chapter 5

A client is prescribed a medication and is concerned it might have teratogenic effects. Which response by the nurse is the most appropriate? 1. "Let me check the pregnancy risk category of the drug." 2. "Are you in your first trimester of pregnancy?" 3. "If your health care provider ordered the medication, it should be okay." 4. "You should avoid taking any medications while pregnant."

1

A client is receiving an antiviral drug that is a substrate of the CYP3A4 enzyme system. When a drug that is an inhibitor of the 3A4 system is added to the client's regimen, the nurse should assess the client for which result? 1. Toxicity of the antiviral drug 2. No change in viral-related symptoms 3. A decrease in the antiviral drug side effects 4. An increase in viral load

1

A client on long-term therapy with itraconazole (Sporanox) for treatment of a nail fungus is admitted to the hospital with right upper quadrant pain, nausea, and abdominal pain. Which laboratory results found in the medical record would support the diagnosis of hepatotoxicity? 1. Elevated liver function tests 2. Elevated creatinine levels 3. Decreased blood sugar 4. Decreased prothrombin time

1

A nurse educator explaining drug allergies to students includes which statements in the teaching? Select all that apply. 1. "Drug allergies occur with very small amounts of drug." 2. "The symptoms of drug allergies are unrelated to the pharmacologic actions of the drug." 3. "Drug allergies require a previous exposure to the drug." 4. "The symptoms of a drug allergy are produced by an underactive response by the body's defenses." 5. "The severity of the allergic response is directly related to the dose of the drug."

1,2,3

The nurse is caring for a client who has been admitted for uncontrolled hypertension. When the health care provider orders a second antihypertensive drug for the client, the client asks the nurse why the health care provider ordered another drug instead of increasing the first drug. The nurse's response is based on which principles? Select all that apply. 1. A second drug from the same class is added to prevent the dose of the first drug from being increased. 2. Adding a second drug may allow both drugs to be used at a lower dose. 3. The effect of two drugs from different classes may have a greater effect than two drugs from the same class. 4. Adding the second drug will result in the diminished response of the first drug, which will increase the effects. 5. It is important to counteract the increased dose with another drug to decrease the potential for adverse effects.

1,2,3

The nurse is planning care for a client newly diagnosed with emphysema who complains that the medication is causing a "shaky" feeling. What does the nurse recognize this to be?Select all that apply. 1. A predictable side effect of the medication 2. An annoying side effect of the medication 3. A dose-dependent side effect of the medication 4. An allergic response to the medication 5. A serious adverse effect of the medication

1,2,3

When teaching the client about a new medication, the nurse should include which information? Select all that apply. 1. Adverse effects that can be expected 2. Which adverse effect to report to the health care provider 3. The drug's therapeutic action 4. Chemical composition of the drug 5. Name of the drug manufacturer

1,2,3

A client reports an adverse effect to the Adverse Event Reporting System. The nurse recognizes if a potential safety concern is identified, the Food and Drug Administration (FDA) may take which actions? Select all that apply. 1. Determine the extent of the safety concern by conducting additional studies 2. Require changes be made to the product's labeling information 3. Recall the product 4. Restrict the product's use in certain populations 5. Continue to log in public concerns regarding the safety of the product before taking further action

1,2,3,4

A client returns to the clinic for follow up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which statement? Select all that apply. 1. "I've been taking my medication on an empty stomach, like the prescription label said to do." 2. "I always take my medication with a full glass of water." 3. "I'm not drinking any alcohol close to the time that I take my medication." 4. "I switched all my medications to one pharmacy, like you suggested." 5. "I was glad I could take my medications and supplements together. I don't really like to take a lot of pills during the day."

1,2,3,4

A nurse caring for a client taking a drug that can cross the blood-brain barrier determines the client is experiencing possible neurotoxicity when which symptoms are observed? Select all that apply. 1. Visual changes 2. Loss of balance 3. Sedation 4. Depression 5. Nausea and vomiting

1,2,3,4

A nurse is caring for a client diagnosed with acute asthma who is taking several medications. The nurse would suspect a common adverse drug effect when the client exhibits which symptoms?Select all that apply. 1. Headache 2. Nausea 3. Vomiting 4. Changes in blood pressure 5. Loss of hearing

1,2,3,4

A nurse is caring for a client recently prescribed an oral antibiotic who is exhibiting signs of dermatologic toxicity. Which assessment findings support dermatologic toxicity? Select all that apply. 1. Rash 2. Itching 3. Urticaria 4. Sunburn 5. Photosensitivity

1,2,3,4

A nurse is planning care for a client taking a medication with the potential to cause bone marrow toxicity. Which interventions exemplify the nurse's role in preventing complications? Select all that apply. 1. Assess the client for signs and symptoms of infection. 2. Assess the client for signs and symptoms of anemia. 3. Monitor the client for signs and symptoms of fatigue. 4. Monitor the client for evidence of bruising. 5. Monitor the client for insomnia.

1,2,3,4

A nurse is preparing care for a newly admitted client with diabetic mellitus. Which information would be critical for the nurse to assess? Select all that apply. 1. Medical history 2. Current lab results 3. Medication allergies 4. Use of dietary supplements 5. Number of previous hospitalizations

1,2,3,4

A nurse is reinforcing discharge instructions concerning food-drug interactions. Which statements by the client indicate correct understanding of the discharge instructions? Select all that apply. 1. "I should take my medications with water to avoid any problems with my medications being absorbed." 2. "I cannot take one of my medications with grapefruit juice because it will decrease the absorption of the medication." 3. "I need to be sure to read the prescription label because the pharmacist will indicate if I need to take my medication with food or without food." 4. "I should take my daily vitamin 2 hours after my medication so they do not affect each other." 5. "If I take my medication with hot tea, it will not affect absorption."

1,2,3,4

A nurse teaching a prenatal class is reinforcing precautions concerning the use of medications during pregnancy. The nurse determines the class understands when the students make which comments? Select all that apply. 1. "There are some medications I cannot take because I am pregnant and they could hurt my baby." 2. "I need to check with my doctor before I take any medication because some drugs can hurt my baby." 3. "I should consider all drugs to be harmful to my baby unless my doctor tells me it is okay." 4. "I have to be very careful to let all my health providers know that I am pregnant before they prescribe medications for me." 5. "Once I am halfway through my pregnancy, I won't need to worry about taking over-the-counter medications because the baby will be more fully-formed."

1,2,3,4

The nurse is caring for a client who is prescribed laxatives. Which statements are most relevant to the absorption of medications? Select all that apply. 1. Drugs that increase peristalsis may decrease absorption. 2. Drugs that decrease peristalsis may increase absorption. 3. The presence of food will usually decrease absorption. 4. Drug-drug interactions that affect absorption may be prevented by taking the drugs 2 hours apart. 5. Increasing fluid intake will increase absorption.

1,2,3,4

The nurse is caring for a client who is taking a drug known to cause nephrotoxicity. Which interventions are appropriate to prevent drug-induced nephrotoxicity? Select all that apply. 1. Encouraging hydration 2. Monitoring diagnostic lab tests for changes in kidney function 3. Identifying drugs that affect kidneys and discuss adjusting doses 4. Determining whether the client has kidney impairment 5. Providing proper nutrition

1,2,3,4

A nurse is caring for a client who may be experiencing an allergic response to medication. The nurse bases the assessment on which information? Select all that apply. 1. Signs and symptoms of drug allergy range from minor to life threatening. 2. Drug allergy symptoms may appear the same as common allergies to other substances, such as environmental triggers. 3. It is important to determine the source of the allergy. 4. Nausea and vomiting are the most common drug allergy symptoms. 5. Drug allergies require previous exposure.

1,2,3,5

The nurse would anticipate an alteration in drug absorption in clients with which conditions? Select all that apply. 1. Vomiting 2. Diabetes 3. Diarrhea 4. Asthma 5. Alzheimer disease

1,3,4

A client develops angioedema and difficulty swallowing after receiving an intravenous medication. The nurse recognizes this is characteristic of which effect? 1. A minor adverse effect 2. A life-threatening adverse effect 3. An unpredictable side effect 4. A reaction secondary to urticaria

2

The nurse determines that an idiosyncratic reaction to a drug has occurred when the client experiences drug effects that have which characteristic? 1. Predictable 2. Unexplained 3. Irreversible 4. Life threatening

2

The nurse plans to monitor a client for dermatologic toxicities after administering which medication? 1. Salicylates 2. Antiseizure drugs 3. Antithyroid drugs 4. Loop diuretic

2

A client is prescribed a chemotherapeutic drug for treatment of leukemia and asks the nurse why a drug that can also cause cancer is being used to treat cancer. Which response by the nurse is the most appropriate? 1. "The incidence of carcinogenic effects is really quite small, and you shouldn't be concerned about it." 2. "Since you are receiving such potent drugs, they have to warn of you of every possible side effect." 3. "The risk for causing another cancer is there, but sometimes the benefit of the treatment outweighs the risks." 4. "The carcinogenic effects often do not show up for a few decades, and we want to cure this leukemia now."

3

A client with a history of multiple allergies is prescribed a new anti-infective. At which time should the nurse plan to monitor the client for an anaphylactic reaction? 1. Within 24 hours of receiving the first dose 2. Immediately after receiving the first dose 3. At any time while receiving the drug 4. Within one hour of receiving the first dose

3

The nurse explains to a student nurse that side effects differ from adverse events in which way? 1. Adverse effects cause permanent damage. 2. Side effects are usually more serious than adverse effects. 3. Side effects are predictable at therapeutic levels. 4. Adverse effects are only dose-related.

3

The nurse monitors a client on a newly prescribed antihypertensive drug. The nurse recognizes the symptom of hypotension would be indicative of which reaction? 1. An allergic response to the drug 2. A therapeutic drug effect 3. An adverse drug effect 4. An idiosyncratic drug reaction

3

A client is scheduled to receive a diuretic and a beta blocker. The nurse determines the combination of these drugs will have which effect on the client's blood pressure? 1. Oppositional 2. Synergistic 3. Antagonistic 4. Additive

4

The nurse administers zolpidem (Ambien) to a client at 11 p.m. for sleep. The client awakens at 3 a.m. and is wide awake and agitated. How will the nurse document this client's reaction to the medication in the medical record? 1. Allergic response 2. Side effect 3. Adverse effect 4. Idiosyncratic reaction

4

When checking on the potential interactions of two drugs being administered at the same time, the nurse recognizes which principle? 1. Drug-drug interactions are more serious than drug-food interactions. 2. All drugs will have some type of interaction. 3. Drug interactions should always be avoided. 4. Some drug interactions can produce therapeutic effects.

4

The nurse determines that the client is most at risk for renal toxicity while receiving an aminoglycoside anti-infective when which diagnostic lab result is abnormal? 1. Kidney function test 2. White blood cell count 3. Liver function test 4. Platelet count

1

Which clinical manifestation would the nurse identify as an allergic reaction? 1. Urticaria 2. Photosensitivity 3. Abdominal cramping 4. Complaints of diarrhea

1

A nurse in the emergency department is preparing to care for a client suspected of an opiate overdose. The nurse is preparing to give the client a medication called naloxone (Narcan). Which rationales support the use of this medication? Select all that apply. 1. It reverses the effects of the overdose. 2. It is an antagonist. 3. It has an additive effect. 4. It has a synergist effect. 5. It causes CNS depression.

1,2

The nurse would anticipate an alteration in drug excretion in clients with which conditions? Select all that apply. 1. Kidney disease 2. Heart disease 3. Diarrhea 4. Asthma 5. Alzheimer disease

1,2

A client with a documented allergy to penicillin is prescribed cephalosporin. The nurse will monitor the client for allergic responses, since cephalosporin can cause which reaction? 1. A heightened drug reaction 2. Pseudoallergy 3. Cross-allergy 4. A hyporesponsive reaction

3