Final Pharm Exam
A diet child is born with congenital hypothyroidism. What element was lacking in the mother's during pregnancy?
lodine
The nurse administers hydroxyzine to a client with nausea. After administration, the nurse should monitor for what adverse effect?
Dry mouth
What antiemetic is the most common first-line drug for the treatment of postoperative nausca and vomiting?
Ondansetron
A client has been prescribed acarbose. What is the advantage of acarbose over altermative drugs?
It delays the digestion of complex carbohydrates.
A client newly diagnosed with diabetes reports "constant, insatiable thirst " When providing teaching to the client, how should the nurse explain the symptom?
"Excess glucose pulled more water through your kidneys and the increased urination caused thirst,"
A client asks the nurse, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response?
"You will lose less potassium with spironolactone than with furosemide."
Laboratory testing reveals that a client is in a severely hyperthyroid state, and propylthiouracil has been prescribed. When providing health education related to this drug. nurse should stress what information to the client?
"You'll need to take these pills every 8 hours."
A nurse is providing education to a 23-ycar-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching?
Use effective contraceptive measures
During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin?
"Insulins have different onsets and durations of action."
A client is receiving digoxin and a potassium supplement. When monitoring daily laboratory values, what should the potassium level be for this client?
3.5-5.0 mEqL
A client asks the nurse why two diuretics have been prescribed when a friend takes only a single combination medication. The client takes hydrochlorothiazide 75 mg every day with potassium-sparing diuretic. What is the nurse's best response?
"It could be that you need a larger dose than is available in the combination medications."
The nurse is providing education to a client who has been prescribod hydroxyzine. Which statement indicates that the client has understood the teaching?
"I may experience drowsiness with this medication."
A client newly diagnosed with type 2 diabetes has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching?
"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."
A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond?
"I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."
The nurse is providing education to a client who has been preseribed diphenoxylate with atropine for diarrhea. What statement should the nurse include in teaching
"Once diarhea slows down, stop using the drug."
The nurse is educating a client regarding the use of pramlintide acetate for the treatment of diabetes mellitus type 1. What statement made by the client indicates that further education is required?
"Since I am on this new medication, I don't have to take my insulin any longer"
The parent of child with diabetes asks the nurse why a quick-acting sugar given by mouth is better in the regulation of insulin than the use of intravenous glucose for a low blood sugar. Which statement by the nurse represents the most appropriate response to the question?
"The ingestion of food allows the digestive tract to stimulate vagal activity and the release of incretins."
The nurse is educating a client diagnosed with peptic ulcer disease about the prescribed medications aluminum hydroxide-magnesium, hydroxide -simethicone mixture and ranitidine. Which statement made by the client indicates the need for further clarification?
"To decrease interactions with other drugs I take, 1 will take the drug 30 minutes before taking the rest of my medications."
The client recently diagnosed with peptic ulcer disease states achieving adequate symptom relief with the use of over-the-counter (OTC) antacids but has asked the nurse about the optimal schedule for taking these drugs. What action should the nurse recommend?
1 and 3 hours after each meal and at bedtime
The nurse knows that the lunch trays are usually distributed at appreximately 12:15. The nurse should plan to administer the client's prescribed 4 units of regular insulin at what time?
11:45
A client has contacted the clinic, stating to the nurse, "1 have been taking loperamide for the past day-and-a-half, and my diarhea shows no signs of slowing down." The nurse should respond to the client in the knowledge that loperamide should be discontinued if the diarrhea does not improve within what time frame?
12 hours
A client is in the intensive care unit and being administered ranitidine parenterally. How long will it take for ranitidine to reach peak blood levels?
15 minutes
A client is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the client severe nausea and vomiting. The oncology nurse should nomally administer antiemetics on what schedule?
30 to 60 minutes before the treatmient
A client has edema of the lower extremities and abdomen. What is the reason to administer stronger diuretic than a thiazide diuretic to this client?
A thiazide diuretie will be ineffective when immediate diuresis is needed.
A client will be using an insulin pump to delivera consistent amount of insulin to meet the client's needs. Where should the nurse insert the pump for the maximum amount of absorption?
Abdomen
A client's severe diarrhea has necessitated treatment with polycarbophil. The nurse should caution the client about the possibility of what adverse effect?
Abdominal fullness and bloating
A client with ulcers has asked the nurse if it would be acceptable to take bismuth subsalicylate. Before recommending an over-the-counter (OTC) formulation of bismuth subsalicylate, the nurse should conduct which client assessment?
Allergy status
The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration?
Allergy to aspirin
The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?
Allergy to sulfonamides
The nurse is caring for a female client diagnosed with chronic severe diarrhea-predominant irritable bowel syndrome that has not responded to conventional therapy. Which medication should the nurse anticipate being prescribed?
Alosetron
An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?
An increase in serum lactate
A client diagnosed with peptic ulcer disease has begun taking sucralfate. The nurse should caution the client against the concurrent use of which classification of medications?
Antacids
A client is administered a phenothiazine for nausca and vomiting What is the action of phenothiazine?
Antagonizes dopamine receptors
A Multiple hospital client has a standing prescription for aprepitant on an as-needed basis. The client should be encouraged to request a dose of the drug in response to which event?
Anticipation of becoming nausceous
A client who has been treated successfully for diarrhea has had only one loose bowel movement during the day. Which food should be introduced back into the diet first?
Baked potato
A hospital client diagnosed with type I diabetes is prescribed regular insulin on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication?
Between 09:45 and 10:45
Cholestyramine and colestipol are useful in treating diarhea due to which cause?
Bile salt accumulation
A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency?
By aspirating stomach contents and measuring the pH
An older adult client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.
Cardiac function, Renal function,Hepatic function
When reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. The nurse is justified in suspecting that this client's medical history includes which therapy/treatment?
Chemotherapy
A client diagnosed with Crohn's disease is experiencing dianhea during an eracerbation of symptoms. What medication will the nurse most likely administer?
Cholestyramine
The nurse is caring for an adult client presenting with recent heartbun, which the client treated with over-the-counter omeprazole 20 mg PO daily. Afier reviewing the client's current list of medications, the nurse should report which medication because concurrent use may increase blood levels of omeprazole?
Clarithromycin
A client prescribed promethazine for nausea and vomiting should be monitored for which adverse effect?
Confusion
An older adult has been taking a calcium-based antacid on an increasingly frequent basis. When teaching this client, the nurse should include suggestions for the prevention of which adverse effect?
Constipation
A client diagnosed with hypothyroidism admits knowing the term "thyroid gland" but not knowing its function. The nurse should explain the fact that thyroid hormone is responsible for which action?
Controlling the rate of cell metabolism throughout the body.
A client being treated for hypothyroidism has developed symptoms of adrenal insufficiency. What medication will be added to the client's medication regimen?
Corticosteroid agent
What is the recommended treatment of nausea and vomiting when caring for a child prescribed pediatric chemotherapy agents?
Corticosteroids and 5-HT3 receptor antagonists
The nurse is providing education to a client who has been prescribed hydroxyzine. What adverse effect should the nurse mention during teaching?
Drowsiness
The nurse is providing education to a client who has been prescribed furosemide 20 mg PO. The nurse should teach the client that a diet high in sodium will cause what effect?
Decreased diuresis
A client has been prescribed both digoxin and furosemide. The murse should monitor the client for development of what adverse effect?
Digoxin toxicity
An 8-month-old infant admitted with a new diagnosis of diabetes is to receive I unit of regular insulin. How will that I unit be administered?
Dilution strength of U-10
A client diagnosed with Parkinson's disease develops nausea and vomiting. Promethazine may be contraindicated because it depletes levels of what neurotransmitter?
Dopamine
The nurse practitioner instructs the client to use over-the-counter ranitidine instead of cimetidine. What risk is decreased when using ranitidine over cimetidine?
Drug-to-drug interaction
20-month-old child is experiencing diarthea. When planning the child's care, the nurse should prioritize assessments related to what health problem?
Electrolyte deficiencies
The nurse is caring for a client who has been receiving propranolol for the treatment of hyperthyroidism. The nurse is aware that what client condition will warant the tapering or possible discontinuation of the medication?
Euthyroid state
A client is started on levothyroxine for the treatment of hypethyroidism. During client teaching, the nurse indicates that the dosage may be increased how often until symptoms are relieved?
Every 2 weeks
The nurse is providing education to the parents of a child who has been newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching?
Exogenous insulin is required for life.
An older adult client has received a third dose of diphenoxylate. In addition to monitoring the number and consistency of the client's stools, the nurse should prieritize what assessment?
Fluid and electrolyte balance
A client has cdema of the lower extremities with crackles in the lang bases. What diuretic is most likely to be prescribed for a client assessed with lower extremity edema and bilateral lung crackles?
Furosemide
A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary health care provider has prescribed furosemide. What order would be most consistent with this client's health needs?
Furosemide 40 mg PO BID
The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb?
Garlic
A nurse is caring for a client who has been diagnosed with diarrhea. The prescriber has ordered a clear liquid diet for the first 24 hours of admission. What liquids can the nurse offer to the client during this period? Select all that apply
Gelatin, Теа, Broth, Decaffeinated cola
When reviewing a client's medication history, the nurse notes that the client has recently completed a course of treatment with nitazoxanide. The nurse is justified in suspecting that the client was infected with what microorganism?
Giardia lamblia
What is a nonpharmacologic measure that is effective in treating nausca and vomiting in pregnant woman?
Ginger
A client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine; receptor antagonists?
Gynecomastia
The nurse is preparing to administer 20 units of NPH insulin to a client. Before administering the medication, the nurse should implement which intervention?
Have a colleague confirm the dosage.
The nurse is preparing to administer a scheduled dose of levothyroxine to a client. What assessment should the nurse perform prior to giving the drug?
Heart rate
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?
Hepatic disease
A hospital client with a diagnosis of liver failure has been prescribed a low dose of spironolactone in order to treat ascites. The nurse who is providing this client's care should prioritize assessments for the signs and symptoms of what health problem?
Hepatic encephalopathy
The nurse is reviewing the history of a client who has been prescribed diphenonylate. The nurse is aware that documentation of what disorder in the history requires that the drag be administered cautiously?
Hepatorenal disease
The nurse is assessing a client who has been receiving therapy with levothyroxine. What findings would suggest to the nurse that the client may be experiencing an adverse effect?
Hyperactivity and insomnia
An older adult client has a complex medical history that includes heart failure, type I diabetes, and diabetic nephropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?
Hyperkalemia
A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?
I to 2 weeks
A nurse notes that a newly admitted client is curently prescribed both a loop diuretic and a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?
Increased diuretic effect
The nurse should be aware that ranitidine achieves a therapeutic effect by which means?
Inhibiting the secretion of gastric acid
The nurse is providing education to a client who has been newly prescribed propylthiouracil. What information should the nurse provide about the drug's primary mode of action?
Inhibits production of thyroid hormone
A newbom is diagnosed with hypothyroidism. What will the client likely develop if the condition is left untreated?
Intellectual disability
The nurse is preparing to administer polycarbophil to a client experiencing liquid stools. How should the nurse describe the action of this substance?
It absorbs large amounts of water and decreases fluidity of stools.
A client has been prescribed a combination diuretic agent. The nurse knows that the major purpose of this combination is whar?
It prevents potassium imbalance.
A client diagnosed with type 2 diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?
It slows gastric emptying.
What is the expected action of sitagliptin on type 2 diabetes?
It slows the rate of inactivation of the incretin hormones
Which organism is most likely to cause gastroenteritis and vomiting among the students and staff at a local school?
Norwalk-like virus (calicivirus)
The nurse is assessing an older adult client who reports diarhea. What should the nurse explore as the most likely cause?
Laxative abuse
A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen?
Metformin is contraindicated in the presence of an infection
A client diagnosed with hypothyroidism is currently taking an opioid for knee pain. This client is at increased risk for developing which adverse reaction?
Myxedema coma
A client is diagnosed with hyponatremia and hypoglycemia and is currently experiencing lactic acidosis. What condition is most consistent with this clinical presentation?
Myxedema coma
A client diagnosed with myxedema currently takes ibuprofen for knee pain. For what is this client at increased risk
Nephrotoxicity
A client diagnosed with HIV/AIDS has diarrhea that is not responding to antidiarrheal agents. Which medication will best assist in treating this client's diarnhea?
Octreotide acetate
A client is unconscious and experiencing increasing intracranial pressure. What type of diuretie will the client most likely be prescribed?
Osmotic diuretic
A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?
Peptic ulcer discase
The client diagnosed with peptic uleer disease states, "I've never been a really anxious type of person, so I never thought l'd develop ulcers." The nurse has responded with health education addressing the etiology of peptie ulker disease (PUD). What causative factors should the nurse cite? Select all that apply.
Physiologic or psychological stress, Cigarette smoking Infections, Nonsteroidal anti-inflammatory drugs
A client prescribed promethazine has an elevated creatinine level. Which action is the health care provider likely to take considering any possible related risk this client?
Prescribe administration of a lower dose.
A 1 year-old postoperative client has been experiencing repeated vomiting What antiemetic drug has a black box warning against in client of this age?
Prometharine
A postoperative school-age pediatric client is experiencing nausea and vomiting. What is the antiemetic drug of choice in children?
Promethazine
A client has been scheduled fora thyroidectomy to treat thyroid cancer. What medication would the nurse expect to be administerod preoperatively?
Propylthiouracil
An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?
Protect from injury.
A client is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the medication regimen?
Provides antibacterial effect
The majority of the reabsorption process takes place in what anatomical location?
Proximal tubule
A client with a complex medical history states that the primary health care provider has changed the client's proton pump inhibitor (PPI) from omeprazole to rabeprazole. The client is unsure of the rationale for this change in medication and has raised this question with the nurse. What rationale is most plausible?
Rabeprazole has fewer drug interactions.
The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dl (33.33 mmol/L). What type of insulin will the nurse most likely give?
Regular insulin
The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?
Renal dysfunction
The nurse is providing client education prior to administering propylthiouracil. During teaching, the nurse should inform the client about the need for what form of follow-up?
Routine liver function testing
What expectorant is sometimes prescribed for the treatment of hyperthyroidism?
Saturated solution of potassium iodide
A client was successfully treated for thyroid storm carlier in the year. In subsequent health education, the nurse should caution the client against excessive intake of what foods?
Seafood and kelp
A client diagnosed with hyperthyroidism is scheduled to receive a medication to destroy the thyroid gland. Which medication will be administered?
Sodium iodide
The nurse is preparing to administer the first dose of hydrochlorothiazide to a client. What assessment should the nurse perform prior to administration?
Sulfonamide allergy
A client diagnosed with hypothyroidism is started on levothyroxine. What should the client taught regarding medication administration in the home setting?
Take the medication on an empty stomach
A client who has been scheduled to begin chemotherapy for the treatment of breast cancer is anxious about the possibility of experiencing nausea. When explaining the physiology of nausea and vomiting, the nurse should include what informational statement?
The chemoreceptor trigger zone (CTZ) is composed of neurons in the fourth ventricle.
A 4-year-old child with type I diabetes mellitus becomes angry and then lethargic. What should the nurse educate the parents regarding the behavioral changes?
The child may be experiencing a hypoglycemic response.
A client has not had anything to eat or drink within the past 12 hours and has a fasting blood glucose level of 125 mg/dL. What does the nurse interpret these findings to indicate?
The client has an impaired fasting blood glucose level.
Which condition must be met in order for glyburide treatment to be effective?
The client must have functioning pancreatic beta cells.
An adult elient diagnosed with hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session?
The client will identify strategies for limiting sodium intake.
An adult client has presented to the emergency department (ED) after 36 hours of severe diarrhea that shows no sign of abating. The ED nurse should be aware that the use of diphenoxylate would be contraindicated in which circumstance?
The client's diarrhea is caused by the ingestion of toxins.
A client eats a large meal of pasta. When does the nurse inform the client the insulin levels will rise?
The insulin levels will rise to a peak in a matter of minutes then decrease to baseline in 2 to 3 hours.
An adult hospital elient has been experiencing intractable nausea and vomiting for several hours, so the nurse has obtained a prescription for an antiemetic from the health care provider. The prescription reads: "Promethazine 25 mg subcutanoously every 6 hours PRN." The nurse should contact the health care provider to question what aspect of this prescription?
The route
A client who has been prescribed an antihistamine for nausea should be monitored for which adverse effect of this classification of medication?
Urinary retention
A pregnant client is experiencing morning sickness. Which should be considered as a first-line treatment for the management of moming sickness?
Vitamin B6
A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?
Weigh the client daily.
