ATI Pharmacology 2019 A
a nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?
decreased respirations might occur
alcohol toxicity
diazepam - benzodiazepine, decrease manifestation of alcohol w/d and prevent w/d seizures
tall, tented T waves
hyperkalemia
ST depression
hypokalemia
fattened or inverted T waves
hypokalemia
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take?
* monitor the client for constipation (can) lead to fecal impaction - hold other oral med 6 hrs before and after - stable for 24 hrs refrigerated
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?
* prevent delirium tremens - acamprosate: maintain abstinence by decreasing anxiety - atenolol: minimize autonomic components like diaphoresis - propranolol: decrease cravings during alcohol w/d
a nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension and dyspnea. Which of the following medications should the nurse administer first?
*epinephrine - induce vasoconstriction and bronchodilation during anaphylaxis - diphenhydramine: antihistamine, 2nd line med, decrease angioedema and urticaria FU anaphylaxis - albuterol inhaler: bronchodilator - prednisone: glucocorticoid, urticaria FU anaphylaxis, prevent delayed anaphylactic reaction
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?
*miosis: pupillary constriction due to excessive muscarinic stimulation causing difficulty w/visual accommodation - can cause increased salivation, urinary urgency, and bradycardia
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?
*tinnitus: aminoglycosides are ototoxic (monitor x high pitch ringing and HA) - gastrointestinal AE: inflammation of the liver and spleen - neuromuscular AE: twitching/flaccid paralysis
a nurse is developing a teaching plan for a client with a new prescription of simvastatin. which following instructions should the the include?
- report muscle pain to MD: myopathy AE that can lead to rhabdomyolysis - avoid grapefruit juice: increases risk of muscle injury from elevations in creatine kinase - expect therapy to be lifelong; if discontinued then cholesterol levels will return to pretreatment range w/in several weeks to months
A nurse is preparing to administer dextrose 5% in water D5W 400 ml IV to infuse over 1 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
100 gtt/min
a nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine dtap. The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages?
2 months
a nurse is preparing to administer ciprofloxacin 15mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose?
300mg/dose
a nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today" Which of the following actions should the nurse take?
Document the refusal and inform the client's provider
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 if the following client statements indicates a contraindication for administering this medication?
I have tendonitis, so I haven't been able to exercise
A nurse is an emergengy 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?
atropine - anticholinergic agent
a nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?
bibasilar crackles - osmotic diuretic; can precipitate heart failure and pulmonary edema
a nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to teat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?
blood in the urine (manifestation of heparin toxicity; bruising, hematoma, hypotension, tachycardia)
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; causes accelerated inactivation of oral contraceptives due to its action on hepatic medication metabolizing enzymes
A nurse administers a dose of metformin to client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?
check the client's blood glucose - at risk for hypoglycemia (provide snack)
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine.
constipation
a nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate?
digoxin - can cause hypercalcemia, increase risk of digoxin toxicity
a nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately
dyspnea
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?
flumazenil - reverse benzodiazepines
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mmHG, heart rate 55/min and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?
heart rate - slows conduction rate through SA and AV nodes; early indication of digoxin toxicity
Widened QRX complex
hyperkalemia
a nurse is collectiing a medication history from a 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?
ibuprofen - most NSADIS can increase lithium levels
ST elevation
ischemia
a nurse receives a verbal order from the provider to administer morphine 5 mg every 4 hours subQ for sever pain as needed. the nurse should identify which of the following entries as the correct format doe the medications administration record (MAR)
morphine 5 mg subcut every 4 hr PRN severe pain
a nurse is an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?
naloxone - opioid antagonist reverse respiratory depressive effects of heroin - do not administered too quickly as it can cause HTN, tachycardia, n/v, can can cause state of opioid w/d
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
A nurse is planning to teach about the use of spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. the nurse should include that spacer decreases the risk for which of the following adverse effects of the medications.
oral candidiasis
a nurse is caring for 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?
pregnancy test; teratogenic effects - lab test x aspartate aminotransferase levels prior to starting
a nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?
report yellowing of the skin - hepatotoxic, can cause jaundice - minimum of 6 weeks to a year of treatment
a nurse is providing teaching to a client who is to start treatment for asthma bethmethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?
rinse your mouth after inhaling the beclomethasone - glucocorticoid inhaler; prevent oropharyngeal candidiasis and hoarseness
A nurse is assessing a client who has schizophrenia and is taking haloeridol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome NMS?
temperature of 39.7 C (103.5 F) - respiratory distress, diaphoresis, hyper/hypotension, incontinence, tachycardia, severe muscle rigidity
A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Whcih of the following instructions should the nurse include?
- Blood glucose levels will be monitored during therapy: glucocorticoids increase serum glucose levels and may require insulin or antihyperglycemics - avoid contact with people who have known infection: glucocorticoids depress immune system, increase risk of infection - grapefruit juice can increase the effects of the medication
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
sedation (dizziness and fatigue) - central dopamine receptor antagonist, increases gastrointestinal motility, prevents nausea - AE: tardive dyskinesia
a nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?
sexual dysfunction - SSRI; cause muscle twitching - decreased libido, impotence, delayed orgasm/anorgasmia - CNS AE: abnormal dreaming, sedation, delusions, hallucination, and psychosis - neurologic AE: agitation, euphoria, and sedation
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?
store unused medication sticks in a storage container - expect analgesia effects to begin w/in 10 to 15 min
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 the instructions?
take one tablet at onset of migraine - max: 3 tablets in 24 hr period - excessive dosing can lead to ergotism: cause peripheral gangrene due to vasoconstriction and ischemia
Benztropine
anticholinergic medication - treat adverse effects of Parkinson's disease; reduce rigidity and tremors
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 transition in care requires the nurse to coduct medication reconciliation
a nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medication?
acetylcysteine - orally or IV infusion w/in 8 to 10 hours
a nurse is teaching a client about warfarin. the client asks if they can take aspirin while taking Warfarin. Which of the following responses shoudlthe nurse make?
Aspirin will increase the risk of bleeding - inhibits platelet aggregation and can potentiate actions of anticoagulant
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching.
Forms a protective barrier over ulcers - mucosal protectant
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?
I should sit up for 30 minutes after taking the risedronate will reduce gastrointestinal effects of esophagitis and dyspepsia - take w/full glass of water - bisphosphonate: take antacid 2 hrs after
a nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?
I should tell my provider if I develop a sore throat - indicate neutropenia - take on empty stomach - Naproxen/NSAIDS can interact with and increase risk of kidney dysfunction
a nurse is instructing a client on the application of nitroglycerin transdermal patches. which of the following statements by the client indiciates an understanding of the teaching
I will take the patch off right after my evening meal - remove patch 12 to 14 hrs before applying new patch to avoid tolerance - takes 30 to 60 min to take effect
A nurse is reviewing the 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?
Platelets 96,000/mm3 (normal range 150,000 - 400,000/mm3) = heparin induced thrombocytopenia
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?
The client rates pain as 3 on a scale from 0-10
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?
determine apical pulse prior to administering (life threatening bradycardia AE) - less than 60: notify MD - AE: hypotension - wt daily x monitor heart failure and wt gain - admin FU meals or at bedtime if orthostatic hypotension occurs
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?
0.9% sodium chloride 1L IV infused over 4 hr. Vital signs stable, provider notified
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?
0830
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 taper of the medication before discontinuing (prevent abstinence syndrome or rebound insomnia)
a nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge?
a client's capnography has returned to baseline (indicates gas exchange is adequate)
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 radius of the umbilicus
Physostigmine
antimuscarinic poisoning; atropine, scopolamine, some antihistamines, phenothiazines, and tricyclic antidepressant
a nurse is assessing a client who is taking propylthiouracil for the treatment of Graves diease. Which of the following findings should the nurse identify as an indication that the medication has been effective?
increase in ability to focus: thyroid hormone antagonist decreases circulating T4 hormone reducing hyperthyroidism - AE: decreased WBC, can cause myelosuppression
a nurse is caring for a client who is receiving oprelvekin. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?
increased platelet count
a nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication
insomnia - atypical antidepressant, stimulant properties; agitation, tremors, mania
a nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to provider?
potassium level 2.8 mEq/L (notify provider prior to administration due to increased risk of digoxin toxicity and cardiac dysrhythmias)
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.
report muscle pain to the provider avoid taking the medication with grapefruit juice expect therapy with this medication to be lifelong
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 fingers (paresthesia) - AE: diarrhea, wt loss, polyuria
a nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. which of the following adverse effects should the nurse include in the teaching?
- dry mouth - blurred vision due to increased intraocular pressure - dry eyes (anticholinergic agent)
A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia?
Presence of U waves
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 (uteroplacental insufficiency) - discontinue oxytocin to reduce uterine contractions - apply oxygen to provide supplemental oxygen to the fetus - increase maintenance IV infusion rate to maintain adequate blood flow and promote placental perfusion
a nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching?
hot flashes due to estrogen receptor blocking action of tamoxifen - cardiovascular AE: chest pain, flushing, thrombus development - genitourinary AE: vaginal discharge and uterine cancer
