ATI pharmacology

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The nurse is preparing to administer meperidine 100 milligrams IM to a client who has a BMI of 23. Which of the following year links should the nurse use to administer the medication? A. Half inch B. 1 1/2 inch C. 2 1/2 inch D. 3 inch

- 1 ½ inch in general needle lengths for I am injections are one to 1 1/2 inches unless the client is obese a BMI of 23 is considered to be an optimal weight

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention? a. Heart rate 106 per minute b. Dry skin c. Oral temperature 36.8 degrees Celsius or 98.2 degrees Fahrenheit d. Lethargy

A - heart rate 106/min tachycardia can be a manifestation of hyperthyroidism possibly due to excessive hormone replacement the client might require a lower dosage of levothyroxine

A nurse is preparing to administer IV nitroprusside for a client who has had a myocardial infarction. Which of the following actions should the nurse take? a. Regulate the infusion pump rate using the client's weight in the calculation b. Change the IV solution bag every 48 hours after the time of preparation c. Ensure the freshly prepared IV solution has a slight greenish tint d. Cover the medication with an amber plastic bag to protect it from light

A - regulate the infusion pump rate using the client's weight in the calculation The nurse should regulate the infusion pump rate based on the client's weight sodium nitroprusside is a potent vasodilator that works faster than any other medication available and is administered as a continuous IV infusion to clients who require a rapid reduction of blood pressure the nurse should monitor the client's blood pressure either continuously with an arterial line or at least every 15 minutes with an electric monitoring device because this medication can cause a rapid reduction of blood pressure that could be life threatening if not managed properly

A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. nitroglycerin B. aspirin C. Morphine D. Metoprolol

B - aspirin Aspirin suppresses platelet aggregation producing an immediate antithrombotic effect the client should chew the first dose of aspirin to allow rapid absorption

A nurse is performing a preoperative assessment of a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? a. Soy b. Garlic c. Black cohosh d. Green tea

B - garlic many dietary supplements can affect clotting or interact with other medications that affect clotting thereby increasing the clients risk of bleeding, examples of these dietary supplements include garlic ginger and ginkgo biloba. The nurse should notify the provider immediately about this potential risk

A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client A. epinephrine B. Nitroglycerin C. Lidocaine D. Atropine

B - nitroglycerin the nurse should anticipate administering nitroglycerin to a client who has unstable angina. This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries, which increases oxygenation and blood flow

A nurse is reviewing the medical record of a client who is scheduled for induction of Labor and has a prescription for misoprostol which of the following conditions would the nurse identify as a contradiction to administering this medication? a. Gestational diabetes b. Past cesarean delivery c. Preeclampsia d. Genital herpes

B - past caesarean delivery Misoprostol is used for cervical ripening and induction of Labor. It causes higher incidence of uterine tachysystole therefore it is contraindicated in clients who have a history of major uterine surgery or cesarean delivery with past pregnancies because of the risk of uterine rupture

A nurse is providing teaching to a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client that which of the following findings is an indication of thyrotoxicosis? A. Weight gain B. Constipation C. chest pain D. fatigue

C. Chest pain thyroid toxicosis can result if a client takes too much levothyroxine. Manifestations include chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and diaphoresis. The client should notify the provider if any of these manifestations are present.

A nurse is teaching about the adverse effects of Baclofen with a client who has multiple sclerosis with spasms. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. Adverse effects include urinary frequency b. I should increase my fiber intake to counteract the adverse effect of diarrhea c. This medication can cause addiction d. I should not stop taking this medication suddenly

D - I should not stop taking this medication suddenly the nurse should inform the client about the adverse effects associated with abrupt withdrawal of baclofen such as visual hallucinations comma paranoid ideations comma and seizures

A nurse is providing teaching to a client with asthma who has a new prescription for a short acting beta 2 agonist (SABA) bronchodilator . Which of the following pieces of information should the nurse share? a. The SABA will provide prolonged control of asthma attacks b. SABA's are also available in an oral form c. The SABA will have to be taken with an inhaled glucocorticoid d. Notify the provider if the SABA is needed more than twice per week

D - notify the provider if the SBA is needed more than twice per week SABA bronchodilators are used as a PRN rescue medication to stop an ongoing asthma attack. If the client requires the SABA more than twice per week, the provider should be notified because a prescription for a long acting beta 2 agonist LABA might be required using an SABA more than twice per week can lead to serious adverse effects

A nurse is caring for a client who has tuberculosis and is taking rifampin which of the following clients statements should indicate to the nurse that the client is experiencing an adverse effect of the medication? a. I have noticed my urine is orange in color b. I still eat more than I used to c. My tongue and mouth are sore d. My voice seems hoarse

a - I have noticed my urine is orange in color The nurse should identify that an adverse effect of rifampin can be red orange colored urine, saliva, sweat and tears as the medication is excreted from the body. The nurse should also inform the client that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The client should inform the provider if urine becomes dark in color since this can be an indication of hepatotoxicity

the nurse is teaching to a client who has systemic lupus erythematous about a new prescription for oral glucocorticoid therapy. which of the following client statements indicates an understanding of the teaching? a. I should take a calcium supplement while on this medications b. regular liver function studies will have to be done while I am taking this medication c. I can take NSAIDs to treat mild pain while using this medication d. I will be sure to eat 6 small meals a day to prevent hypoglycemia from this medication

a - I should take a calcium supplement while on this medication an adverse effect of systemic glucocorticoid therapy is osteoporosis. increasing calcium-rich foods in the diet and adding calcium and Vitamin D supplements should be encouraged to prevent osteoporosis and decrease the risk of fractures

a nurse is teaching a client who is about to start taking propylthiouracil to treat hyperthyroidism. which of the following statements should the nurse identify as an indication that the teaching has been effective? a. I will need lab tests to check my liver function b. I should take this medication once daily. c. if I get a risk, I am probably having an allergic reaction d. if I have difficulty sleeping, it is probably because of this medication

a - I will need laboratory tests to check my liver function this drug is heaptotoxic and can cause sever liver injury. the nurse should instruct the client to report dark urine and yellowing of the eyes, which can indicate liver injury.

a nurse is teaching a client who has osteoporosis about a new prescription for risedronate. which of the following client statements indicates an understanding of the teaching? a. I will take this medication with a full cup of water b. I will lie down after I take this medication c. I will take the medication with food d. I will take this medication at bedtime

a - I will take this medication will a full cup of water

a nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. which of the following pieces of information should the nurse include? a. a full therapeutic response may take several months to happen b. the medication should be taken with high-protein foods c. a full therapeutic response might cause vivid dreams d. the medication is given at the onset of mild symptoms

a - a full therapeutic response may take several months to happen

a nurse is caring for client who has a new prescription for tamoxifen. the nurse should recognize that tamoxifen has which of the following therapeutic effects? a. anti-estrogenic b. antimicrobial c. androgenic d. anti-inflammatory

a - anti-estrogenic

a nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. which of the following findings should the nurse identify as an adverse effect of receiving this medication? a. bleeding b. increased clot formation c. shortness of breath d. blockage of the central venous catheter

a - bleeding

a nurse is caring for a client who has a prescription for a QT interval medication. which of the following conditions should the nurse identify as an adverse effect of this medication? a. bradycardia b. jaundice c. low blood pressure d. dark urine

a - bradycardia

a nurse is planning discharge teaching for a client who has major depressive disorder and a new prescription for phenelzine. which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? a. broiled beef steak b. Mac and cheese c. pepperoni pizza d. smoke salmon

a - broiled beef steak phenelzine, a MAOI, is an antidepressant. this med interacts with a variety of foods to produce a hypertensive crisis. beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume not b - most cheeses, except for cottage cheese and cream cheese, interact with MAOIs not c - pepperoni, salami, and other dried or cured meat interact with MAOIs not d - fish that has been cured or dried interacts with MAOIs *interaction in all of these can lead to hypertensive crisis

a nurse is preparing to administer an epinephrine IV bolus to a client. which of the following should the nurse verify before initiating the IV medication? a. concentration of the formulation b. reversibility of the medication c. potential barriers to absorption d. gastric emptying time

a - concentration of the formulation

a nurse is providing discharge teaching for a client who has a new prescription for metoprolol. which of the following instructions should the nurse include? select all that apply a. do not stop taking this med abruptly b. take the med right before bedtime c. avoid exposure to sunlight d. count your radial pulse daily e. change positions slowly

a - d - e - do not stop taking abruptly (increased risk for angina, hypertension, and myocardial infarction, reduce over 1-2 weeks) count radial pulse daily (report a HR slower than 60/min) change positions slowly (this med can cause orthostatic hypotension, prevent injury like falls, by moving from lying down or sitting to standing slowly not b - metoprolol can cause insomnia not c - does not cause photosensitivity

a nurse is preparing to administer dantrolene to a client who has muscle spasticity. which of the following findings from he client's medical history should the nurse identify as a contraindication to the administration of the medication? a. history of cirrhosis b. history of multiple sclerosis c. history of cerebral palsy d. history of malignant hyperthermia

a - history of cirrhosis

a nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. when assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem? a. hypotension b. tachycardia c. decreased LOC d. history fo diuretic use

a - hypotension *is a treatment for hypertension so watch the opposite side

a nurse is caring for ancient who has multiple sclerosis and is receiving interferon bet-1a. the nurse should identify that which of the following client stamens indicates a potential adverse effect of the medication? a. my body aches all over b. I have abdominal cramping c. my hair seems to be thinning d. it hurts when I urinate

a - my body aches all over flu-like symptoms are an adverse effect

a nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. which of the following assessments is the nurse's priority? a. pulmonary function b. CBC c. urinary output d. peripheral edema

a - pulmonary function ABCs

a nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta2-agonist combination dry-powdered inhaler (DPI) for maintenance therapy. the nurse should identify that which of the following is a disadvantage of this medication? a. restricted dosage flexibility b. complicated delivery device c. serious systemic effects d. limited efficacy over time

a - restricted dosage flexibility the nurse should identify that a disadvantage of an inhaled glucocorticoid and a long acting beta2-agonist being combined is that the dosages of the medications are fixed, so the dose cannot be adjusted not b - easy to use device for self-administration after receiving basic instruction not c - the combo med DPI is delivered locally t the lungs, systemic effects are mild, and generally do not occur not d - the combo med DPI is effective for long-term use for clients who have asthma

a nurse is caring for a client who has asthma and requires long-term treatment. the nurse should identify that which of the following meds is used for long-term treatment places the client at an increased risk of asthma-related death? a. salmeterol b. fluticasone c. budesonide d. theophylline

a - salmeterol the nurse should identify that salmeterol is along-acting beta2-agonist. when this medication is used alone for the long-term treatment of asthma, this class of med increased the client's risk of asthma-related death. to decrease this risk, the client should be prescribed both a long-acting beta2-agonist along with an inhaled corticosteroid

a nurse is caring for a school-aged child who has cystic fibrosis (CF) and has been using a corticosteroid inhaler for long-term treatment. which of the following findings should the nurse identify as an adverse effect of long-term use of the medication? a. small stature for age b. decreased weight c. poor dentition d. atrophied muscles

a - small statue for age the nurse should identify that an adverse effect go the long-term use of inhaled glucocorticoid can be a slowing in the rate of growth in children

a nurse is caring for ancient who has a prescription for subnormal etonogestrel. the nurse should alert the provider about which of the following findings in the client's medical history? a. takes St. John's wort b. breastfeeds a 6 month old infant c. has a parent with hypertension d. has a positive human papillomavirus (HPV) test result

a - takes st johns wort st johns wort can reduce the effects of subnormal etonogestrel because it stimulates hepatic drug-metabolizing enzymes, therefore, the nurse should alert the provider about the client's med history and it should be discontinued

a nurse is caring for client who is developing acute pulmonary edema and has a new prescription for furosemide 40 mg IV bolus. the nurse should plan to administer the medication using which of the following methods? a. undiluted administered over 2 min b. diluted administered over 20 min c. undiluted administered as rapidly as possible d. diluted administered over 5 min

a - undiluted administered over 2 min should be a low-dose furosemide at a rate of 20mg/min

a nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. the nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects? a. urinary health promotion b. immune system stimulation c. decreased leg pain from arterial disease d. prevention of nausea cause by motion sickness

a - urinary health promotion related to prostatic conditions

a nurse is an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily. the client reports taking extra doses to promote weight loss. which of the following findings should indicate to the nurse that the client is hydrated?m a. urine specific gravity 1.035 b. distended neck veins c. BUN 18 mg/dL d. bounding radial pulses

a - urine specific gravity 1.035 is oliguria, an increased urine concentration and an increased urine specific gravity greater than 10.30 are expected findings in clients who are dehydrated

a nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. for which fo the following adverse effects should the nurse monitor? a. orthostatic hypotension b. diarrhea c. urinary frequency d. bradycardia

a- orthostatic hypotension

A nurse is planning care for a client with thrombophlebitis who has a prescription to receive heparin via continuous IV infusion which of the following actions should the nurse include in the plan of care? a. Infuse the heparin using an electric Ivy pump b. administer vitamin K if the client has indications of hemorrhage c. adjust the dosage of heparin based on the clients PT levels d. inform the client that the Hepburn will dissolve the thrombus

a-infuse the heparin using an electronic IV pump the nurse should administer heparin using an electronic ivy pump rather than by gravity to prevent an accidental increase or change in the rate of infusion

a nurse is providing teaching to a group of new parents about medications. the nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? a. Reye's syndrome b. visual disturbances c. diabetes mellitus d. Wilms' tumor

a. Reye's syndrome aspirin should not be given to children or adolescents who have a viral infection like chickenpox due to the risk of developing Reye's Syndrome

a nurse is preparing to administer a hydromorphone IV infusion to a client for pain. which of the following actions should the nurse take? a. administer the med over 4-5 minutes b. place the client in a high-fowlers position c. assess the client's pain level after administering the pain med d. review the client's last set of vitals

a. administer the medication over 4-5 minutes administer over 4-5 minutes to prevent the adverse effects of the medication such as respiratory depression and cardiac arrest

a nurse is reviewing the medical record of a client. the medication administration record shows the client is taking clopidogrel. which of the following events should the nurse expect in the client's medical history? a. recent myocardial infarction b. history of hemorrhagic stroke c. current outbreak of psoriasis d. history of hypertension

a. recent myocardial infarction the nurse should expect the client's medical record to indicate a history of an atherosclerotic event such as myocardial infarction, ischemic stroke, or peripheral vascular disease. Clopidogrel is an anti platelet medication that inhibits the aggregation of platelets to prevent such thrombotic events

a nurse is providing teaching about sodium phosphate to a client who has a new prescription for sodium phosphate. the client is scheduled for a colonoscopy and is currently taking furosemide for hypertension. which of the following client statements should indicate to the nurse that the teaching has been effective? a. I can take my water pill as prescribed b. I can experience an imbalance in my electrolyte from this medication c. I should drink 8 oz of bowel cleanser every 10 minutes until I drink a total of 4 liters d. I can experience rebound constipation after using this medication

b - I can experience an imbalance in my electrolytes from this medication can cause excess fluid loss as a result of cleansing the bowel of stool

a nurse is teaching licentious who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. which of the following client statements indicates an understanding of the teaching? a. I can take my second dose of medication no late than 9:00 PM b. I should change positions slowly when getting out of bed c. if I miss a dose, I should double the next dose d. I should notify my provider if I experience a headache while taking this medication

b - I should change positions slowly when getting out of bed

a nurse is teaching a client who has a new prescription for alosetron. which of the following client statements indicates an understanding of the teaching? a. nausea is a common adverse effect of this medication b. I should contact my provider immediately if I experience constipation c. if I do not respond to treatment at the lowest dosage, my provider may continue to increase the dosage at weekly intervals d. abdominal pain with diarrhea can indicate a serious complication

b - I should contact my provider immediately if I experience constipation

a nurse is teaching a client who will be taking dexamethasone daily for pain due to spinal edema. the nurse should identify which of the following client statements as an indication that the teaching has been effective? a. I should eat a snack at bedtime to avoid low blood glucose b. I should stay away from people who are ill c. I should increase my fluid intake to about 3 quarts per day d. I will call my provider if I am experiencing to much sedation

b - I should stay away from people who are ill this is a glucocorticoid that decreases inflammation by affecting the client's immune system

a nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription for amitriptyline. which fo the following statements by the client indicates an understanding of the teaching? a. I will take amitriptyline in the morning because I will likely have trouble falling asleep if I take it in the evening b I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease c. I can drink a glass of beer or wine with my evening meal because amitriptyline does not interact with alcohol d. I will avoid foods that are high in fiber because amitriptyline can cause diarrhea

b - I will move slowly when I stand because amitriptyline can cause my BP to decrease this med can cause orthostatic hypertension, take fall risk precautions

a nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. which of the following pieces of information should the nurse include about the application of topical lidocaine? a. apply a dressing after covering the affected areas with topical lidocaine b. apply topical lidocaine to affected areas that are intact c. apply topical lidocaine in a thick layer to affected areas d. apply topical lidocaine frequently to large affected areas

b - apply topical lidocaine to affected areas that are intact

a nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The Ads selection of which of the following foods for the client's lunch indicates an understanding of the teaching? a. bologna on wheat bread b. chicken salad c. cheddar cheese and crackers d. pizza with pepperoni

b - chicken salad this is an MAOI, avoid tyramine

a nurse is caring for a client who has atrial fibrillation and is scheduled for cardio version. the nurse should anticipate a prescription from the provider for which of the following medications for this procedure? a. amlodipine b. diltiazem c. nifedipine d. lidocaine

b - diltazem it is an anti arrhythmic med that is used during cardio version to treat atrial fibrillation

a nurse is caring for client who is taking selegiline. the nurse should monitor the client for which of the following adverse effects of selegiline and notify the provider if it occurs? a. bruising b. drowsiness c. coughing d. constipation

b - drowsiness

a nurse is caring for a client who is taking streptomycin. which of the following medications increases the client's risk of developing ototoxicity when taken with streptomycin? a. cefoxitin b. furosemide c. naproxen d. amphotericin B

b - furosemide

a nurse in a provider's office is reviewing a client's medication history. the client asks the nurse if she should begin taking high-dose vitamins as she ages. which of the following pieces of information should the nurse provide about high doses of vitamin supplements? a. high doses of water-soluble vitamins enhance their therapeutic actions b. high doses of water-soluble vitamins can have adverse effects c. high doses of vitamin supplements are restricted to use during pregnancy d. tolerance might develop, resulting in an increased vitamin need

b - high doses fo water-soluble vitamins can have adverse effects this can cause harm to the body, any supplements consumed should not exceed the recommended dietary allowance. elevated levels of vitamin A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. excessive intake of beta-carotene can increase the risk of lung cancer in clients who smoke. in addition increased doses of vitamin E can increase the risk of death in clients who have chronic illnesses

a nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0-10. which of the following routes of administration will deliver the medication with the shortest time of onset? a. oral b. intravenous c. intramuscular d. subcutaneous

b - intravenous

a nurse is caring for a client who is receiving chlorpromazine to treat schizophrenia. which of the following statements by the client should promote the nurse to nitty the provider immediately? a. my last bowel movement was 2 days ago b. my tongue keeps moving like a worm c. I feel dizzy when I stand up too quickly d. I can't stop blinking when I am in the sun

b - my tongue keeps moving like a worm

a nurse is caring for client who has been in the PACU for more than 1 hr, has a RR of 9/min, and is difficult to arouse. the nurse should expect a prescription for which of the following medications? a. pentazocine b. naloxone c. naltrexone d. butorphanol

b - naloxone this med displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia that opiates cause

a nurse is caring for client who is taking glucocorticoids. the nurse should monitor the client for which fo the following adverse effects of the med? a. weight loss b. peptic ulcer c. hyperkalemia d. diplopia

b - peptic ulcer the nurse should monitor for development of peptic ulcer disease due to irritation of the gastric mucosa. the nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black or tarry stools occur not a - watch for weight gain not c - hypokalemia not d - monitor for visual disturbances like cataracts and glaucoma

a nurse is providing teaching about benzodiazepines to a client who is discontinuing long-term alprazolam use. which of the following pieces of information should the nurse include in the teaching? a.you might experience somnolence b. plan to taper the dose slowly over several months c. call the provider if you have muscle weakness d. confusion is common during this process

b - plan to taper the dose slowly over several months

a nurse is caring for ancient who has rheumatoid arthritis and a new prescription for etanercept. which of the following values should the nurse review prior to the administration of the med> a. ability to swallow b. results of last purified protein derivative (PPD) test c. serum creatinine level b. blood glucose level

b - results of last PPD test a client who is taking etanercept is at risk for infection such as TB. to reduce this risk, the client should be tested for latent Tb, if positive, the client should undergo TB tx before receiving this med. while taking this med the client should be monitored closely for the development of TB

a nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. which of the following should the nurse identify as the expected outcome of the med? a. reduces the frequency of attacks b. reverse bronchospasm c. prevents inflammation d. decrease chronic manifestations

b - reverses bronchospasm the nurse should identify that the expected outcome of short-acting beta2-agonist is several of bronchospasm, these bind to beta2-adrenergic receptors in the lungs, resulting in relaxation of bronchial smooth muscles

a nurse is caring for a client who has cystic fibrosis (CF) and has a prescription for a high-dose ibuprofen daily. the nurse should identify that which of the following is an expected outcome for the client receiving this medication? a. thinned pulmonary secretions that are retained in the airways b. slowed progression of pulmonary damage c. potentiated action of bronchodilator therapy d. decreased risk of fevers associated with CF

b - slowed progression of pulmonary damage

a nurse is providing teaching to a client who has a new prescription for sertraline. the client asks the nurse if he should continue to take st. johns wort for depression. which of the following instruction should the nurse give the client? a. take the medication and herbal supplement together b. stop taking the herbal supplement while taking the medication c. take the herbal supplement and the medication at least 2 hours apart d. take an antacid with both the herbal supplement and the medication

b - stop taking the herbal supplement while taking the medication it increases the risk of serotonin syndrome

a nurse is teaching a client who is postmenopausal and has a prescription for alendronate. which of the following statements should the nurse include in the teaching? a. you can lie down 15 minutes after taking this medication b. take this medication on an empty stomach c. crush this medication to improve absorption d. avoid taking antacids or supplements that contain calcium while taking this medication

b - take this medication on an empty stomach

a nurse is reviewing the laboratory report for a client who is taking tobramycin and notes that the peak blood level is 9.3mcg/dL. which of the following actions should the nurse take? a. administer half of the prescribed dosage at the client's next scheduled dose b. tell the client that the medication seem to be appropriate c. advise the client to drink more water through the day d. ask if the client has been experiencing any peripheral neuropathy

b - tell the client that the medication seems to be appropriate expected range is 5-10mcg/dL

a nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. which of the following instructions should the nurse include in the teaching? a. use the inhaler just before exercise b. the medications therapeutic effects can take up to several weeks to develop c. you will shake the medication container for 3 seconds d. you will need to exhale slowly after you inhale

b - the medication's therapeutic effects can take up to several weeks to develop

the nurse is teaching a client who has allergic rhinitis about a new prescription for brompheniramine. which of the following pieces of information should the nurse include in the teaching? a. report GI disturbances immediately b. you might find that you develop a dry mouth c. you should not experience any CNS alterations d. increased urinary frequency is an expected effect

b - you might find that you develop a dry mouth a client who take a first - generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. taking frequent sips of liquid or sucking hard, sugarless candy can help relieve dry mouth.

a nurse is providing teaching for a client who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus. which of the following instructions should the nurse include in the teaching? a. take both meds together for 72 hours and then stop taking the cyclosporine b. stop taking cyclosporine for 24 hours and then begin taking the tacrolimus c. alternate train the meds for 48 hr and then take only the tacrolimus d. if adverse reactions to the tacrolimus occur stop taking it and restart the cyclosporine

b- stop taking the cyclosporine for 24 hours and then begin taking the tacrolimus instruct the patient that these meds should not be taken concurrently due to the increased risk of developing nephrotoxicity. the client should stop cyclosporine for 24 hours prior to bringing the tacrolimus prescription

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse take into consideration? a. increased intestinal transit rate b. accelerated excretion of fluids c. reduced renal blood flow d. decreased hepatic metabolism

b. accelerated excretion of fluids there are physiologic changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow. this results in increased GFR, to compensate for these changes, dosages of medications that GFR eliminates must be increased to achieve a comparable therapeutic effect. a- pregnancy reduces tone and motility of the intestines, decreasing transit rate c- renal blood flow doubles in pregnancy, increasing GFR and clearance of medications that GFR eliminates d- pregnancy causes changes in the liver, increased in liver metabolism

a nurse is teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? a. you might notice that you see better in dim areas b. you should increase your fluid intake c. you should expect to have excessive urination d. you might experience difficulty sleeping

b. increase fluid intake the nurse should inform the client that an adverse effect of morphine is constipation. therefore, the nurse should encourage the client to increase oral fluids to promote motility of the bowel

a nurse is teaching a client who had kidney transplant surgery about immunosuppressive medication. which of the following adverse effects of these meds should the nurse include in the teaching? a. increased urinary output b. increased susceptibility to infection c. increased hair loss d. increased risk of autoimmune disorders

b. increased susceptibility to infection immunosuppressive medications such as cyclosporine increase the risk of infection. as the medication classification indicates, these medications impair immunity

a nurse is teaching a client who has persistent cancer pain about the adverse effects of opioids. which of the following statements should the nurse include in the teaching? a. opioids do not relieve pain without causing server adverse effects b. physical dependence is not the same as addiction c. tolerance typically means that the medication will no longer be effective d. the most common adverse effect is respiratory depression with prolonged use

b. physical dependence is not the same as addiction

a nurse is teaching a client who has a new prescription for warfarin. which of the following statements should the nurse identify as an indication that the client understands the instructions? a. I will use a safety razor to shave each day b. ill be sure to eat lots of spinach c. I will avoid contact sports like football d. I will take ibuprofen if I get a headache

c - I will avoid contact sports like football the most common adverse effect is bleeding, therefore avoid things that commonly cause injury, like contact sports not a - use an electric razor not b - dark green leafy veggies are high in Vitamin K and can reduce anticoagulation if the client eats an excessive amount. the client should keep Vitamin K intake consistent.

a nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calciton-salmon. which of the following statements y the client indicates an understanding of the teaching? a. I will administer a spray into each nostril daily b. I should expect nasal bleeding for the first week c. I will need to depress the side arms to activate the pump d. I should expect to take this medication for a short-term course of treatment

c - I will need to depress the side arms to activate the pump

I nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. which of the following client statements indicates an understanding of the teaching? a. I might have a sore throat that will go away after a few days b. I will take this medication with food to avoid getting an upset stomach c. I might feel dizzy at time while taking this medication d. I will take ibuprofen if I get a fever while taking this medication

c - I will take ibuprofen if I get a fever while taking this medication

a nurse is caring for ancient with a pseudomonas infection who has a new prescription for ticarcillin-clavulanate. which of the following state should the nurse collect before administering this medication? a. indications of superinfection b. peak and trough medication levels c. baseline BUN and creatinine d. history of allergy to amino-glycoside antibiotics

c - baseline BUN and creatinine

a nurse is caring for a client who has a prescription for clopidogrel. the nurse should monitor the client for which of the following adverse effects/ a. insomnia b. hypotension c. bleeding d. constipation

c - bleeding

a nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. the client asks the nurse why the provider prescribe an enteric-coated medication. which of the following responses should the nurse give? a. the enteric coating allows a lower dosage to be given b. enteric-coated medication have better absorption in the body c. enteric-coated medications cause less gastric irritation d. the enteric coating provides a steady release of the medication over time

c - enteric - coated medications cause less gastric irritation they do not dissolve until they reach the small intestine

a nurse is preparing to administer. digoxin to a client. which of the following findings should the nurse identify as a contradiction to the client receiving this medication? a. blood pressure 180/70 mmHg b. oxygen saturation rate 94% c. heart rate 51/min d. respiratory rate 21/min

c - heart rate 51/min

a nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). the nurse should recognize that these findings are potential indications of which of the following conditions? a. renal dysfunction b. myelotoxicity c. hepatic toxicity d. cardiac dysrhythmia

c - hepatic toxicity

a nurse is caring for a client who has a new prescription for enalapril. the nurse should monitor the client for which of the following adverse effects of this medication? a. ecchymosis b. jaundice c. hypotension d. hypokalemia

c - hypotension this is an ACE inhibitor, and can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage

a nurse is teaching a group of nurses about the effects of client receiving spinal anesthesia. which of the following pieces of information should the nurse include in the teaching? a. lidocaine toxicity will cause the client to develop tachycardia b. most clients develops a headache from spinal anesthesia c. hypotension is an adverse effect of spinal anesthesia d. urinary urgency occurs when the client has spinal anesthesia

c - hypotension is an adverse effect of spinal anesthesia

a nurse is teaching a client about the use of a dinoprostone vaginal insert pouch to stimulate labor. which of the following statements should the nurse include in the teaching? a. it is inserted using a catheter b. one pouch is given every 4 hours until labor occurs c. lie on your back for at least 2 hours without getting up d. if labor doesn't occur within 6 hours, a second dose can be administered

c - lie on your back for at least 2 hours without getting up the client should remain supine for at least 2 hours after the dinoprostone vaginal pouch is inserted to allows a slow release of the medication from the pouch to stimulate labor

a nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. which of the following prescriptions should the nurse clarify with the provider? a. metoprolol b. ondansetron c. lorazepam d. naloxone

c - lorazepam this can cause CNS depression which can result in increased respiratory depression and sedation when administered with an opioid

a nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has been taking tiotropium. which of the following client statement should indicate to the nurse that the client is experiencing an adverse effect of this medication? a. my body aches all over b. I am urinating more during the day c. my mouth feels dry all the time d. I have trouble sleeping at night

c - my mouth feels dry all the time

a nurse is teaching self-administration of NPH insulin to a client who has Type 2 diabetes mellitus. which of the following instructions should the nurse include? a. alternate injecting doses between the abdomen and the thigh b. shake the vial before withdrawing the dosage c. rotate injection sites within the same area d. discard the vial if the insulin is cloudy

c - rotate injection sites within the same area to prevent lipodystrophy, the client should rotate injection sites and keep them about 2.5 cm (1 in) apart within the same anatomical area not a - because absorption varies with the sire of injection, the client should use the same general area such as the thigh OR the abdomen each time not b - the client should roll the vial between the palms, do not shake it not d - NPH insulin is a cloud suspension

a nurse is preparing to administer the first injection of the diphtheria, tents, and pertussis (CTaP) vaccine to an infant. which of the following pieces of information should the nurse tell the guardian prior to administering the immunization? a. your child might develop diarrhea or vomiting within 24 hours of receiving this vaccine b. I can either give your child all the injections in this serious at once or individually c. the vaccine will be injected into the infant's thigh d. this injection contains a live virus

c - the vaccine will be injected into the infant's thigh

a nurse is teaching a client with a new diagnosis of peptic ulcer disease (PUD) who has a prescription for bismuth subsalicylate. the client asks the nurse, "how will this med help my ulcer?" which of the following statements should the nurse make? a. this med will decrease prostaglandins b. the amount of bicarbonate in your body will be increased c. the med can decrease bacteria in the GI tract d. the med acts by increasing blood flow to the stomach

c - this medication can decrease bacteria in the GI tract the nurse should teach that bismuth subsalicylate can assist by eliminating the bacteria H. pylori, which can cause PUD.

a nurse is caring for client who has heart failure and is taking oral furosemide 40 mg daily. for which of the following adverse effects should the client be taught to monitor and notify the provider if occurs? a. nasal congestion b. tremors c. tinnitus d. frontal headache

c - tinnitus loop diuretics such as furosemide can cause ototoxicity. the client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs

a nurse in a providers office s assessing a client who reports taking a dietary supplement to reduce hot flashes to menopause. which of the following supplements should the nurse expect the client to report taking? a. flaxseed b. Ginkgo biloba c. black cohosh d. St. Johns wort

c. black cohosh black cohosh is an herb that is used for the Tx of menopausal symptoms such as hot flashes, vaginal dryness, irritability, and sleep disturbance

a nurse is providing teaching to a client who has heart failure and is taking spirolactone. which of the following statements by the client indicates an understanding of the teaching? a. I will increase my intake of citrus fruits, bananas, and potatoes b. I will use salt substitutes on my food c. I will drink as much water as I can while taking this medication d. I will watch for increased breast tissue growth while taking this medication

d - I will watch for increased breast tissue growth while taking this medication this med can cause adverse endocrine effects such as gynecomastia, impotence in men, and irregular mess and hirsutism in women

a nurse is caring for a client who is taking warfarin. which of the following lab values should the nurse recognize as an effective response to the medication? a. Hct 45% b. Hgb 15 g/dL c. aPPT 35 seconds d. INR 3.0

d - INR 3.0 INR measures effectiveness and 3.0 is indicative of effective therapy from warfarin

a nurse is teaching a female client about vitamin A supplementation. which of the following client statements indicates an understanding of the teaching? a. vitamin A supplements are usually prescribed during pregnancy b. vitamin A can be taken in high doses because it is water-soluble c. vitamin A is encouraged for women who have osteoporosis d. A deficiency of vitamin A can cause night blindness

d - a deficiency of Vitamin A can cause night blindness

a nurse administered an antibiotic 10 min ago to a client who is now reporting wheezing and swelling of the eyelids. which of the following actions should the nurse perform first? a. give oral corticosteroids b. administer dopamine c. give diphenhydramine IV d. administer epinephrine subcutaneously

d - administer epinephrine subcutaneously this will constrict blood vessels, increase cardiac output, and dilate bronchiole passage first-line medication to administer for anaphylaxis

a nurse is providing teaching to the parents of a school-ages child with asthma about medications for bronchospasm. which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack? a. salmeterol b. cromolyn c. fluticasone d. albuterol

d - albuterol

a nurse is teaching a client who has severe chronic gout and a new prescription for pegloticase. the client has been taking allopurinol for 1 month. which of the following instructions should the nurse include about pegloticase? a - you will take this med along with allopurinol b. you will take this medication by mouth c. there are very few adverse effects of the medication d. if you experience a flare-up, you can take an NSAID while receiving this medication

d - if you experience a flare-up, you can take an NSAID while receiving this medication the nurse should instruct this client who has chronic gout that, during the first few months of treatment, an increase in gout manifestations is expected. to reduce the intensity of these manifestations, clients are instructed to take an NSAID such as Naproxen.

a nurse is caring for female adult client who is experiencing menopause and has a prescription for estrogen along with progestin. the nurse should identify that the provider has prescribed these medications for which of the following reasons? a. long-term use to reduce the risk of breast cancer b. short-term use to stimulate the endometrium c. long-term use to prevent osteoporosis d. short-term use to control urogenital atrophy

d - short-term use to control urogenital atrophy

a nurse is assessing a client who receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. which fo the following actions should the nurse take? a. flush the IV line with saline b. administer flumazenil c. lower the head of the bed d. slow the rate of the infusion

d - slow the rate of infusion the should should decrease infusion rate to reduce the amount of morphine the client receives and limit the risk of respiratory depression not a - this will cause the morphine to be given as a bolus not b - flumazenil is for treating benzodiazepine toxicity not c - lowering head of the bed could decrease the client's chest expansion and impair ventilation

A nurse is caring for a female client who has osteoporosis and is taking Raloxifene. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? A. severe leg cramps B. urinary frequency C. Jaw pain D. sudden onset of dyspnea

d - sudden onset of dyspnea The nurse should identify that raloxifene is a selective estrogen receptor modulator a SERM, which can have estrogenic effects in some tissues and antiestrogenic effects in other tissues. Clients who are taking Raloxifene have an increased risk of thromboembolic events such as deep vein thrombosis, pulmonary embolism, or stroke. The nurse should notify the provider if the client is experiencing this adverse effect of Raloxifene

a nurse is assessing a client who is receiving clozapine to treat schizophrenia. the nurse should indetify an increase in which of the following parameters as an early indication of an adverse effect of this medication? a. urine specific gravity b. urine output c. blood pressure d. temperature

d - temperature

a nurse is providing teaching to client who is scheduled to start taking hydrochlorothiazide for hypertension. the nurse instructs the client to eat foods that are rich in potassium. which of the following statements by the client indicates an understanding of the teaching? a. this medication will not work unless I have enough potassium b. potassium will increase the therapeutic effect of my blood pressure medication c. potassium will lower my blood pressure d. the medication cause a loss of potassium

d - this medication can cause a loss of potassium hydrochlorothiazide can result in hypokalemia caused by excessive excretion from the kidneys. client should supplement his or her diet with potassium rich foods to avoid the occurrence of hypokalemia. these foods include: bananas, raisins, baked potatoes, pumpkins, and milk

A nurse is caring for a client who is due to receive general anesthesia the client asked the nurse what is the difference between an analgesic and anesthesia? Which of the following statements should the nurse make? a. Analgesics can cause lack of sensation b. anesthesia is specifically for eliminating pain perception c. analgesics treat pain without causing sedation d. anesthesia can cause loss of consciousness

d- anesthesia can cause loss of consciousness general anesthesia reduces or causes a complete loss

a nurse is teaching a client who has a new prescription for disulfiram to treat alcohol use disorder. which of the following statements by the client indicates and understanding of the teaching? a. if I have a strong urge to drink alcohol, I should skip my dose for that day b. been when I am not drinking alcohol, adverse effects an include seizures c. medication therapy can begin as soon as I enter the detoxification program d. I should check the labels of my skin-care products, meds, and food for alcohol

d. I should check the labels of my skin-care products, medications, and food for alcohol the client should check all products for the presence of alcohol when taking disulfiram. the nurse should inform the client that 7 mL of alcohol is needed to precipitate adverse effects of the medication. alcohol can be found in cough syrups, vinegar, and sauces. it might also be applied to the skin in aftershave and cologne also not a - the nurse should inform the client that the effects of disulfiram will continue for up to two weeks following the last dose, the nurse should stress the importance of avoiding alcohol during this time period as well not b- side effects include drowsiness and skin eruptions. respiratory depression and convulsions are manifestations of acetaldehyde syndrome, which is a potentially dangerous even that can occur when alcohol is consumed while taking this medication not c - disulfiram should not be administered until at least 12 hours after alcohol was last ingested

a nurse is caring for a client who take sulfasalazine twice daily for rheumatoid arthritis. which of the following values should the nurse review prior to the administration of the medication? a. respirations b. serum creatinine level c. blood pressure d. complete blood count

d. complete blood count identify that sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocyclic anemia. as a result, the client's complete blood count should be periodically monitored, and the nurse should review it prior to administering this medication

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to thee nurse that the treatment is effective? a. decreased blood glucose b. increased potassium c. increased prostaglandin synthesis d. decreased inflammation

d. decreased inflammation for Crohn's, a decrease in inflammation of the GI lining of the the pt's large intestine is a therapeutic effect of taking budesonide. this med is a glucocorticoid that works by suppressing the immune system, also inhibits the actions of prostaglandins and leukotrienes. a- actually increased BG b- budesonide has mineralocorticoid activity causing sodium, water retention, and potassium loss. hypokalemia is an adverse effect and cause life-threatening dysrhythmias c- actually inhibits, not increases prostaglandin synthesis.

The nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the adverse effects? A. Hyperkalemia B. Hypertension C. Constipation D. Nephrotoxicity

d. nephrotoxicity Amphotericin B is an antifungal medication used to treat severe fungal infections however it can cause nephrotoxicity. The nurse should monitor the clients creatinine every three to four days and increase fluid intake the dosage of amphotericin B should be reduced if the clients creatinine is 3.5 mg/dL or less


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