include in the teaching? A. "Report changes in hearing." B. "Avoid foods high in potassium." C. "Take the prescribed second dose at nighttime." D. "Limit your fluid intake to no more than 1.5 L a day."

A. "Report changes in hearing." Rationale: Bumetanide is a high-ceiling loop diuretic. It promotes diuresis by inhibiting sodium and chloride reabsorption in the thick ascending limb of the loop of Henle. High-ceiling loop diuretics can cause ototoxicity. Concurrent use of aminoglycosides, such as gentamycin, increases the risk of ototoxicity. Inform clients about possible hearing loss, and instruct clients to notify the prescriber if a hearing deficit or tinnitus develops.

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? A. Administer a short-acting ß2 -agonist (SABA). B. Obtain a peak flow reading. C. Administer an inhaled glucocorticoid. D. Determine the cause of the acute exacerbation.

A. Administer a short-acting ß2 -agonist (SABA). Rationale: When using the urgent versus non-urgent approach to client care, the nurse should determine that the priority action is to administer a nebulized high-dose SABA to relieve bronchoconstriction and improve ventilation.

A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of the following actions should the nurse take? A. Administer another nitroglycerin tablet. B. Initiate a peripheral IV. C. Call the Rapid Response Team. D. Obtain an ECG

A. Administer another nitroglycerin tablet. Rationale: Administration guidelines for sublingual nitroglycerin indicate that it is appropriate to administer another tablet 5 min after the first one if the client is still reporting pain.

A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take? A. Administer the blood as ordered. B. Contact the provider for further orders C. Notify the blood bank of the discrepancy. D. Complete an incident report.

A. Administer the blood as ordered. Rationale: The nurse should administer the blood as ordered. Type B blood is compatible with type AB. Type AB blood is considered a universal recipient, as it contains no antibodies to react to transfused blood.

A nurse is preparing to administer blood to a client. The unit of blood on hand is type O negative, and the client has type A positive blood. Which of the following actions should the nurse take? A. Administer the blood as ordered. B. Contact the provider for further orders. C. Notify the blood bank. D. Complete an incident report.

A. Administer the blood as ordered. Rationale: The nurse should administer the blood as ordered. Type O blood is compatible with type A. Type O blood is considered a universal donor, as it contains no antigens to react to transfused blood.

A nurse is providing dietary teaching for a client who takes furosemide. The nurse should recommend which of the following foods as the best source of potassium? A. Bananas B. Cooked carrots C. Cheddar cheese D. 2% milk

A. Bananas Rationale: The nurse should determine that bananas are the best food source to recommend because 1 cup of bananas contains 806 mg of potassium. In addition to the potassium supplements the provider might prescribe, the client should increase his daily intake of foods that have high potassium content, such as bananas, orange juice, and spinach.

A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.) A. Bounding pulse B. Pitting edema C. Swelling at the IV site D. Urine-specific gravity greater than 1.030 E. Crackles upon auscultation

A. Bounding pulse B. Pitting edema E. Crackles upon auscultation Rationale: Bounding pulse is correct. Fluid volume excess is due to excessive fluid intake or inadequate fluid excretion. Manifestations include increased blood pressure, pulse, and respirations. With fluid volume excess, the pulse is full and bounding.Pitting edema is correct. Excess extracellular fluid can lead to pitting edema in dependent areas of the body.Swelling at the IV site is incorrect. Edema at the IV site indicates a localized accumulation of fluid due to infiltration. Although this is a concern, this finding does not suggest fluid volume excess. This finding would suggest infiltration. The nurse should discontinue the IV and restarted at another site.Urine specific gravity greater than 1.030 is incorrect. Urine-specific gravity measures the concentration of all chemical particles in the urine. A therapeutic range is 1.005 to 1.030. A urine-specific gravity greater than 1.030 indicates dehydration, and a gravity of less than 1.010 indicates fluid volume excess.Crackles upon auscultation is correct. Pulmonary edema can occur with fluid volume excess.

A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching? A. Diazepam can cause drowsiness. B. This medication must be swallowed whole. C. It is important to avoid foods that contain tyramine. D. Grapefruit juice inactivates this medication.

A. Diazepam can cause drowsiness. Rationale: Diazepam has sedative properties, so the client should not engage in potentially hazardous activities after receiving diazepam.

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? A. Do not use salt substitutes while taking this medication. B. Take the medication with food C. Count your pulse rate before taking the medication. D. Expect to gain weight while taking this medication.

A. Do not use salt substitutes while taking this medication. Rationale: Captopril, an ACE inhibitor, can cause hyperkalemia due to potassium retention by the kidney. The client should avoid salt substitutes, as most of them are high in potassium.

A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Select all that apply.) A. Dyspnea B. Gastrointestinal bloating C. Jugular vein distention D. Confusion E. Hypotension

A. Dyspnea C. Jugular vein distention D. Confusion Rationale: Dyspnea is correct. Dyspnea is a clinical manifestation of fluid volume overload.Gastrointestinal bloating is incorrect. Gastrointestinal bloating is not a clinical manifestation of heart failure.Jugular vein distention is correct. Jugular vein distention is a clinical manifestation of fluid volume overload.Confusion is correct. Confusion is a clinical manifestation of fluid volume overload.Hypotension is incorrect. Hypertension, not hypotension, is a clinical manifestation of fluid volume overload. Hypotension is a manifestation of a hemolytic transfusion reaction.

A nurse is assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome? A. Elevated temperature B. Hypertension C. Peripheral edema D. Erythema at the insertion site

A. Elevated temperature Rationale: An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multi-organ system failure due to fat overload syndrome.

A nurse is preparing to administer potassium chloride (KCL) to a client who is receiving diuretic therapy. The nurse reviews the client's serum potassium level results and discovers the client's potassium level is 3.2 mEq/L. Which of the following actions should the nurse take? A. Give the ordered KCL as prescribed. B. Omit the KCL dose and document that it was not given C. Hold the prescribed dose and notify the provider of the serum potassium level. D. Call the lab to verify the client's results.

A. Give the ordered KCL as prescribed. Rationale: The client's serum potassium level is below the recommended reference range. The nurse should administer the KCL as prescribed.

A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication? A. Insomnia B. Bradycardia C. Hearing loss D. Hypertension

A. Insomnia Rationale: The nurse should monitor the client for paradoxical effects such as insomnia and excitation. If these occur, the medication should be withdrawn.

A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? A. Keep the open vial of insulin at room temperature. B. Inject the insulin into a large muscle. C. Aspirate the medication prior to administration. D. Administer the insulin in two separate injections.

A. Keep the open vial of insulin at room temperature. Rationale: The client should keep the vial in use at room temperature to minimize tissue injury and to reduce the risk for lipodystrophy.

A nurse is caring for a client who has prostate cancer. The nurse should expect the provider to prescribe which of the following medications for this client? A. Leuprolide B. Cyclophosphamide C. Finasteride D. Tamoxifen

A. Leuprolide Rationale: Leuprolide treats cancer of the prostate hormonally. It antagonizes the androgens that androgen-dependent neoplasms require.

A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? A. Liver function tests B. Gallbladder studies C. Thyroid function studies D. Blood glucose levels

A. Liver function tests Rationale: Pyrazinamide and rifampin can both cause hepatotoxicity, thus the provider will monitor liver function regularly.

A nurse is preparing to instill ear drops to a 3-year-old child. Which of the following techniques should the nurse use? A. Pull the auricle down and back. B. Pull the auricle down and out. C. Pull the auricle up and back. D. Pull the auricle up and out.

A. Pull the auricle down and back. Rationale: The nurse should pull the auricle down and back. This is the correct technique used for infants and young children under the age of 4.

A nurse is preparing to administer a rectal suppository to a client. In which of the following positions should the nurse place the client for insertion of the suppository? A. Sim's position B. Prone position C. Lying on the right side D. Supine

A. Sim's position Rationale: The nurse should assist the client to the Sim's position by lying on the left side, left hip and lower extremity straight, and right hip and knee bent. This position exposes the anus and helps the client relax the external sphincter, allowing for easier insertion of the suppository.

A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements? A. Sodium B. Potassium C. Vitamin K D. Vitamin C

A. Sodium Rationale: Lithium is a salt. If sodium level falls, the client will retain lithium and have an increased risk for lithium toxicity.

A nurse is assessing a client who is receiving a unit of packed RBCs. The client appears flushed and reports low-back pain. Which of the following actions is the nurse's priority? A. Stop the transfusion. B. Collect a urine specimen. C. Notify the blood bank D. Begin an infusion of 0.9% sodium chloride through new tubing.

A. Stop the transfusion. Rationale: The greatest risk to the client is injury due to further hemolysis; therefore, the priority action is to stop the transfusion. When a hemolytic reaction is suspected, the priority action by the nurse is to immediately stop the transfusion to prevent further hemolysis.

A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? A. Systolic blood pressure is increased B. Cardiac output is reduced C. Apical heart rate is increased D. Urine output is reduced

A. Systolic blood pressure is increased Rationale: When dopamine has a therapeutic effect, it causes vasoconstriction peripherally and increases systolic blood pressure.

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects? A. Tardive dyskinesia B. Parkinsonism C. Dystonia D. Akathisia

A. Tardive dyskinesia Rationale: These findings indicate tardive dyskinesia, which can develop in clients during long-term therapy with chlorpromazine. For many clients, the manifestations are irreversible.

A nurse is providing teaching to a client who has a skin infection and a new prescription for gentamicin topical cream. Which of the following instructions should the nurse provide? A. Wash the affected area with soap and water before applying cream. B. Increase intake of fluids while using this medication. C. The medication might cause temporary blurred vision. D. Apply the cream to large areas around the infection.

A. Wash the affected area with soap and water before applying cream. Rationale: The client should wash the affected area with soap and water and dry it thoroughly before applying the cream.

A nurse is caring for a client who has been prescribed Ceftriaxone (Rocephin). The nurse notes that the cleint's chart lists a penicillin allergy. Which of the following actions should the nurse take first? Notify the provider that the client is allergic to the medication Teach the client about signs of allergic response Question the the client about pervious allergic reaction Administer the medication and monitor the client for allergic response

Administer the medication and monitor the client for allergic response

A nurse is caring for a client who has a new prescription for estrogen-progestin combination (Ortho-Novum). Which of the following medications may interact with this medication and require the use of additional non-hormonal birth control? Thiamine ( Vitamin B1) Dilantin(Phenytoin) Amalodipine(Norvasc) Docusate sodium (colace)

Amalodipine(Norvasc)

nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide? A. "An antacid may be taken with the medication if indigestion occurs." B. "Take sucralfate 1 hr before meals." C. "Take the tablets whole." D. "Store sucralfate in the refrigerator."

B. "Take sucralfate 1 hr before meals." Rationale: Sucralfate is a mucosal protectant. The client should take it on an empty stomach, 1 hr before meals, for maximum effectiveness.

A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching? A. "Do not take this medication before bedtime." B. "Take the medication with a full glass of water." C. "Expect abdominal pain with this medication." D. "Take this medication on an empty stomach."

B. "Take the medication with a full glass of water." Rationale: The nurse should instruct the client to take this medication with a full glass of water, unless contraindicated, to reduce the risk for constipation.

A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching? A. "Take the medication with an antacid to minimize stomach upset." B. "Your doctor might need to reduce your theophylline dose while taking this medication." C. "Take the medication on an empty stomach for better absorption." D. "You should plan to take this medication for at least 6 months."

B. "Your doctor might need to reduce your theophylline dose while taking this medication." Rationale: The nurse should instruct the client that the provider might need to reduce his theophylline dose due to the possibility of increased medication levels.

nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should prime the blood administration tubing using which of the following IV solutions? A. Lactated Ringer's solution B. 0.9% sodium chloride C. Dextrose 5% in water D. Dextrose 5% in 0.45% sodium chloride

B. 0.9% sodium chloride Rationale: The nurse should prime the tubing with 0.9% sodium chloride, as this is the only IV solution that does not hemolyze RBCs.

nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide? A. Phenytoin turns urine blue. B. Alcohol increases the chance of phenytoin toxicity. C. Avoid flossing the teeth to prevent gum irritation. D. Take an antacid with the medication if indigestion occurs.

B. Alcohol increases the chance of phenytoin toxicity. Rationale: The nurse should include in the home instructions that alcohol alters the blood level of phenytoin.

nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis? A. Aspirin PO B. Enoxaparin subcutaneous C. Heparin infusion D. Warfarin PO

B. Enoxaparin subcutaneous Rationale: Enoxaparin is a low molecular heparin that inhibits thrombus and clot formation. Preventive doses of enoxaparin are low and the client does not require monitoring of prothrombin time or activated partial thromboplastin time, making it the preferred treatment for DVT prophylaxis following orthopedic surgery.

A nurse is caring for a client who is at 6 weeks of gestation and has pneumonia. While the nurse is obtaining the client's history, the client tells the nurse that she takes the herb feverfew for migraine headaches. Which of the following actions should the nurse take? A. Tell the client that she should take an over-the-counter analgesic instead. B. Explain to the client that she should not take this herb while she is pregnant. C. Ask the client why she would take an herb during pregnancy D. Suggest that the client ask her herbalist within the next few weeks about taking it while pregnant

B. Explain to the client that she should not take this herb while she is pregnant. Rationale: The nurse should explain that feverfew interferes with platelet action and can therefore cause bleeding. It is unsafe for the client to take during pregnancy.

nurse is teaching a class about safe medication administration. The nurse should include in the teaching that which of the following references are acceptable for safe medication administration? (Select all that apply.) A. A website that ends in .com B. Published journals C. Pharmacists D. Physicians' Desk Reference E. Pharmaceutical sales representatives

B. Published journals C. Pharmacists D. Physicians' Desk Reference A website that ends in .com is not correct. A website that ends in .com indicates it is a commercial enterprise and not a reliable source of information. The Internet can be a valuable source of drug information. However, because anyone can post information on the Internet regardless of qualifications, not everything that is found on the Internet is accurate.Published journals is correct. Published journals and reputable newsletters, such as The Medical Letter on Drugs and Therapeutics, and the Prescriber's Letter, are bimonthly and monthly publications that present current information on medications.Pharmacists is correct. Pharmacists provide expert information about medications, expected versus unexpected side effects, contraindications, compatibilities, and indications for use. Physicians' Desk Reference is correct. The Physicians' Desk Reference (PDR) is a reference work financed by the pharmaceutical industry. The information on each drug is identical to the information on the package insert. The PDR is updated annually to reflect current recommendations. Pharmaceutical sales representatives is not correct. Pharmaceutical sales representatives can be useful sources of medication information. However, the role of the pharmaceutical representative is sales, not education.

A nurse is reviewing a client's admission record. The nurse notes that there are prescriptions for several medications. Which of the following factors should the nurse recognize is of primary consideration when determining the schedule of administration? A. Institutional policies regarding routine medication administration times B. Specific characteristics of the medications C. Schedule of administration that the client follows at home D. Time at which the medication can be available from the pharmacy

B. Specific characteristics of the medications Rationale: Evidence-based practice indicates that the specific characteristics of the medications be the primary consideration of scheduling administration times. The characteristics of each medication, including the indication, onset, durations of action, and potential adverse effects and interactions, primarily determine the schedule of administration. Although an institutional policy may require that all once daily medications be administered at 0800, the nurse should be aware that some classifications of medications should only be given at bedtime, or should only be given with food. Likewise, the client's preferences, as well as the availability of each medication from the pharmacy, play important but smaller roles in determining the schedule of administration.

nurse is caring for a client who has E. coli infection and a prescription for gentamicin 5mg/kg/day by intermittent IV bolus every 8 hr. Which of the following manifestations indicate the client is experiencing gentamicin toxicity? (Select all that apply.) A. Insomnia B. Tinnitus C. Dizziness D. Restlessness E. Xerostomia

B. Tinnitus C. Dizziness Rationale: Insomnia is incorrect. A client with gentamicin toxicity is at risk for neurotoxicity. Clinical manifestations can include ringing of the ears and complaints of dizziness.Tinnitus is correct. A client with gentamicin toxicity is at risk for neurotoxicity. Clinical manifestations can include ringing of the ears and complaints of dizziness.Dizziness is correct. A client with gentamicin toxicity is at risk for neurotoxicity. Clinical manifestations can include ringing of the ears and complaints of dizziness.Restlessness is incorrect. A client with gentamicin toxicity is at risk for neurotoxicity. Clinical manifestations can include ringing of the ears and complaints of dizziness.Xerostomia is incorrect. A client with gentamicin toxicity is at risk for neurotoxicity. Clinical manifestations can include ringing of the ears and complaints of dizziness.

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Mild nosebleeds are common during initial treatment. B. Use an electric razor while on this medication. C. If a dose of the medication is missed, double the dose at the next scheduled time. D. Increase fiber intake to reduce the adverse effect of constipation.

B. Use an electric razor while on this medication. Rationale: Warfarin, an anticoagulant, increases the client's risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding.

A nurse is providing teaching about insulin glargine to a client who has type 1 diabetes mellitus. Which of the following information should the nurse include in the instructions? A) Observe for hypoglycemia when the insulin peaks. B) Administer the insulin immediately before meals. C) Do not mix this medication in a syringe with other insulin. D) Rotate the bottle gently prior to drawing up the insulin. Insulin glargine is clear. Therefore, there is no need for the client to rotate the bottle prior to drawing up the insulin

C) Do not mix this medication in a syringe with other insulin. The client should not mix insulin glargine with any other type of insulin in the same syringe, because this procedure can alter the medication's effects.

A nurse is teaching a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse included? A. "Take this medication every night before sleep." B. "Take this mediation with a high fat meal." C. "Avoid activities that require alertness such as driving." D. "Monitor for urinary retention."

C. "Avoid activities that require alertness such as driving." Rationale: The client should avoid activities that require alertness. Diazepam is a benzodiazepine that causes sedation and dizziness.

A nurse is educating a group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? A. "Clients who have glaucoma should not take warfarin." B. "Clients who have rheumatoid arthritis should not take warfarin." C. "Clients who are pregnant should not take warfarin." D. "Clients who have hyperthyroidism should not take warfarin."

C. "Clients who are pregnant should not take warfarin." Rationale: Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding.

A clinic nurse is giving instructions to a mother on the proper technique of applying ophthalmic ointment to her preschool-age child who has conjunctivitis. Which of the following should the nurse include in the instructions? A. "Warm the ointment by placing the tube in glass of hot tap water." B. "Cleanse the eye with a wet cotton ball in a direction towards the inner canthus before applying the ointment." C. "Discard the first bead of ointment before each application." D. "Instruct your child to squeeze his eyes shut following application."

C. "Discard the first bead of ointment before each application." Rationale: The parent should discard the first bead of ointment from the tube because it is considered contaminated.

A nurse is teaching a client who has a new prescription for disulfiram. Which of the following information should the nurse include in the teaching? A. "Avoid grapefruit juice while taking this medication." B. "Do not crush this medication before swallowing." C. "Do not drink alcohol while taking this medication." D. "Take this medication with food."

C. "Do not drink alcohol while taking this medication." Rationale: Disulfiram is a type of aversion therapy that helps maintain abstinence from alcohol. Drinking alcohol while taking disulfiram can produce a life-threatening response that can include palpitations, headache, and hypotension. Therapy must not begin until the client has abstained from alcohol for at least 12 hr. The client should avoid all forms of alcohol including cough syrups and after-shave lotions.

A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take my flu vaccine within one week of starting this medication." B. "I can expect a sore throat for the first week after starting this medication." C. "I should eat more bananas while taking this medication." D. "I should take aspirin for minor aches and pains while taking this medication."

C. "I should eat more bananas while taking this medication." Rationale: The nurse should instruct the client to eat more potassium-rich foods such as bananas and citrus fruits while taking this medication. Prednisone can cause a loss of potassium, and the nurse should instruct the about the manifestations of hypokalemia such as muscle weakness and cramping and to notify the provider should these occur.

A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll rinse my mouth after taking this medication." B. "I'll take this medication when I get an asthma attack." C. "I'll take this medication once a day in the evening." D. "I'll use a spacer device when I inhale this medication."

C. "I'll take this medication once a day in the evening." Rationale: Montelukast, a leukotriene modifier, is used to prevent asthma exacerbations. The client should take it on a daily basis once a day in the evening.

A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? A. "Limit your fluid intake to meal times." B. "Do not take this medication on an empty stomach." C. "Increase your daily intake of dietary fiber." D. "You can expect swelling of the ankles while taking this medication."

C. "Increase your daily intake of dietary fiber." Rationale: The nurse should instruct the client to increase his daily intake of dietary fiber to reduce the risk of constipation associated with verapamil.

nurse is teaching a client who has a new prescription for erythromycin. Which of the following information should the nurse include? A. "Take this medication with a glass of grapefruit juice." B. "Expect your skin to turn yellow." C. "Monitor for ringing in your ears." D. "Increase fiber intake to prevent constipation."

C. "Monitor for ringing in your ears." Rationale: Ototoxicity is an adverse effect of erythromycin. The client should monitor and report manifestations of ototoxicity, such as tinnitus, dizziness, and vertigo.

A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication? A. "Take this medication after each meal and at bedtime." B. "Take one tablet every 15 min during an acute attack." C. "Take one tablet at the first indication of chest pain." D. "Take this medication with 8 ounces of water."

C. "Take one tablet at the first indication of chest pain." Rationale: The client should take nitroglycerin as soon as he feels pain, pressure, or tightness in his chest and not wait until his chest pain is severe.

nurse at a family practice clinic receives a call from a client who is prescribed oral contraceptives but forgot to take one dose. The client reports she is in the first week of a 28-day cycle pack. Which of the following instructions should the nurse provide? A. "Do not have vaginal intercourse until after your next period." B. "Stop taking the pills and switch to a different contraceptive method." C. "Take the missed dose now, then continue the medication as ordered." D. "Take a home pregnancy test."

C. "Take the missed dose now, then continue the medication as ordered." Rationale: The nurse should tell the client to take the missed dose immediately, then continue with the pack as ordered. The nurse should also tell the client to use an additional form of contraception for 7 days.

A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make? A. "Take only one dose of nitroglycerin to reduce the risk of getting a headache." B. "There's nothing that can be done to relieve the headaches that nitroglycerin causes." C. "Try taking a mild analgesic to relieve the headache." D. "We will ask the provider to prescribe a different medication for you."

C. "Try taking a mild analgesic to relieve the headache." Rationale: Headache is a common side effect of nitroglycerin. The nurse should suggest conservative measures, such as taking aspirin, acetaminophen, or some other mild analgesic, to manage the headache. Generally, headaches that are a side effect of nitroglycerin are transient.

nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide? A. Administer the medications by touching the tip of the dropper to the sclera of the eye. B. Hold pressure on the conjunctiva sac for 2 min following application of drops. C. Administer the medications 5 min apart. D. It is not necessary to remove contact lenses before administering medications.

C. Administer the medications 5 min apart. Rationale: The nurse should instruct the client that, if more than one ophthalmic medication is to be administered, they should be given 5 min apart.

A nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder. Which of the following interventions should the nurse anticipate? A. Laboratory analysis of cardiac enzymes B. Monitoring for the presence of esophageal varices C. Administration of thiamine D. Placing the client in protective isolation

C. Administration of thiamine Rationale: Thiamine is administered to the client who has Wernicke-Korsakoff psychosis due to hepatic dysfunction and inadequate intake of sufficient vitamins.

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication? A. Grapefruit juice B. Milk C. Alcohol D. Coffee

C. Alcohol Rationale: The nurse should teach the client to avoid alcohol while taking this medication to prevent a disulfiram reaction, such as nausea, headache, and hypoglycemia.

A nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP). The nurse should plan to administer the client's PRN bethanechol when the client reports which of the following manifestations? A. Bladder spasms B. Severe pain. C. An inability to void D. Frequent episodes of painful urination

C. An inability to void Rationale: Bethanechol is a cholinergic medication that stimulates the parasympathetic nervous system, thus improving the tone and motility of the smooth muscles of the urinary tract enough to initiate urination.

nurse is preparing to administer heparin subcutaneously to a client who has a deep vein thrombosis. Which of the following techniques should the nurse use? A. Cleanse the skin with an alcohol swab, insert the needle, aspirate, and inject the heparin. B. Cleanse the skin with an alcohol swab, insert the needle, aspirate, inject the heparin, and massage the site. C. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding. D. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, aspirate, and observe for bleeding.

C. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding. Rationale: This is the correct technique for the nurse to use to inject heparin.

A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect? A. Seizures B. Bradycardia C. Constipation D. Hypothermia

C. Constipation Rationale: Mydriatic eye drops can cause systemic anticholinergic effects, such as constipation and dry mouth.

A nurse is caring for a client who has a prescription for olanzapine. The nurse should monitor the client for which of the following manifestations as an expected response to this medication? A. A decrease in resting blood pressure B. Control of seizure activity C. Decreased auditory hallucinations D. Increased energy level and involvement in activities

C. Decreased auditory hallucinations Rationale: Olanzapine is prescribed for the treatment of the manifestations of schizophrenia, one of which is auditory hallucinations.

A nurse is caring for a client who is exhibiting signs of alcohol withdrawal. Which of the following medications should the nurse plan to administer? A. Methadone B. Disulfiram C. Diazepam D. Buprenorphine

C. Diazepam Rationale: Diazepam is prescribed to treat the symptoms and prevent complications of alcohol withdrawal.

nurse is administering timolol eye drops to a client who has glaucoma. Which of the following actions should the nurse take? A. Apply pressure to the bridge of the nose after administration. B. Wipe the eye from the outer canthus to the inner canthus before instillation. C. Drop prescribed amount of medication into the conjunctival sac. D. Protect the distal portion of the eyedropper using clean technique

C. Drop prescribed amount of medication into the conjunctival sac. Rationale: With the dominant hand resting on client's forehead, hold filled medication eyedropper or ophthalmic solution approximately 1 - 2 cm above conjunctival sac. Instill prescribed number of medication drops into the conjunctival sac. After instilling the drops, ask the client to close his eye gently. If the client is to receive more than one eye medication to the same eye, wait at least 5 min before administering the next medication.

A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following prescriptions for this client? A. Aspirin B. Clopidogrel C. Enoxaparin D. Alteplase

C. Enoxaparin Rationale: The nurse should anticipate a prescription for enoxaparin as prophylaxis therapy for venous thromboembolism. Clients following hip arthroplasty are usually on anticoagulants for 3 to 6 weeks after surgery.

A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching? A. Follow a low-sodium diet. B. Limit daily fluid intake C. Obtain a daily weight D. Avoid foods that have a high tyramine content.

C. Obtain a daily weight. Rationale: Clients who are taking lithium should monitor their daily weight due to the risk of fluid imbalance.

nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Ototoxicity B. Tachycardia C. Postural hypotension D. Hypokalemia

C. Postural hypotension Rationale: Propranolol can cause postural hypotension. The client should change positions slowly and the nurse should monitor the client's blood pressure from a lying to sitting to standing position

nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment? A. Blood pressure B. Apical heart rate C. Respiratory rate D. Temperature

C. Respiratory rate Rationale: The priority action the nurse should take when using the airway, breathing, and circulation (ABC) approach to client care is to evaluate the client's respirations. The respiratory rate is especially important because opioid analgesics like morphine can cause respiratory depression.

nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication? A. Metallic taste B. Diarrhea C. Skin rash D. Anxiety

C. Skin rash Rationale: Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.

A nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements? A. Saw palmetto B. Cranberry C. Soy D. Garlic

C. Soy Rationale: The nurse should instruct the client to avoid soy because soy can reduce the effectiveness of the levothyroxine.

A nurse is teaching a group of young women about the use of oral contraceptives. The nurse should teach that taking which of the following herbal preparations reduces the effectiveness of this birth control method? A. Ginseng B. Gingko biloba C. St. John's wort D. Saw palmetto

C. St. John's wort Rationale: St. John's wort decreases the effectiveness of oral contraceptives and can be responsible for breakthrough bleeding and unintended pregnancies.

A nurse is teaching a client who has iron deficiency anemia about ferrous sulfate. Which of the following instructions should the nurse include in the teaching? A. Take the ferrous sulfate at bedtime B. Take the ferrous sulfate with an antacid. C. Take the ferrous sulfate between meals. D. Take the ferrous sulfate with yogurt

C. Take the ferrous sulfate between meals. Rationale: The client should take the medication between meals for optimal absorption.

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? A. Weigh weekly to monitor therapeutic effect. B. Take the medication on an empty stomach. C. Take the medication early in the day. D. Muscle pain is an expected adverse effect

C. Take the medication early in the day. Rationale: The nurse should instruct the client to take hydrochlorothiazide early in the day to avoid nocturia.

nurse is caring for a client who is taking montelukast. Which of the following outcomes indicates a therapeutic effect of the medication? A. The client experiences less muscle pain. B. The client's seizure threshold is reduced C. The client experiences an increased ease of breathing. D. The client's platelet count is increased.

C. The client experiences an increased ease of breathing. Rationale: Montelukast is a bronchodilator that is prescribed for clients who have chronic asthma or seasonal rhinitis. Therapeutic effects of the medication are an increased ease of breathing.

A nurse is admitting a client who states he takes ginkgo biloba every day to improve his memory. The nurse should identify a potential interaction with which of the following medications the client is taking? A. Ranitidine B. Levothyroxine C. Warfarin D. Loratadine

C. Warfarin Rationale: The nurse should identify a potential interaction between gingko biloba and warfarin. Ginkgo might suppress coagulation and should be used with caution with antiplatelet drugs such as aspirin or anticoagulants such as warfarin or heparin.

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? A. Sedation B. Increased appetite C. White coating in the mouth D. Dry oral mucous membranes

C. White coating in the mouth Rationale: Fluticasone/salmeterol is an inhaled glucocorticoid and long acting beta2 adrenergic agonist combination inhalation medication that is used for daily management of asthma. It is not a rescue medication. An adverse effect of the medication is oropharyngeal candidiasis. The nurse should instruct the client to gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue to the provider.

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? Chest pressure White patches on the tongue Bruising Insomnia

Chest pressure Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.

A nurse is admitting a client to a long-term care facility. While reconciling the medication prescribed at home with those prescribed in the facility, the nurse discovers a discrepancy in the dosages. Which action should the nurse take? Clarify the medication dosages with the provider Change the prescribed medication dosage to reconcile the discrepancy Contact the pharmacist regarding the dosage discrepancies Ask a family member to verify the medication dosage

Clarify the medication dosages with the provider

A nurse is providing instruction to four clients regarding medication self-administration. Which of the following actions by a client indicates a need for further teaching? Client rolls insulin suspension between his palms Client takes iron supplements at bedtime. Client uses cotton swab to apply antibiotic ointment. Client allows 1 min between puffs when he uses a metered-dose inhaler.

Client takes iron supplements at bedtime.

A nurse is caring for a client who has received acetaminophen (Tylenol) 650 mgand Hydrocodone (Vicodin) 5 mg every 4 hr for the past 24 hr. Which of the following is an appropriate action for the nurse to take? Complete an incident report Stagger the medications every 2hr Suggest a time with the pharmacy. Decrease acetaminophen to 325 mg every 4hr.

Complete an incident report

nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via an external insulin pump. Which of the following statements by the client indicates a need for further teaching? A. "I will change the needle every 3 days." B. "I should store all unused insulin in the refrigerator." C. "If I skip lunch, I will skip my mealtime dose of insulin." D. "I will use insulin glargine in my insulin pump."

D. "I will use insulin glargine in my insulin pump." Rationale: The client should use a short-acting insulin in the insulin pump. The insulin pump is designed to administer rapid-acting or short-acting insulin 24 hr a day. Insulin glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24-hr period.

nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart." B. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period." C. "I'll dial 911 when I have pain and then take the nitroglycerin tablets." D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."

D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting." Rationale: If 1 nitroglycerin tablet does not relieve the client's pain, he should access emergency services and then take 2 more tablets at 5-min intervals if he still has pain.

nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching? A. "It's okay to have a couple of glasses of wine with dinner each evening." B. "I'll be sure to eat more foods with vitamin K." C. "I'll take aspirin for my headaches." D. "I'll use my electric razor for shaving."

D. "I'll use my electric razor for shaving." Rationale: Because this medication prolongs clotting times, the client should avoid situations that put him at high risk for bleeding, such as shaving with a straight razor or a razor blade.

nurse is providing teaching to a client who is taking warfarin about monitoring its therapeutic effects. Which of the following explanations should the nurse provide about the international normalized ratio (INR) test? A. "The INR also monitors heparin therapy if the provider switches the medication prescription." B. "The INR is the only test available for anticoagulant therapy monitoring." C. "You will only need the test twice per month." D. "The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times."

D. "The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times." Rationale: The INR is a standardized test, which means that the result will be the same, no matter which laboratory performs it.

nurse is teaching an adolescent about medication therapy with oral acetylcysteine. Which of the following information should the nurse include in the teaching? A. "You should avoid eating eggs." B. "Your mouth will become dry." C. "It is necessary to monitor your serum electrolyte levels." D. "This medication has a very unusual odor."

D. "This medication has a very unusual odor." Rationale:

A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide? A. "Treatment with this medication will last for 1 month." B. "This medication can cause insomnia." C. "It is best to take the medication with meals." D. "Urine and other secretions might turn orange."

D. "Urine and other secretions might turn orange." Rationale: Rifampin might turn the urine and other secretions reddish-orange. This includes sputum, tears, and sweat.

nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report? A. A client received gentamicin intermittent IV bolus over 1 hr. B. A nurse used a 25-gauge 3/8 inch needle to administer a heparin injection. C. A nurse injected Demerol IM into the vastus lateralis site of adult. D. A client received a crushed bupropion XL tablet mixed with applesauce

D. A client received a crushed bupropion XL tablet mixed with applesauce. Rationale: Extended or sustained release medications are intended to release medication levels over a long period of time to sustain therapeutic relief. Crushing, breaking, or chewing an extended release medication releases the medication at once into the bloodstream and could be life-threatening. Mixing this medication in applesauce deviates from standard of care and requires the nurse to complete an incident report.

nurse is reviewing the medical record of a client who is to receive the first dose of cefoxitin via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive cefoxitin and report to the provider? A. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride B. A recent history of diarrhea for 3 days C. Serum creatinine 0.8 mg/dL D. A severe allergy to amoxicillin

D. A severe allergy to amoxicillin Rationale: A client who has a suspected or documented history of severe allergy to penicillins may also have an allergy to cephalosporins that could result in anaphylaxis. The nurse should withhold the dose and notify the provider.

nurse is preparing to administer phenytoin 50 mg by intermittent IV bolus to a client who has a seizure disorder. Which of the following actions should the nurse take? A. Slow the injection if the medication crystallizes. B. Dilute the medication before injecting. C. Follow the IV injection with sterile water D. Administer the medication over 1 min.

D. Administer the medication over 1 min. Rationale: The nurse should administer phenytoin slowly, no faster than 50 mg/min.

nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack? A. Beclomethasone B. Salmeterol C. Formoterol D. Albuterol

D. Albuterol Rationale: Albuterol is an inhaled short-acting beta2 agonist (beta2-adrenergic agonist) used as a rescue medication to relieve an acute asthma attack. Albuterol dilates the airways, decreases wheezing, and improves oxygenation.

A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following gastrointestinal changes? A. Decreased mucus in stools B. Decreased black tarry stools C. Decreased watery stools D. Decreased fat in stools

D. Decreased fat in stools Rationale: Pancrelipase is a combination of pancreatic enzymes used to increase digestion of fats, carbohydrates and proteins. The client should expect a reduction of fat in stools.

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? A. Draw up the NPH insulin into the syringe first. B. Inject air into the regular insulin first. C. Shake the NPH insulin until it is well mixed. D. Discard regular insulin that appears cloudy

D. Discard regular insulin that appears cloudy. Rationale: The nurse should teach the client to discard any regular insulin that appears cloudy, as regular insulin should be clear. NPH insulin has a cloudy appearance.

nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take? A. Give the insulin at 0700. B. Give the insulin when the breakfast tray arrives. C. Give the insulin 30 min after breakfast with the client's other routine medicines. D. Give the insulin at 0730

D. Give the insulin at 0730. Rationale: Regular insulin has an onset of 30 to 60 minutes and should be given at a specific time before meals, usually within 30 min. The nurse should always check the blood glucose levels prior to administering short-acting insulin

nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? A. Milk B. Orange juice C. Coffee D. Grapefruit juice

D. Grapefruit juice Rationale: Grapefruit juice increases blood levels of verapamil, a calcium channel blocker, by inhibiting its metabolism. The excess amount of medication can intensify the medication's hypotensive effects, putting the client at risk for syncope and dizziness.

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)

D. Inspect vials for contaminants. C. Roll NPH vial between palms of hands. A. Inject air into NPH insulin vial. E. Inject air into regular insulin vial. B. Withdraw short-acting insulin into syringe. F. Add intermediate insulin to syringe.

nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider? A. Hematocrit 45% B. Partial thromboplastin time (PTT) 65 seconds C. White blood cell count 8,000/mm3 D. Platelets 74,000/mm3

D. Platelets 74,000/mm3 Rationale: Heparin-induced thrombocytopenia is a disorder characterized by low platelet counts. It is an adverse effect of heparin that causes the activation of platelets, resulting in widespread clot formation and depletion of platelets. The expected reference range for platelets is 150,000-400,000/mm3 .

A nurse is caring for a client who requires a medication that is packaged in a single dose glass ampule. Which of the following techniques should the nurse use when opening the glass ampule? A. Wear sterile gloves and break off the neck of the glass ampule with a single snap to the right side. B. Wear sterile gloves and break off the neck of the glass ampule with a single snap in a downward motion. C. Tap the bottom of the ampule, place a gauze pad around the ampule neck, and break off the bottom with a forward motion away from the body. D. Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body.

D. Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body. Rationale: The nurse should tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body. The sterile gauze prevents broken glass coming in contact with the fingers, and bending the ampule top toward the body allows glass fragments to spray away from the nurse.

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? A. The client follows a low-fat diet to reduce cholesterol. B. The client drinks a glass of grapefruit juice every day. C. The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. D. The client uses garlic to lower cholesterol levels.

D. The client uses garlic to lower cholesterol levels. Rationale: The nurse should recognize that garlic can potentiate the action of the warfarin.

A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed RBC. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse? A. The nurse initiates an infusion of 0.9% sodium chloride. B. The nurse collects a urine specimen. C. The nurse sends a blood specimen to the laboratory. D. The nurse starts the transfusion of another unit of blood product.

D. The nurse starts the transfusion of another unit of blood product. Rationale: When suspecting a hemolytic reaction, the nurse should immediately stop the transfusion of all blood products. The transfusion of additional products can increase the client's risk for further complication.

A nurse is caring for an older adult client who is receiving gentamicin (Garamycin)following abdominal surgery Which of the following physiological changes is most important for thenurse to consider when administering thismedication? Decreased serum albumin Decreased renal blood flow Increased gastric pH Increased body fat

Decreased renal blood flow

A nurse is caring for a client who has a systemic infection. During the infusion of vancomycin (Vancocin) the client develops a rash and becomes flushed. Which of the following is an appropriate action for the nurse to take? Document a Penicillin allergy in the client's chart. Decrease the rate of administration. Obtain a prescription for oral vancomycin. Administer naloxone (Narcan) 1mgIV.

Document a Penicillin allergy in the client's chart.

A nurse is reviewing the laboratory tests for a client who had an acute myocardialinfarction. The client is prescribed warfarin (Coumadin) 10mg PO. The nurse notes an INR of 2.6. Whichof the following actions should the nursetake? Give the dose as prescribed. Hold the next dose. Increase the dose by 2.5mg Decrease the dose by 5mg.

Hold the next dose.

A nurse is reviewing the medication administration record for a client who has metastatic cancer and a fentanyl (Duragesic) transdermal patch for pain. The client reports a pain level of 10 on a scale of 0 to 10. Which of the following medications should the nurse anticipate administering? Hydormorphone (Dilaudid) Butorphanol (Stadol) Alprazolam (Xanax) Carbenezepine (Tegretol)

Hydormorphone (Dilaudid)

A client is questioning the nurse about why she is receiving frequent doses of IVantibiotics. Which of the following responses by the nurse isappropriate? It helps to maintain a steady druglevel It helps to prevent the emergence of drug-resistant bacteria It decreases the risk of an allergicreaction It decreases the length of necessary treatment

It helps to prevent the emergence of drug-resistant bacteria

A nurse is assessing a client who has been taking anti-tuberculosis medications for the past3 months. The nurse should instruct the client to notify the provider if which of thefollowing occurs? Weight gain Jaundice Alopecia Polyuria

Jaundice

A nurse is preparing to administer infliximab (Remicade) to a client who has rheumatoid arthritis. The nurse should watch the patient for which of following adverse effects? Select all that apply Bradycardia Jaundice Plyuria Urtipenia Fever

Jaundice Urtipenia Fever

A nurse is assessing a school age client who is experiencing seizure activity and is prescribed diazepam (Valium) IV. The nurse should clarify the order if the client is receiving a continuous infusion of which of the following: Lactated Ringer solution 0.9% Sodium chloride with 100 unites of regular insulin 0.9% sodium chloride 0.9% Sodium chloride with 20 mEq of potassium chloride

Lactated Ringer solution

Clinical finding of a client who has prescription for lithium carbonate (Lithobid). For which reasons should the nurse withhold the medication and notify the provider? Lither level 1.0 mEq/L Potassium at 3.7 mEq/L Sodium at 143 mEq/L Lithium level 2.5 mEq/L

Lithium level 2.5 mEq/L