ATI Pharmacology Practice Set #4

A nurse is preparing to administer hydrocortisone sodium succinate 250 mg IV bolus every 6 hours. Available is hydrocortisone sodium succinate 1,000 mg/8 mL. How many mL should the nurse administer?

2 mL Rationale: 1. 1,000 mg/8 mL = 250 mg/x mL 2. 1,000x = 2,000 3. x = 2 mL

A nurse is preparing to administer erythromycin ethylsuccinate 800 mg PO every 4 hours. Available is erythromycin ethylsuccinate 200 mg/5 mL. How many mL should the nurse administer?

20 mL Rationale: 1. 200 mg/5 mL = 800 mg/x mL 2. 200x = 4,000 3. x = 20 mL

A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching? A. "Glucosamine may help to increase joint functionality." B. "Glucosamine can be used in the treatment of herpes simplex infections." C. "Glucosamine can improve age-related memory impairment." D. "Glucosamine is derived from red peppers."

A. "Glucosamine may help to increase joint functionality." Rationale: A. The nurse should include in the teaching that glucosamine may increase joint functionality by decreasing destruction of cartilage. B. Echinacea may help treat herpes simplex infection by acting as an antiviral supplement. C. Although evidence is inconclusive, ginkgo biloba may improve age-related memory impairment and senile dementia. D. Capsicum is derived from red peppers and the ingredient is found in topical preparations that treat arthritis pain. Capsicum may reduce the pain of inflammation by interfering with substance P, which transmits pain impulses.

A nurse is teaching a client who has a new prescription for ranitidine to treat peptic ulcer disease. Which of the following statements by the client indicate an understanding of the teaching? (Select all that apply.) A. "I can take this medication with or without food." B. "I will take this medication in the morning." C. "I should expect my stools to turn black." D. "I will take this medication with an antacid." E. "I will take this medication when I need it for pain." F. "I will eat five small meals each day."

A. "I can take this medication with or without food." F. "I will eat five small meals each day." Rationale: A. Food does not affect the absorption of ranitidine. B. The client should take ranitidine in the evening to reduce nocturnal acid production. C. The client should report black stools because this is a manifestation of gastrointestinal bleeding. D. The client should take an antacid 1 hr before or after the ranitidine to increase absorption. E. Ranitidine is taken on a regular basis to relieve pain, promote healing, and prevent recurrence. F. The client should eat 5 to 6 small meals each day to enhance the therapeutic effects of ranitidine.

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

A. "It might take up to three days for the medication to work." Rationale: A. The client understands docusate sodium is a stool softener and the therapeutic effect might take up to 3 days to achieve. B. The client's statement indicates the need for further teaching. Docusate sodium is a stool softener and is not used to treat diarrhea. C. The client's statement indicates the need for further teaching. Docusate sodium is a stool softener and the client should drink 8 ounces of water when taking the medication. The nurse should also instruct the client to increase fluid intake to prevent constipation. D. The client's statement indicates the need for further teaching. Docusate sodium may lead to toxicity if taken with mineral oil.

A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hours as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? A. "The medication relieves nausea by promoting gastric emptying." B. "The medication works by decreasing gastric acid secretions." C. "The medication relieves nausea by slowing peristalsis." D. "The medication works by relaxing gastric muscles."

A. "The medication relieves nausea by promoting gastric emptying." Rationale: A. Reglan is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and a persistent feeling of fullness after meals. Reglan works by promoting gastric emptying. B. Reglan does not decrease gastric acid secretions. C. Reglan does not slow peristalsis. D. Metoclopramide increases gastric muscle contraction.

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

A. Constipation Rationale: A. Aluminum hydroxide can cause constipation. The nurse should tell the client to increase fluid and fiber intake to reduce the risk for constipation. B. Calcium-containing antacids can cause flatulence. C. Cimetidine can cause dysrhythmias. D. Proton pump inhibitors can cause headaches.

A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor? A. Headache B. Dependent edema C. Polyuria D. Photosensitivity

A. Headache Rationale: A. Headache is a common adverse effect of ondansetron. Analgesic relief is often required. B. Dependent edema is not an adverse effect of ondansetron. C. Urinary retention, not polyuria, is a common adverse effect of ondansetron. D. Photosensitivity is not an adverse effect of ondansetron.

A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H2 receptor antagonist (H2RA). Which of the following outcomes indicates the H2RA is therapeutic? A. Relief of heartburn B. Cessation of diarrhea C. Passage of flatus D. Absence of constipation

A. Relief of heartburn Rationale: A. Histamine2 receptor antagonists are used to treat duodenal ulcers and prevent their return. In over-the-counter strengths, these medications, such as cimetidine and ranitidine, are used to relieve or prevent heartburn, acid indigestion, and sour stomach. B. This is not a therapeutic effect of taking H2RA. C. This is not a therapeutic effect of taking H2RA. D. This is not a therapeutic effect of taking H2RA.

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

A. Senna Rationale: A. Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort. B. Ibuprofen is contraindicated for clients who have asthma or severe hepatic or renal disease. It should be used with caution in clients who have a bleeding disorder. C. Omeprazole is contraindicated in clients who are allergic to omeprazole. It should be used with caution in clients who are pregnant or breastfeeding. D. Zolpidem is contraindicated in clients who are allergic to benzodiazepines. It should be used with caution in older adults and clients who have respiratory disease.

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

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

A nurse is caring for a client who reports taking bisacodyl to promote a daily bowel movement. Which of the following assessment questions should be the nurse's priority? A. "What do your bowel movements look like?" B. "How long have you been taking bisacodyl?" C. "Do you take the bisacodyl with a glass of milk?" D. "How often do you have a bowel movement?"

B. "How long have you been taking bisacodyl?" Rationale: A. The nurse should ask the client what his bowel movements look like to assess for adverse effects of the bisacodyl; however, another question is the priority. B. The greatest risk to this client is injury from dependency on laxatives, as bowel tone can be lost; therefore, the priority question the nurse should ask the client is how long he has been using bisacodyl. C. The nurse should ask the client how he takes the bisacodyl, as taking it with dairy products or antacids decreases the absorption of the medication; however, another question is the priority. D. The nurse should ask the client how often he has a bowel movement to assess for regularity and the need for a laxative; however, another question is the priority.

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

B. "Take the medication with a full glass of water." Rationale: A. The client can take this medication in the morning or in the evening before bedtime. B. The nurse should instruct the client to take this medication with a full glass of water, unless contraindicated, to reduce the risk for constipation. C. The client should notify the provider if abdominal pain occurs. D. The client can take this medication with or without food.

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

B. "Your doctor might need to reduce your theophylline dose while taking this medication." Ratioanle: A. Clients should not take this medication within 1 hr of taking an antacid because the antacid will interfere with the absorption of cimetidine. B. The nurse should instruct the client that the provider might need to reduce his theophylline dose due to the possibility of increased medication levels. C. Clients should take cimetidine with food to minimize gastric irritation. D. The nurse should instruct the client that he should plan to take cimetidine for short-term treatment of a duodenal ulcer, which will be approximately 4 to 6 weeks.

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in client who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? A. Glucose B. Ammonia C. Potassium D. Bicarbonate

B. Ammonia Rationale: A. Lactulose does not decrease serum glucose. B. Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. C. Lactulose has no effect on the potassium level. D. Lactulose has no effect on the bicarbonate level.

A nurse is preparing to administer a bisacodyl suppository to a client. Which of the following actions should the nurse take? (Select all that apply.) A. Don sterile gloves B. Lubricate index finger C. Use a rectal applicator for insertion D. Position client supine with knees bent E. Insert suppository just beyond the internal sphincter

B. Lubricate index finger E. Insert suppository just beyond the internal sphincter Rationale: A. The nurse should wear clean gloves for the procedure. Gloves prevent the transmission of pathogens by direct and indirect contact. The nurse should wear clean gloves when touching blood, body fluid, secretions, excretions, most mucous membranes, non-intact skin, and contaminated items or surfaces. B. The rounded end of the suppository is lubricated with a sterile water-soluble lubricating jelly. C. The nurse should administer the suppository with the dominant index finger, which is lubricated. The nurse should not use an applicator to insert a suppository. D. To avoid the rupturing the rectum, the client is positioned on the left lateral side. E. The nurse should gently retract the buttocks with the nondominant hand. Insert the suppository gently through the anus, past the internal sphincter, and against the rectal wall. Following the administration of the medication, the nurse should apply gentle pressure to hold the buttocks together momentarily if needed to keep medication in place.

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

B. Metabolic alkalosis Rationale: A. Hypermetabolism, such as with fever or exercise, can cause metabolic acidosis. B. Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid. C. Respiratory depression can cause respiratory acidosis. D. Hyperventilation can cause respiratory alkalosis.

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

B. Relief of gastrointestinal pain Rationale: A. This is not an intended effect of sucralfate. B. Sucralfate, an antiulcer medication, is prescribed for acute or maintenance therapy of duodenal ulcers. A therapeutic effect of the medication is relief of gastrointestinal pain associated with gastric ulcers. Sucralfate also promotes ulcer healing. C. This is not an intended effect of sucralfate. D. This is not an intended effect of sucralfate.

A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include? A. "To prevent dehydration, drink an additional liter of fluid during preparation time." B. "Expect bowel movements to begin 3 hours following completion of solution." C. "Abdominal bloating might occur." D. "Drink 400 mL every hour until bowel movements are clear."

C. "Abdominal bloating might occur." Rationale: A. Dehydration does not occur with PEG. No additional fluid intake is necessary. B. Bowel movements begin about 1 hr following the first dose. C. While PEG is well-tolerated, adverse effects include nausea, bloating, and abdominal discomfort. D. The client should ingest the full solution by drinking 250 mL to 300 mL every 10 minutes over 2 to 3 hr.

A nurse is preparing a presentation about black cohosh to a group of clients. Which of the following information should the nurse include in the teaching? A. "Black cohosh helps relieve nocturia." B. "Black cohosh is used to treat the common cold." C. "Black cohosh is used to alleviate menopausal symptoms." D. "Black cohosh can help to reduce arthritis pain."

C. "Black cohosh is used to alleviate menopausal symptoms." Rationale: A. Saw palmetto may help relieve urinary and prostate symptoms, such as nocturia, by suppressing inflammation. B. Echinacea may help boost the immune system and thus prevent or treat the common cold. C. Black cohosh may relieve menopausal symptoms, such as hot flashes, by suppressing the release of luteinizing hormone. D. Capsicum is derived from red peppers and is an ingredient in topical preparations that treat arthritis pain. Capsicum may reduce the pain of inflammation by interfering with substance P, which transmits pain impulses.

A nurse is preparing a presentation about echinacea to a group of clients. Which of the following information should the nurse include in the teaching? A. "Echinacea blocks testosterone receptors." B. "Echinacea boosts the immune system." C. "Echinacea is used to treat vertigo." D. "Echinacea increases the ability to walk further distances by decreasing pain in the lower extremities."

D. "Echinacea increases the ability to walk further distances by decreasing pain in the lower extremities." Rationale: A. Saw palmetto may help block testosterone receptors. B. The nurse should include in the teaching that echinacea may help boost the immune system. C. Ginger root is used to treat vertigo associated with motion sickness, morning sickness, seasickness and general anesthesia. D. Ginkgo biloba can increase the client's ability to walk further distances by decreasing pain in the lower extremities.

A nurse is preparing a presentation about glucosamine to a group of clients . Which of the following information should the nurse include in the teaching? A. "Glucosamine can help relieve urinary frequency." B. "Glucosamine is used to treat viral infections." C. Glucosamine can help relieve hot flashes." D. "Glucosamine can suppress joint inflammation."

D. "Glucosamine can suppress joint inflammation." Rationale: A. Saw palmetto may help relieve urinary frequency by anti-inflammatory effects. B. Echinacea is used orally to treat viral infections, such as influenza. C. Black cohosh may relieve menopausal symptoms, such as hot flashes, by suppressing the release of luteinizing hormone. D. The nurse should include in the teaching that glucosamine suppresses joint inflammation and cartilage degradation by stimulating the activity of chondrocytes.

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

D. "I will take this medication before meals and at bedtime." Rationale: A. The client should take sucralfate 4 times a day for 4 to 8 weeks to promote ulcer healing. B. The client should increase his fluid and fiber intake to prevent constipation. C. The client should wait 30 min between sucralfate and an antacid to increase absorption. D. The client should take sucralfate on an empty stomach, 1 hr before each meal and at bedtime to create a protective coating over the ulcer.

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

D. Decreased fat in stools. Rationale: A. Pancrelipase can cause nausea and vomiting, but does not decrease mucous in stools. B. Pancrelipase can cause hyperglycemia, but does not treat gastrointestinal bleeding. C. Pancrelipase can cause diarrhea. D. Pancrelipase is a combination of pancreatic enzymes used to increase digestion of fats, carbohydrates and proteins. The client should expect a reduction of fat in stools.

A nurse is providing teaching to a client who has gastroesophageal reflux disease and a new prescription for omeprazole. Which of the following instructions should the nurse provide? A. Take NSAIDs if headaches occur. B. Decrease intake of vitamin D. C. Expect muscle cramps for several weeks. D. Report diarrhea to the provider.

D. Report diarrhea to the provider. Ratioanle: A. The nurse should instruct the client to avoid the use of NSAIDs while taking omeprazole, as they increase the risk of GI irritation. B. The nurse should instruct the client to maintain an adequate intake of calcium and vitamin D, as omeprazole can increase the risk of osteoporosis and fractures. C. The nurse should instruct the client to report muscle cramps to the provider, as it may be an indication of decreased magnesium levels. D. Omeprazole is associated with an increased risk of C. difficile infection. The nurse should instruct the client to contact the provider if diarrhea occurs.