ATI Review questions

A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make?

"Ibuprofen will reduce the cardioprotective effects of low-dose aspirin."

A nurse is planning care for a client who has started taking prednisone. which of the following interventions should the nurse include?

Monitor the client's blood glucose

a nurse is caring for a client who is taking to digoxin and develops changes on the ECG tracing and other manifestations that indicates the client has severe digoxin toxicity. which of the following drugs should the nurse expect to administer to treat this complication

antigen binding fragments

the nurse is providing teaching to a client who is taking simvastatin. the nurse should instruct the client to report which of the following manifestations as an indication of serious adverse reaction that could require discontinuation of the drug therapy

muscle pain

a nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. the nurse should recognize that this drug combination places the client at risk for which of the following adverse affects

myopathy

For which of the following reasons should a client attach a spacer to a metered dose inhaler? ​To increase the amount of drug delivered to the lungs To increase the amount of drug delivered to the oropharynx To increase the amount of drug delivered on exhalation To increase the speed of drug delivery into the mouth

​To increase the amount of drug delivered to the lungs

A health care professional is caring for a patient who is about to begin taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should explain to the patient the need to monitor which of the following laboratory tests? (Select all that apply) - Thyroid-stimulating hormone (TSH) - Alanine aminotransferase (ALT) - LDL - CBC - Creatinine clearance

- Alanine aminotransferase (ALT) - LDL

When talking with a patient who is about to begin exenatide (Byetta) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions? (Select all that apply) - Inject the drug subcutaneously - Expect the peak effect in 2 hr. - Use the drug as a supplement to an oral hypoglycemic - Inject the drug 1 hr after a meal - Discard used pens 10 days after the first use.

- Inject the drug subcutaneously - Expect the peak effect in 2 hr. - Use the drug as a supplement to an oral hypoglycemic

A health care professional is caring for a patient who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The health care professional should tell the patient to report which of the following adverse effects? (Select all that apply) - Sore throat - Muscle pain - Insomnia - Bradycardia - Rash

- Sore throat - Muscle pain - Bradycardia - Rash

A nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients?

A client who had a cholecystectomy

A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism?

Fever Tinnitus Diaphoresis Dizziness

A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? A) "Avoid driving or activities require alertness" B) "If you miss a dose, double the next dose" C) "Rinsing the mouth with alcohol-based mouthwash can reduce dryness" D) "Having one glass of wine each night can improve medication effectiveness"

A) "Avoid driving or activities require alertness" Loperamide can cause drowsiness and dizziness. The client should avoid driving or activities requiring alertness while taking the drug.

A health care professional administers pramlintide (Symlin) at 0800 to a patient who has type 1 diabetes mellitus. At which of the following times should the patient expect the drug to exert its peak action? A) 0820 B) 0900 C) 1000 D) 1100

A) 0820

A nurse is caring for a male client who asks the nurse about taking alosetron for irritable bowel syndrome (IBS) with diarrhea (IBS-D) lasting 3 months. Which of the following information should the nurse provide the client about alosetron? A) The drug is prescribed to female clients who have IBS-D lasting more than 6 months B) The drug is prescribed to clients who have chronic diarrhea lasting more than 12 months C) The drug is most beneficial for male clients who have inflammatory bowel disease D) The drug is most beneficial in treating clients who have constipation-predominant IBS (IBS-C)

A) The drug is prescribed to female clients who have IBS-D lasting more than 6 months alosetron is approved only to be prescribed to females who have IBS-D lasting 6+ months that has not been controlled by conventional treatment.

A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following conditions is a contraindication for acetaminophen?

Alcohol use disorder

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? Ipratropium Beclomethasone Acetylcysteine Azelastine

Acetylcysteine

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone/salmeterol via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? Albuterol will increase the absorption of fluticasone. Albuterol will decrease inflammation. Albuterol will reduce nasal secretions. Fluticasone will reduce the adverse effects of albuterol.

Albuterol will increase the absorption of fluticasone.

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? Start at a low dose and gradually increase it. Take the drug as needed for nasal congestion. Allow at least 2 weeks for the full therapeutic effect. Use the drug prior to exercise.

Allow at least 2 weeks for the full therapeutic effect.

A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections?

Aspirin

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

Avoid driving or activities that require mental alertness

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client's phosphorus levels when administering which of the following drugs? A) Omeprazole B) Aluminum Hydroxide C) Sucralfate D) Ranitidine

B) Aluminum Hydroxide Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophosphatemia because of aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the client's phosphorus levels while administering the drug.

To determine the effectiveness of desmopressin (DDAVP), a health care professional should monitor a patient's __________. A) peripheral pulses B) urine output C) skin integrity D) blood glucose

B) urine output

A health care professional is caring for a patient who is about to begin taking acyclovir (Zovirax) to treat a herpes simplex infection. The health care professional should monitor which of the following laboratory values for the patient?

BUN Rationale: Acyclovir, an antiviral drug, can cause renal toxicity because of drug accumulation in renal tubules. The health care professional should monitor the patient's urine output, BUN, and creatinine levels, and increase fluid intake to hydrate and flush the kidneys.

A health care professional is caring for a patient who is taking warfarin (Coumadin) and is about to begin taking trimethoprim/sulfamethoxazole (Bactrim) to treat a urinary tract infection. The health care professional should question the drug regimen because taking these two drugs concurrently can increase the patient's risk for which of the following?

Bleeding Rationale: Trimethoprim/sulfamethoxazole, a sulfonamide combination, can increase the effects of warfarin and increase the patient's risk for bleeding. The health care professional should request another prescription to treat the infection, or, if the patient must take the drug, ask the provider to prescribe a lower warfarin dose and monitor prothrombin time carefully. The patient should report any sign of bleeding, such as easy or unexplained bruising.

A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions?

Bone loss

A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus plans to undergo angiography using iodine-containing contrast dye. The health care professional should recognize that an interaction between metformin and the IV contrast dye can increase the patient's risk for which of the following? A) Hypokalemia B) Hyperglycemia C) Acute renal failure D) Acute pancreatitis

C) Acute renal failure Rationale: Metformin, a biguanide, can interact with iodine-containing contrast dye, causing acute renal failure and lactic acidosis. A healthcare professional should withhold metformin for 48 hour prior to and following the procedure. A healthcare professional should also monitor the patient for indications of acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation, and abdominal pain.

A nurse is providing teaching to a client who has a new prescription for loperamide. Which of the following instructions should the nurse include? A) Dissolve the powder thoroughly in 8 oz (237 mL) of water B) Take with diphenhydramine to prevent extrapyramidal effects C) Avoid activities that require alertness D) Take 30 min before activities that trigger nausea

C) Avoid activities that require alertness Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.

A patient who is taking amoxicillin (Amoxil) to treat a respiratory infection contacts the health care professional to report a rash and wheezing. Which of the following instructions should the health care professional provide?

Call emergency services immediately. Rationale: Amoxicillin can cause a severe anaphylactic reaction. A patient who has breathing difficulties should call emergency services or seek immediate care. The health care professional should prepare to administer epinephrine and an antihistamine, such as diphenhydramine, to treat an anaphylactic reaction.

When administering erythromycin to a patient who has pneumococcal pneumonia, the health care professional should monitor for which of the following adverse effects of the drug?

Cardiac dysrhythmias Rationale: Erythromycin, a macrolide, can cause ECG changes, including a prolonged QT interval, and put the patient at risk for a potentially fatal ventricular dysrhythmia. The health care professional should monitor the patient's ECG, and tell the patient to report palpitations, fainting, or dizziness. The drug is inappropriate for patients who have a history of QT prolongation.

A nurse is caring for a client who has a new prescription for ranitidine to treat GERD. The nurse should instruct the client to wait at least 1hr between taking ranitidine and which of the following over-the-counter drugs? A) Ginkgo Biloba B) Antidiarrheals C) St. John's Wort D) Antacids

D) Antacids Antacids can decrease the absorption of ranitidine, a H2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking ranitidine and taking an antacid.

A health care professional is caring for a patient who is about to begin taking radioactive iodine-131 (Iodotype) to treat Grave's disease. Which of the following instructions should the health care professional include when talking with the patient about this drug? A) Take the drug once daily for 5 days. B) Expect a bitter, acid-like taste. C) Restrict fluid intake after taking the drug. D) Expect full effects in 2 to 3 months.

D) Expect full effects in 2 to 3 months

Which of the following drugs should a health care professional have available for a patient who is experiencing an insulin overdose? A) Naloxone B) Diphenhydramine C) Acetylcysteine (Acetadote) D) Glucagon (GlucaGen)

D) Glucagon (GlucaGen)

A health care professional is talking to a patient about self-injecting Regular insulin (Humulin). The health care professional should tell the patient to rotate injection sites to prevent which of the following? A) Rapid absorption B) Intradermal injection C) Injection pain D) Lipohypertrophy

D) Lipohypertrophy

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? Thins mucus Relaxes bronchial smooth muscle Decreases inflammation Increases the cough threshold

Decreases inflammation

A health care professional is caring for a patient who is about to begin receiving acyclovir (Zovirax) IV to treat a viral infection. The health care professional should recognize that cautious use of the drug is essential if the patient also has which of the following?

Dehydration Rationale: Acyclovir, an antiviral drug, can cause renal toxicity, especially in patients who are dehydrated. Hydration during and after IV infusion of the drug can help keep it from precipitating in the renal tubules.

a nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity?

Diaphoresis Nausea Diarrhea

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

Discontinue the drug gradually Report illness or infection Increase intake of calcium and vitamin D Monitor for signs of gastric bleeding

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? Muscle tremors Drowsiness Excitation Insomnia

Drowsiness

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? Respiratory depression Drug abuse Drug tolerance Rebound congestion

Drug abuse

A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include?

Eat a small meal before taking the drug.

A health care professional is caring for a patient who is about to receive gentamicin to treat a systemic infection. The health care professional should question the use of the drug for a patient who is also taking which of the following drugs?

Furosemide (Lasix) Rationale: Gentamicin, an aminoglycoside, and furosemide, a high-ceiling diuretic, are ototoxic drugs. Concurrent use multiplies the patient's risk for hearing loss.

A health care professional is caring for a patient who is about to begin taking ketoconazole to treat a fungal infection. The health care professional should tell the patient to report which of the following adverse effects of the drug?

Gynecomastia Rationale: Ketoconazole, an azole antifungal drug, can cause a temporary decrease in sexual hormone synthesis, resulting in gynecomastia, reduced libido, low sperm counts, and menstrual irregularities.

The nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? Check apical pulse before taking the drug. Take the drug only as needed before exercising. Rinse mouth after using the drug. Have laboratory tests performed at regular intervals.

Have laboratory tests performed at regular intervals.

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? Headache Sleepiness Hypotension Constipation

Headache

A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs?

Hypokalemia

A nurse is teaching a client who had a new prescription for tramadol. Which of the following instructions should the nurse include?

Increase fiber and fluid intake Take the drug with food Avoid driving after taking the drug Change positions gradually

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? Take the drug as needed for acute asthma. Follow a low-sodium diet. Use an alternate-day dosing schedule. Increase weight-bearing activity.

Increase weight-bearing activity.

A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions?

Increased respiratory rate Increased pain Ventricular arrhythmias Hypertension

a nurse is caring for a client with a new prescription for dobutamine. the nurse should clarify the prescription with the if the client is receiving which of the following types of drugs

MAOI general anesthetic tricyclic antidepressant beta blocker

a nurse is caring for a client with a new prescription for propranolol to treat tachydysrhythmia. the nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propranolol

NSAIDs

A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse reactions?

Nausea Dizziness Headache

For which of the following reasons should a nurse instruct a client to avoid guaifenesin with combination over the counter products? Over-the-counter cold products can also contain guaifenesin. Blood glucose levels are increased. Rebound congestion is likely. Drug tolerance is likely.

Over-the-counter cold products can also contain guaifenesin.

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? Fever Bruising Polyuria Palpitations

Palpitations

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? Reduced antitussive effect of dextromethorphan Potentiation of depression of CNS actions Increased renal reabsorption of the dextromethorphan Delayed analgesic effect of the opioid

Potentiation of depression of CNS actions

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? Decrease viscosity of nasal secretions Block H2 receptors Prevent histamine from binding to receptors Reduce nasal congestion

Prevent histamine from binding to receptors

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse reactions?

Sore throat Vertigo Bruising Vision changes

A patient who is taking tetracycline orally to treat a chlamydia infection contacts the health care professional to report severe blood-tinged diarrhea. Recognizing the adverse effects of tetracycline, the health care professional should suspect which of the following?

Pseudomembranous enterocolitis Rationale: Severe diarrhea, often containing mucus and blood, can indicate pseudomembranous colitis. Treatment includes stopping drug therapy and replacing fluids and electrolytes. Patients should report severe diarrhea and blood in the stools promptly.

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? Increases leukocyte activity Blocks muscarinic receptors Causes bronchodilation Reduces inflammation

Reduces inflammation

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? Suppresses the cough stimulus Reduces surface tension Reduces inflammation Dries mucous membranes

Reduces surface tension

A primary care provider should prescribe a lower dose of aztreonam (Azactam) for a patient who has a respiratory tract infection and also has which of the following?

Renal impairment Rationale: Aztreonam, a monobactam, requires cautious use with patients who have renal dysfunction because the kidneys eliminate it virtually intact. The primary care provider should prescribe a lower dose for the patient or prescribe a different antimicrobial drug.

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? Blood pressure Apical heart rate Respirations Level of consciousness

Respirations

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include (Select all) Restlessness Bradycardia Insomnia Muscle pain Anxiety

Restlessness Insomnia Anxiety

A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol?

Seizure disorder

A health care professional is caring for a patient who is about to begin taking metronidazole (Flagyl) to treat an anaerobic intra-abdominal bacterial infection. The health care professional should recognize that cautious use of the drug is indicated if the patient also has which of the following?

Seizure disorder Rationale: Metronidazole, an antiparasitic drug, can cause ataxia, vertigo, and seizures. It requires cautious use with patients who have a history of seizure activity, liver or renal failure, or heart failure.

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the clients drug level indicates toxicity? Seizures Constipation Normal sinus rhythm Somnolence

Seizures

While administering IV cefotetan to a patient to treat bacterial meningitis, the health care professional finds the IV insertion site warm and reddened. Which of the following actions should the health care professional take?

Stop the cefotetan infusion. Rationale: The health care professional should stop the infusion, remove the IV catheter, assess for tissue damage, and treat it accordingly. The health care professional should then initiate IV access via another site, and continue cefotetan therapy slowly and with a diluted solute.

A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib?

Sulfonamide allergy

A patient who is taking imipenem (Primaxin) to treat a bacterial infection contacts the health care professional to report an inability to eat because of mouth pain. Recognizing the adverse effects of imipenem, the health care professional should suspect which of the following?

Suprainfection Rationale: Imipenem, a carbapenem, can cause a suprainfection, Candida albicans in the mouth, throat, or vagina. It can also cause glossitis, an inflammation or infection of the tongue. Patients taking the drug should report any mouth pain or vaginal discharge and itching because they could need treatment with an antifungal drug.

A health care professional is caring for a patient who is about to begin using nystatin (Mycostatin) to treat oral Candida albicans that resulted from tetracycline therapy. Which of the following instructions should the health care professional include about using the antifungal preparation?

Swish the suspension in the mouth before swallowing it. Rationale: The health care professional should tell the patient to swish the nystatin oral suspension inside the mouth for at least 2 min and then swallow it. This allows the drug to coat the inside of the mouth, where it exerts its therapeutic effect against Candida albicans lesions.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? Use a spacer to improve inhalation. Take the drug at the onset of bronchospasm. Rinse mouth to prevent an oral fungal infection. Take the drug once a day in the evening.

Take the drug once a day in the evening.

A health care professional is caring for a patient who is about to begin gentamicin therapy to treat an infection. The health care professional should monitor the patient for which of the following?

Urine output Rationale: Gentamicin, an aminoglycoside, can cause nephrotoxicity. The health care professional should monitor BUN and creatinine and for an increased output of diluted urine. It is also essential to monitor serum gentamicin levels and maintain a therapeutic range.

A health care professional is caring for a patient who takes an oral contraceptive and is about to begin rifampin (Rifadin) therapy to treat tuberculosis. The health care professional should include which of the following instructions?

Use additional contraception. Rationale: Rifampin, an antimycobacterial drug, can increase the metabolism of oral contraceptives, reducing their effectiveness. Patients taking oral contraceptives and rifampin should use additional contraceptive methods to prevent an unwanted pregnancy. Some antifungal drugs can also reduce the effectiveness of oral contraceptives.

A primary care provider is prescribing drug therapy for a patient whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered?

Vancomycin (Vancocin) Rationale: Vancomycin, a potentially toxic antibiotic, is used primarily for serious infections either in patients who are allergic to penicillin or in those whose infecting bacteria are resistant to penicillin, such as MRSA. Although methicillin is no longer available, the term methicillin-resistant generally refers to a lack of susceptibility to all penicillins, cephalosporins, tetracyclines, beta-lactams, and many other antimicrobial drugs.

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? Do not drink anything for 30 min after using the drug. Wait 5 min between using the drug and another inhaled drug. This drug is used to thin respiratory secretions. Check pulse rate after inhaling the drug.

Wait 5 min between using the drug and another inhaled drug.

A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drugs interacts with allopurinol?

Warfarin

a nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions

acute myocardial infarction

a nurse is caring for a client with a new prescription for aliskiren to treat hypertension. the nurse should monitor the client for which of the following adverse effects of the drug

hyperkalemia throat swelling cough

a nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. the nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug that needs to be reported

facial edema

a nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. which of the following should the nurse instruct the client to avoid while taking this drug

grapefruit juice

a nurse is teaching a client with a new prescription for nitroglycerin. the nurse should instruct the client that which of the following manifestations is a potential adverse effect of the drug

headache

a nurse is administering hydrochlorothiazide to a client who has gouty arthritis. the nurse should monitor the client for which of the following findings that indicates an adverse effects of the drug

hyperuricemia

A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions? A) Gout B) Constipation C) Insomnia D) Hirsutism

A) Gout An adverse effect of methotrexate is hyperuricemia, which causes gout. The nurse should instruct the client to drink plenty of fluids to minimize the effect, and to report edema or pain in the joints.

A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus contacts the health care professional to report muscle pain. The health care professional should suspect which of the following adverse reactions? A) Lactic acidosis B) Anticholinergic effects C) Extrapyramidal symptoms D) Hypophosphatemia

A) Lactic acidosis

A nurse is caring for an older adult client who has renal impairment and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestations? A) Lethargy B) Cellulitis C) Dry Mouth D) Myalgia

A) Lethargy cimetidine, a histamine2 (H2) receptor antagonist, can cause CNS effects, such as lethargy, depression, confusion, and seizures, especially in older adults. The nurse should instruct the client to report these manifestations. If they persist, the provider may prefer to prescribe ranitidine for the client.

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome?

Fever

A nurse should recognize that using pseudoeephdrine to treat allergic rhinitis requires cautious use with clients who have. which of the following conditions? Peptic ulcer disease A seizure disorder Anemia Coronary artery disease

Coronary artery disease

When considering replacement therapy options for a patient who has chronic adrenocortical insufficiency, the primary care provider should chose which of the following drugs? A) Somatropin (Genotropin) B) Hydrocortisone (Cortef) C) Glucagon (GlucaGen) D) Desmopressin (DDAVP)

B) Hydrocortisone (Cortef)

A patient who is taking propylthiouracil (PTU) contacts the health care professional to report weight gain, drowsiness, and depression. The health care professional should suspect which of the following adverse reactions to the propylthiouracil? A) Thyrotoxicosis B) Hypothyroidism C) Lactic acidosis D) Radiation sickness

B) Hypothyroidism

A health care professional is caring for a patient who is about to begin pramlintide (Symlin) therapy to treat type 1 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about using the drug? A) Mix pramlintide with insulin. B) Inject pramlintide before meals. C) Take pramlintide at bedtime. D) Inject pramlintide into the upper arm.

B) Inject pramlintide before meals

A patient who is taking glipizide (Glucotrol) to treat type 2 diabetes mellitus contacts the health care professional to report feeling shaky, hungry, and fatigued. The health care professional should tell the patient to do which of the following? A) Drink 16 oz of water. B) Perform a fingerstick blood glucose check. C) Take another glipizide tablet. D) Lie down and rest.

B) Perform a fingerstick blood glucose check.

A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse include? A) Take the drug with food B) Swallow the capsules whole C) Dissolve the tablets in water D) Take the drug at bedtime

B) Swallow the capsules whole Omeprazole, a PPI, is unstable in stomach acid. The nurse should tell the client to swallow the capsules or tablets whole and not chew the delayed-release tablets.

A health care professional is caring for a patient who is about to begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. The health care professional should tell the patient to report which of the following adverse effects of the drug?

Cough Rationale: Nitrofurantoin, a urinary tract antiseptic, can cause respiratory symptoms, such as cough, shortness of breath, chest pain, and fever. These can indicate an acute allergic reaction and warrant immediate discontinuation of drug therapy.

A health care professional is caring for a patient who is about to begin taking cephalexin (Keflex) to treat bacterial meningitis. The health care professional should explain to the patient the need to monitor which of the following laboratory tests?

Creatinine Rationale: Cephalexin, a first-generation cephalosporin, is excreted by the kidneys. The health care professional should evaluate renal function prior to and during treatment with the drug. Patients who have renal insufficiency should receive a reduced dose of the drug or another drug that does not affect renal function, such as ceftriaxone (Rocephin).

A health care professional should question the use of levothyroxine (Synthroid) for a patient who has __________. A) bacterial skin infections B) diabetes insipidus C) immunosuppression D) a myocardial infarction

D) A myocardial infarction

Which of the following drugs has protocols that require clients to meet specific risk-management criteria and sign a treatment agreement before the nurse can administer the drug? A) Lubiprostone B) Azathioprine C) Sulfasazine D) Alosetron

D) Alosetron Clients who take alosetron, a serotonin 5-HT3 receptor antagonist, can develop severe constipation that can lead to impaction, bowel obstruction, perforation, and potentially fatal ischemic colitis. Because of these risks, nurses must inform clients of the benefits and risks of the drug therapy, and clients must sign a treatment agreement.

Which of the following drugs should a provider prescribe for a patient who has streptococcal pharyngitis and is allergic to penicillin?

Erythromycin Rationale: Erythromycin, a macrolide, is an acceptable alternative to penicillin for patients who have bacterial infections and are allergic to penicillin. The drug is effective against most gram-positive bacteria, including streptococci, and some gram-negative bacteria.

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? Suppresses the cough stimulus Reduces inflammation Thins and loosens mucus Dries secretions

Thins and loosens mucus

A nurse is caring for a client who is taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions?

To reduce fever To relieve mild pain

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects. Select all Muscle tremors Urinary retention Dry mouth Insomnia Tachycardia

Urinary retention Dry mouth

A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions?

Urinary retention Respiratory depression Sedation Orthostatic hypotension

A nurse is caring for a client who is opioid dependent and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome?

Vomiting Abdominal cramps Hypertension

A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse reactions?

Chest pain

A nurse is teaching a client who is taking prednisone for chronic asthma. Which of the following instructions should the nurse include? "Avoid taking nonsteroidal anti-inflammatory drugs." "Rinse your mouth after taking the medication to prevent a yeast infection." "Stop taking the medication if you become nauseous." "Change position slowly when standing up."

"Avoid taking nonsteroidal anti-inflammatory drugs."

a nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. when speaking to the client about the drug, which of the following instructions should the nurse include

"apply the patch to a hairless area and rotate sites." "apply a new patch when you start of your day." "remove patches 10 to 12 hours each day."

a nurse is teaching a client with a prescription for quinidine. which of the following statements should the nurse include

"monitor your pulse rate and report changes"

A health care professional is caring for a patient who is about to begin taking somatropin (Genotropin). The health care professional should explain the need to monitor which of the following laboratory tests? (Select all that apply) - Blood amylase - Creatinine clearance - Urine calcium - Blood glucose - CBC

- Urine calcium - Blood glucose

When talking with a patient about taking fludrocortisone to treat adrenocortical insufficiency, the health care professional should tell the patient to do which of the following to reduce the risk of adverse reactions? (Select all that apply) - Weigh yourself daily - Report weakness or palpitations - Have your blood pressure checked regularly - Eat more iron-rich foods - Avoid drinking grapefruit juice

- Weigh yourself daily - Report weakness or palpitations - Have your blood pressure checked regularly

A health care professional is preparing to administer amphotericin B IV to a patient who has a systemic fungal infection. Which of the following drugs should the health care professional administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration? (Select all that apply.)

-Acetaminophen (Tylenol) -Diphenhydramine Rationale: -Acetaminophen is correct. Infusion reactions to IV amphotericin B start 1 to 2 hr after the infusion begins and subside within 4 hr. The health care professional can help prevent these effects by administering acetaminophen prior to the infusion. -Diphenhydramine is correct. The health care professional can help prevent adverse reactions by administering diphenhydramine prior to the infusion.

A primary care provider is considering the various pharmacologic options for a patient who has a gynecologic infection and a history of alcohol use disorder. Which of the following medications can cause a reaction similar to disulfiram (Antabuse) if the patient drinks alcohol while taking it? (Select all that apply.)

-Cefotetan -Metronidazole (Flagyl) Rationale: -Cefotetan is correct. Cefotetan, a second-generation cephalosporin, can cause a reaction similar to what disulfiram causes when patients take it and also drink alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension. -Metronidazole is correct. Metronidazole, an antiparasitic drug, can cause a reaction similar to what disulfiram causes when patients take it and also drink alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension.

A health care professional is caring for a patient who is about to begin taking isoniazid (INH) to treat tuberculosis. The health care professional should tell the patient to report which of the following adverse effects of the drug? (Select all that apply.)

-Jaundice -Numbness of the hands -Dizziness Rationale: -Jaundice is correct. Isoniazid, an antimycobacterial drug, can cause liver toxicity, especially in patients who abuse alcohol. The health care professional should monitor liver enzymes during therapy, and tell the patient to report indications of liver damage, such as jaundice, abdominal pain, and fatigue. -Numbness of the hands is correct. Isoniazid can cause peripheral neuropathy. The health care professional should tell the patient to report numbness, pain, or tingling in the hands or feet. Administering pyridoxine (vitamin B6) can help minimize these effects. -Dizziness is correct. Isoniazid can cause dizziness, ataxia, and seizures. The health care professional should tell the patient to report these CNS effects.

A health care professional is caring for a patient who is about to begin taking chloroquine (Aralen) to prevent malaria. When talking with the patient about taking the drug, the health care professional should include which of the following instructions? (Select all that apply.)

-Wear sunglasses outdoors. -Avoid driving. -Take the drug with food. Rationale: -Wear sunglasses outdoors is correct. Chloroquine, an antimalarial drug, can cause photophobia. Sunglasses can help reduce the risk of eye damage and irritation because of this effect. -Avoid driving is correct. Chloroquine can cause blurred vision. It is best for patients taking the drug to avoid driving and other activities that require visual acuity until they know how the drug will affect them. -Take the drug with food is correct. Chloroquine can cause nausea and diarrhea. Taking the drug with food can help minimize these effects.

When talking with a patient who is about to begin repaglinide (Prandin) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions? A) Do not drink more than 1 L of grapefruit juice per day. B) Carry a high-protein snack at all times. C) Drink 16 oz of water after taking the drug. D) Use ginseng to reduce nausea.

A) Do not drink more than 1 L of grapefruit juice per day.

A health care professional is caring for a patient who is about to begin acarbose (Precose) therapy to treat type 2 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about the drug? A) Eat more iron-rich foods. B) Avoid drinking grapefruit juice. C) Increase fiber intake. D) Avoid drinking green tea.

A) Eat more iron rich foods Rationale: Acarbose, an alpha-glucosidase inhibitor, can cause iron-deficiency anemia. A healthcare professional should tell the patient to increase his intake of iron-rich foods, such as red meat, spinach, and Grains, and monitor the patients CBC.

A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (Select all that apply) A) Level of consciousness B) Skin integrity C) Temperature D) Urine Output E) CBC

B, C, and E B) Sulfasalazine can cause a skin rash, so the nurse should check the client's skin for rashes. The drug can also cause nausea. If the client reports nausea, the nurse should suggest taking the drug with food or water. C) Sulfasalazine can cause fever, so the nurse should check the client's temperature and treat fever with an antipyretic. E) Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The nurse should check the client's CBC periodically during therapy and tell the client to report sore throat or fatigue.

A health care professional is caring for a patient who is about to begin insulin glargine (Lantus) therapy. The health care professional should recognize the need for additional precautions because the patient also takes which of the following types of drugs? A) Oral contraceptives B) Calcium supplements C) Beta blockers D) Iron supplements

C) Beta blockers

A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium has which of the following therapeutic effects? A) Reduces Inflammation B) Reduces Gastric Acid C) Prevents Diarrhea D) Prevents Straining

D) Prevents Straining Docusate sodium, a stool softener, prevents straining during defecation and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools.

A primary care provider should prescribe a lower dose of sitagliptin (januvia) for a patient who has type 2 diabetes mellitus and who also has which of the following? A) Thyroid Disease B) Bronchitis C) Heart Failure D) Renal Impairment

D) Renal impairment

A patient who is taking ciprofloxacin (Cipro) to treat a respiratory tract infection contacts the health care professional to report dyspepsia. The health care professional should recommend which of the following instructions?

Take an antacid at least 2 hr after taking the drug. Rationale: The health care professional should recommend the patient try an antacid, but only after at least 2 hr have passed since taking ciprofloxacin, a fluoroquinolone. This is because antacids decrease the absorption of the drug.

A health care professional is caring for a patient who is taking ciprofloxacin (Cipro) to treat a urinary tract infection and has rheumatoid arthritis, for which he takes prednisolone (Prelone). Recognizing the adverse effects of ciprofloxacin, the health care professional should tell the patient to report which of the following?

Tendon pain Rationale: Ciprofloxacin, a fluoroquinolone, can cause an Achilles tendon to rupture, especially in patients who take glucocorticoids or in older adults. The health care professional should tell the patient to report tendon pain, and stop taking the drug.

A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions?

Weight gain

a nurse is caring for a client who is taking carvedilol in a prescription for oral anti-diabetic to manage their new diagnosis of type 2 DM, by taking both drugs concurrently. the nurse should identify that the client is at an increased risk which of the following conditions

hypoglycemia

a nurse is monitoring a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. the nurse should identify that these manifestations indicate which of the following adverse effects

hypokalemia

a nurse is caring for a client with a new prescription for verapamil to treat atrial fibrillation. the nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following

hypotension

a nurse is caring for a client who is taking spironolactone to treat hypertension. the nurse should recognize that which of the following of the clients laboratory values require immediate intervention

potassium 5.2 mEq/L

the nurse should identify that which of the following drugs is used only for short term treatment cardiac dysrhythmia because of serious adverse affects associated with long term use

procainamide

a nurse is caring for a client who is taking a diuretic. the nurse should instruct the client to include which of the following foods in their diet to increase potassium intake

raisins

a nurse is caring for a client who is about to begin captopril therapy. which of the following adverse effects should the nurse instructed client to report because it could indicate a need to discontinue therapy

rash distorted Taste swelling of the tongue dry cough

a nurse is teaching a client who has a new prescription for gemfibrozil. which of the following instruction should the nurse include

report any new intolerance to fried foods report muscle tenderness expect periodic liver function testing

a nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. the nurse should recognize that which of the following hypertensive drugs are contraindicated for the client

reserpine

a nurse is caring for a client who has a prescription for verapamil. the nurse should clarify the prescription with the provider if the client has a history of which of the following conditions

second degree AV block

a nurse is reviewing new prescriptions for a client with heart failure. the nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesteremia

simvastatin

a nurse is caring for a client with a glomerular filtration rate of 10 mL/min and a reduced urine output. the nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug

the drug does not promote diuresis for clients who have renal insufficiency

A nurse is teaching a client who has a new prescription of sulfasalazine. Which of the following statements should the nurse take? A) "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn" B) "The medication can stain your contact lenses green" C) "The medication can color your urine dark brown" D) "Take an iron supplement when you take sulfasalazine to prevent anemia"

A) "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn" Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning.

When talking to a patient who is about to begin glipizide (Glucotrol) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions? A) Avoid drinking alcohol. B) Sit or stand for 30 min after taking the drug. C) Urinate every 4 hr. D) Take the drug 2 hr after a meal.

A) Avoid drinking alcohol Rationale: Alcohol can interact with Glipizide, a sulfonylurea, causing a reaction similar to disulfiram (Antabuse), manifesting as nausea, palpitations, and flushing. Also increases the drugs hypoglycemic effect. The healthcare professional should tell the patient to avoid drinking alcohol.

A nurse is caring for a client who has a prescription for alosetron. The nurse should recognize that alosetron therapy is effective when the client reports which of the following? A) One formed stool per day B) Urination without burning C) Cessation of nausea or vomiting D) Reduced GI reflux effects

A) One formed stool per day Alosetron, a serotonin 5-HT3 receptor antagonist, treats the diarrhea and pain of severe irritable bowel syndrome (IBS). One formed stool per day indicates effective therapy.

A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions? A) Nausea B) Constipation C) Urinary Retention D) Sore Throat

A) Nausea Lubiprostone, a chloride channel activator, can cause nausea. Clients who develop this effect do not need to discontinue the drug but sould take it with food and water to minimize GI upset.

A nurse is providing teaching to a client who is about to start taking psyllium to treat constipation. Which of the following instructions should the nurse include? A) Expect results in 6 to 12 hrs B) Urinate every 4 hrs C) Take the drug with at least 8 oz (237 mL) of fluid D) Avoid activities that require alertness E) Increase fluid and fiber intake

C and E C) To prevent esophageal obstruction, clients should take psyllium with at least 8 oz of fluid; and after mixing the powdered form, clients should drink it immediately E) The nurse should tell the client to increase activity, fluid intake, and fiber intake, and to keep track of bowel function.

A nurse should recognize that misoprostol is contraindicated for a client who has which of the following conditions? A) A seizure disorder B) Rheumatoid Arthritis C) A positive pregnancy test D) Heart Failure

C) A positive pregnancy test Misoprostol, a prostaglandin E1 analog, is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion; therefore, providers must confirm that clients are not pregnant before prescribing the drug; and clients who take misoprostol must use contraception.

A nurse is caring for a client who has a new prescription for alosetron to treat irritable bowel syndrome. The nurse should instruct the client to report which of the following adverse effects of the drug? A) Headache B) Drowsiness C) Abdominal Pain D) Sore Throat

C) Abdominal Pain alosetron, a serotonin 5-HT3 receptor antagonist, can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding, and t stop taking the drug if these manifestations occur.

A health care professional is caring for a patient who is about to begin levothyroxine (Synthroid) therapy to treat hypothyroidism. Which of the following instructions should the health care professional include when talking with the patient about taking the drug? A) Take levothyroxine with food to inccrease absorption. B) Take levothyroxine with an antacid to reduce GI effects. C) Expect life-long therapy with the drug. D) Carry a carbohydrate snack at all times.

C) Expect life-long therapy with the drug.

A health care professional is caring for a patient who is taking regaglinide (Prandin) 15 to 30 minutes before each meal to treat type 2 diabetes mellitus. The patient asks the health care professional what to do if he skips a meal. Which of the following is the appropriate response? A) Double the dose before the next meal. B) Take half the dose. C) Skip the dose. D) Take the usual dose.

C) Skip the dose.

A health care professional is caring for a patient who is taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should monitor for which of the following findings that indicates an adverse effect? A) Joint pain B) Constipation C) Weight gain D) Dilated pupils

C) Weight gain