ATI Pharm Test A 4th semester

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

A nurse is preparing to administer a scheduled antibiotic a 0800 to a client and discovers the antibiotic is not present in the clients med drawer. The nurse should identify that admin of the med can occur at which of the following time periods w/o requiring an incident report.?

0830

A nurse is teaching about self- admin of transdermal meds with a male client who has a new prescription for nitro. The nurse should identify that which of the following statements by the client indicated an understanding of the teaching?

14 hrs

A nurse scaring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine. The nurse should instruct the mother that her newborn should get them at what age?

2 mo

A nurse is preparing to administer cipro 15mg/kg PO every 12 hours to a child that weighs 44 lbs. How many mg should the nurse administer per dose?

300 mg

1000 mL IV over 8 hrs 15 get/mL

31 gtt/ min

250 mg 200 mg/ 5mL

6.3 mL

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?

8- 10 glasses of water

A nurse is preparing to admin 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? A Obtain the client's blood pressure. B. Contact the client's provider. C. Inform the charge nurse. D. Complete an incident report.

A Obtain the client's blood pressure.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 mo. Which of the following actions should the nurse plan to take?

Obtain WBC w absolute neut count

A nurse is providing teaching for a client who has MS and a new prescription for methylpredinose. Which of the following instructions should the nurse include?

Blood glucose Avoid contact No grapefruit juice

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

A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.

A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. Which adverse effects should the nurse include in the teaching? A. Hot flashes B. Urinary Retention C. Constipation D. Bradycardia

A. Hot flashes The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.

A nurse is caring for a client who is receiving filgrastim. Which of the following finds should the nurse document to indicate the effectiveness of the therapy? A. Increased neutrophil count B. Increased RBC count C. Decreased prothrombin time D. Decreased triglycerides

A. Increased neutrophil count Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized.

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? A. Tingling of fingers B. Constipation C. Weight gain D. Oliguria

A. tingle 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 med record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol?

Asthma

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? A) Weigh the client weekly. B) Determine apical pulse prior to administering. C) Administer the medication 30 min prior to breakfast. D) Monitor the client for jaundice.

B) Determine apical pulse prior to administering. Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in her instructions? A. "Take one tablet three times a day before meals." B. "Take one tablet at onset of migraine." C. "Take up to eight tablets as needed within a 24-hour period." D. "Take one tablet every 15 minutes until migraine subsides."

B. "Take one tablet at onset of migraine."

A nurse is collecting a medication history from client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? A. Aspirin B. Ibuprofen C. Famotidine D. Bisacodyl

B. Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive w pinpoint pupils and has a RR of 6/min. Which med should the nurse give? A. Methadone B. Naloxone C. Diazepam D. Bupropion

B. 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 planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? A. Muscle weakness B. Sedation C. Tinnitus D. Peripheral edema

B. Sedation Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation.

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? A. Constipation B. Tinnitus C. Hypoglycemia D. Joint pain

B. Tinnitus Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.

A nurse is preparing to teach a client who is to start a new prescription of extended release vera

change positions slowly

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 ana verse effect of this medication?

Blurred vision

A nurse is caring for a client who is achieving ling-term treatment for systemic lupus erythematous 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?

Bone density scans

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

C. "I will taper off the medication before discontinuing it."

A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? A. The client's provider is required to complete medication reconciliation. B. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. C. A transition in care requires the nurse to conduct medication reconciliation. D. Medical reconciliation is limited to the name of the medications that the client is currently taking.

C. A transition in care requires the nurse to conduct medication reconciliation. The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.

A nurse in the emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? A. Potassium iodide B. Glucagon C. Atropine C. Protamine

C. Atropine A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.

A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? A. Report the incident to the charge nurse. B. Notify the provider. C. Check the client's blood glucose. D. Fill out an incident report.

C. Check the client's blood glucose.

A nurse is assessing a client after administering a second dose of cefazolin IV. Nurse notes that the client has anxiety, hypotension and dyspnea. Which medication should the nurse administer first? A.Diphenhydramine B. Albuterol inhaler C. Epinephrine D. Prednisone

C. Epinephrine According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis.

A nurse is providing teaching to a client who has peptic ulcer disease and is starting a new prescription for sucralfate. Which of the following actions of sulcralfate should the nurse inclide in the teaching A. Decreases stomach acid secretion B. Neutralizes acids in the stomach C. Forms a protective barrier over ulcers D. Treats ulcers by eradicating H. pylori

C. Forms a protective barrier over ulcers Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.

A nurse is caring for a client who has cancer and is taking oral morphine and decussate sodium. The nurse should instruct the client that taking DS on a daily basis can minimize which of the adverse effects of morphine?

COnstipation

A nurse is reviewing the med list of a client who wants to begin oral contraceptives. The nurse should identify that which of the following client meds will interfere with the effectiveness of oral contraceptives?

Carbamazepine

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

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? A. "I will drink a glass of milk when I take the risedronate." B. "I will take the risedronate 15 minutes after my evening meal." C. "I should take an antacid with the risedronate to avoid nausea." D. "I should sit up for 30 minutes after taking the risedronate."

D. "I should sit up for 30 minutes after taking the risedronate." Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following documented findings should the nurse report to the provider immediately A. Dyspepsia B. Diarrhea C. Dizziness D. Dyspnea

D. Dyspnea When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.

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

D. Mitosis 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 preparing to administer PO sodium polystyrene sulfonate to a client client who has hyperkalemia. Which of the following action should the nurse plan to take? A. Hold the client's other oral medications for 8 hr post administration. B. Inform the client that this medication can turn stool a light tan color. C. Keep the client's solution in the refrigerator for up to 72 hr. D. Monitor the client for constipation.

D. Monitor the client for constipation. The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.

A nurse is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings? A. Potassium 5.0 mEq/ L B. aPTT 2 times the control C. Hemoglobin 15 g/dL D. Platelets 96,000/mm3

D. Platelets 96,000/mm3 A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion.

A nurse is reviewing the lab results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider? A. Calcium level 9.2 mg/dL B. Magnesium level 1.6 mEq/L C. Digoxin level 1.1 ng/mL D. Potassium level 2.8 mEq/L

D. Potassium level 2.8 mEq/L A potassium level of 2.8 mEq/L is below the expected reference range of 3.5 to 5 mEq/L. The nurse should notify the provider if a client has hypokalemia prior to administration of digoxin due to the increased risk of developing digoxin toxicity and cardiac dysrhythmias.

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? A. Minimize diaphoresis B. Maintain abstinence C. Lessen craving D. Prevent delirium tremens

D. Prevent delirium tremens

A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective? A. The client's vital signs are within normal limits. B. The client has not requested additional medication. C. The client is resting comfortably with eyes closed. D. The client rates pain as 3 on a scale from 0 to 10.

D. The client rates pain as 3 on a scale from 0 to 10.

A nurse is admin cetotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first?

Discontinue IV

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

Doxycycline

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence which of the following symptoms should the nurse tell the client to expect. ( all that apply) A. Dry mouth B. Tinnitus C. Blurred vision D. Bradycardia E. Dry eyes

Dry mouth is correct. Oxybutynin is an anticholinergic agent that can cause dry mouth. Tinnitus is incorrect. Oxybutynin can cause several sensory adverse effects including increased intraocular pressure. The nurse should instruct the client to report eye pain, seeing colored halos around lights, and a decreased ability to perceive light changes. However, tinnitus is not an adverse effect associated with oxybutynin administration. Blurred vision is correct. Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure. Bradycardia is incorrect. Oxybutynin can cause several cardiovascular adverse effects such as a prolongation of the QT interval, palpitations, hypertension, and tachycardia. Dry eyes is correct. Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation.

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?

Hero Platelets Potassium

A nurse in a providers 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 to the provider immediately?

Hyperventilation

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teachingZ?

I know smoking makes ranitidine less effective

A nurse is providing teaching to a client about the use of ethanol estradiol/ norelegestromin. The nurse should identify that which of the following statements by the client indicated an understanding of teaching?

I will fold the sticky sides together

A nurse is teaching a client who has an upper rest infection about gaufenesin. Which of the following statements should the nurse include in the teaching?

Increase fluid intake to 2 L

A nurse is caring for a client who has HF and is reviewing an IV infusion of dopamine. Which of the following findings indicated that the medication is effective?

Increased cardiac output

Nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the med w which of the following to promote absorption

OJ

A nurse is monitoring a client who is receiving amphortecerin B intermittent IV bolus for the treat meant of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the med?

Oliguria

A circulatiing nurse is planning care for a client who is scheduled for surgery w a latex allergy. What action should the nurse take?

Place monitoring cords and tubes in a socket

A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe modulo cystic acne vulgarism. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?

Pregnancy test

A nurse is developing a teaching plan for a client who has a new prescription for simvstatin. Which of he following instructions should the nurse include in her teaching plan?

Report muscle pain Avoid taking the medication w grapefruit juice Lifelong

A nurse is reviewing the prescription of a client who has tuberculosis. The nurse should identify that which of the following meds are used to treat tuberculosis?

Rifampin & Isoniazid

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?

Rinse mouth

A nurse is administering ceftazidime to a client with a penicillin allergy

SOB

A nurse is teaching a client who is to start taking diltiazem

SOB

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicated an understanding of the teaching?

Short period of time

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 med?

Smoked sausage

A nurse is providing discharge instruction to a client who is to self- admin insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective?

Store in fridge

A nurse is providing discharge teaching about handling med 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?

Store unused med sticks in container

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 a decrease in BP

A nurse is teaching ac client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of this med?

Urinary retention

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?

Watery diarrhea

A nurse is caring for a client who is recovering from a DVT and is to start warfarin. Which of the following findings is an adverse effect?

bleeding gums

A nurse is caring for a client who has DM and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first?

blood test

A nurse is admin baclofen

decrease in flexor and extensor

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicated an understanding of the teaching?

dentist

A nurse is providing teaching about insulin glargine

do not mix

A nurse is providing teaching to a client who is to start taking lisinopril

dry cough

A nurse in an emergency department is caring for a client whose fan reports the client has taken large amts of diazepam. Which of the following meds should the nurse give? A. Ondansetron B. Magnesium sulfate C. Flumazenil D. Protamine sulfate

flumazenil The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam.

A nurse is monitoring for AE of hydrochlorothiazide

orthostatic hypotension

A nurse is caring for a client in labor.

side lying

A nurse is caring of r a client who is receiving end of life care

stool softener on a daily basis

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?

take with milk

A nurse at an urgent care clinic

tendonitis

A nurse eis reviewign the med record of a client who has schitzophrenia

total cholesterol

A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include?

withdraw med gradually