Medical-Surgical (EAQ)Pharmacology
A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond?
"Antiseizure drugs will probably be continued for life."
An insulin pump is instituted for a client with type 1 diabetes. The nurse plans discharge instructions. Which short-term goal is the priority for this client?
"Demonstrate correct use of the insulin pump."
The client who takes furosemide and digoxin reports that everything looks yellow. How will the nurse respond?
"I will hold the medication until I consult with your healthcare provider."
A female client receiving cortisone therapy for adrenal insufficiency expresses concern that she is developing facial hair. How should the nurse respond?
"The drug contains a hormone that causes male characteristics."
A client with terminal cancer is to receive 4 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. It is supplied at 10 mg/mL. When the client complains of severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place and leading zero if applicable. ___ mL
0.4
A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse advise the client? Select all that apply.
1) Take oral medication 2) Drink fluids throughout the day 3) Monitor capillary glucose levels *All are correct*
At 10 AM the nurse hangs a 1000-mL bag of D5W with 20 mEq of potassium chloride to be administered at 80 mL/hr. At noon the healthcare provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion to use the circulatory access for the secondary infusion of the antibiotic?
1-hour
A man who has 40% of the body surface area burned is admitted to the hospital. Fluid replacement of 7200 mL during the first 24 hours has been prescribed. Fifty percent of fluid replacement should be administered in the first 8 hours; then the remaining 50% given over the next 16 hours. What does the nurse calculate the hourly intravenous (IV) fluid to be for the first 8 hours of fluid replacement therapy? Record your answer using a whole number. ___ mL/hr
450
A client who is obtunded has a blood pressure of 80/35 mm Hg after a blood transfusion. In an effort to support renal perfusion, the nurse administers dopamine at 2 mcg/kg/min as prescribed. What is the most relevant outcome indicating effectiveness of the medication for this client?
An increase in urinary output
Following surgery, total parenteral nutrition is instituted via a central venous infusion. During the fourth hour of the infusion the client complains of nausea, fatigue, and a headache. The hourly urine output is twice the amount of the previous hour. After contacting the primary health care provider, what is the next action the nurse should take?
Check the serum glucose level.
A nurse assesses a client's intravenous site. What clinical finding, unique to infiltration, leads the nurse to conclude that the intravenous (IV) site has infiltrated, rather than become inflamed?
Coolness
What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema?
Decreased intracranial pressure
At 4:30 pm, a client who is receiving NPH insulin every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing?
Hypoglycemia
A pain scale of 1 to 10 is used by a nurse to assess a client's degree of pain. The client rates the pain as an 8 before receiving an analgesic and a 7 after being medicated. What conclusion should the nurse make regarding the client's response to pain medication?
Medication is not adequately effective.
A client with a diagnosis of anemia is receiving packed red blood cells. What is the most important action by the nurse when administering the transfusion?
Monitoring the client's response, particularly within the first 10 minutes
The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. What does the nurse identify as the purpose of these drugs?
Reduce antibody production
A nurse has administered sublingual nitroglycerin. Which parameter should the nurse use to determine the effectiveness of sublingual nitroglycerin?
Relief of anginal pain
A client takes isosorbide dinitrate daily. The client states, "I would like to start taking sildenafil for erectile dysfunction." The nurse explains that taking both of these medications concurrently may result in which complication?
Severe hypotension
Tissue plasminogen activator (t-PA) is to be administered to a client in the emergency department. Which is the priority nursing assessment?
Signs of bleeding
A client with heart failure is to receive digoxin and asks the nurse why the medication is necessary. What physiologic response will the nurse include when answering the client's question?
Slows and strengthens cardiac contractions
A client develops a maculopapular rash on the upper extremities and audible wheezing during the administration of intravenous vancomycin. To ensure the client's safety, which action would the nurse carry out first?
Stop infusion
