Pharm ATI Prep Wk 1

A nurse is preparing to administer acetaminophen 1 g PO 3 times per day PRN to a client who has a fever. The amount available is acetaminophen 325 mg/tablet. How many tablets should the nurse administer per dose?

3 tablets

An 18-month-old toddler has Kawasaki disease (KD). The child is receiving IVIG. The guardian asks the nurse to administer the child's scheduled MMR vaccine before discharge. Which of the following responses should the nurse provide? a. "Your child will not be able to receive the MMR vaccine for at least 3 months after discharge." b. "I cannot administer routine vaccines to children while they are in the hospital." c. "Your child can receive the MMR vaccine once his fever is gone." d. "I can administer the measles and rubella vaccines, but I cannot administer the mumps vaccine."

a. "Your child will not be able to receive the MMR vaccine for at least 3 months after discharge." The nurse should explain to the guardian that IVIG given for the treatment of KD contains antibodies that can interfere with the action of live-virus vaccines like MMR. The MMR immunization should be postponed for 3 to 6 months.

A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several prescription medications using metered-dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? a. Add a spacer to each MDI b. Instruct the child to inhale more rapidly than usual when using an MDI c. Ask the provider to change the child's medications from inhaled to oral formulations d. Administer oxygen by facemark along with the MDI

a. Add a spacer to each MDI MDIs are difficult to use correctly; even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for a lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.

*A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take? a. Administer a small test dose before giving the full dose b. Infuse the medication over 30 seconds c. Monitor the client closely for hypertension after the infusion d. Administer cyanocobalamin as an antidote if iron dextran toxicity occurs

a. Administer a small test dose before giving the full dose A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. A small test dose should be administered over 5 minutes before giving the full dose. The client should be monitored carefully for an allergic reaction during and for a period of time following the test dose.

*A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. Then nurse should identify which of the following laboratory results as supporting the administration of this medication? a. TSH 8 micro units/mL b. T3 300 pg/dL c. T4 7 mcg/dL d. Thyroxine-binding globulin 2.3 mg/dL

a. TSH 8 micro units/mL The expected reference range for TSH is 0.3 to 5 micro units/m:. When a client has primary hypothyroidism, the TSH level becomes elevated in an attempt to normalize the thyroid gland's function. When the client has had a therapeutic response to treatment, the TSH level returns to the expected reference range.

A nurse is teaching a client with type 2 diabetes mellitus about self-administration of a new prescription for acarbose. Which of the following pieces of information should the nurse include in the teaching? a. Tell the client to take the medication with food b. Show the client how to perform an intramuscular injection c. Advise the client to avoid taking this medication with insulin d. Warn the client against exercising while taking this medication

a. Tell the client to take the medication with food Acarbose should be taken with food. The nurse should advise the client that this medication should be taken with the first bite of a meal 3 times each day. Acarbose inhibits an enzyme in the intestines that slows the digestion of carbohydrates and results in a lower postprandial increase of blood glucose levels.

A nurse is caring for a client who is experiencing acute alcohol withdraw. The nurse should expect to administer which of the following medications? a. Disulfiram b. Chlordiazepoxide c. Methadone d. Varenicline

b. Chlordiazepoxide The nurse should expect to administer chlordiazepoxide to a client who is experiencing manifestations of acute alcohol withdrawal. Chlordiazepoxide is a benzodiazepine; this class of medication is often used to facilitate withdrawal. Chlordiazepoxide assists with decreasing withdrawal manifestations, stabilizing vital signs, and preventing seizures and delirium tremens.

A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine. The client states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain that nifedipine works for clients who are pregnant through which of the following mechanisms? a. It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions b. It inhibits uterine contractions by blocking the entry of calcium into uterine cells c. It decreases activity within the CNS, which regulates all smooth muscle d. It stimulates beta-2 receptors in the uterus, which decreases the frequency of contractions

b. It inhibits uterine contractions by blocking the entry of calcium into uterine cells Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus

A nurse is providing teaching to a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client that which of the following findings is an indication of thyrotoxicosis? a. Weight gain b. Constipation c. Chest pain d. Fatigue

c. Chest pain Thyrotoxicosis can result if a client takes too much levothyroxine. Manifestations include chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and diaphoresis. The client should notify the provider if any of these manifestations are present.

A nurse is providing teaching to a client with a seizure disorder who has a new prescription for carbamazepine. Which of the following statements should the nurse include in the teaching? a. "This medication will decrease the effectiveness of oral contraceptives." b. "Once you are seizure-free for a month, you will be able to stop taking the medication." c. "You can cut the dose in half if gastrointestinal upset occurs." d. "This medication might initially increase the frequency of your seizures."

a. "This medication will decrease the effectiveness of oral contraceptives."

*A charge nurse is teaching a newly licensed nurse about the purpose of a client being prescribed a transdermal fentanyl patch. Which of the following clients should the charge nurse include in the teaching as a client who requires this medication? a. A client who is opioid-tolerant b. A client who has difficulty swallowing c. A client who has severe intermittent pain d. A client who is postoperative following abdominal surgery

a. A client who is opioid-tolerant The charge nurse should include in the teaching that a client who is opioid tolerant can be prescribed a fentanyl patch to manage pain.

A nurse is caring for a client who has recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe methotrexate at which of the following times? a. Within 3 months of the initial diagnosis b. When NSAIDs have not provided pain relief c. During an exacerbation of symptoms d. Once bone degeneration progresses

a. Within 3 months of the initial diagnosis The nurse should identify that current guidelines recommend starting a disease-modifying anti rheumatic drug such as methotrexate within 3 months of a diagnosis of rheumatoid arthritis to prevent or delay joint degeneration.

A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? a. "I can take my second dose of medication no later than 9:00 PM." b. "I should change positions slowly when getting out of bed." c. "If I miss a dose, I should double the next dose." d. "I should notify my provider if I experience a headache while taking this medication."

b. "I should change positions slowly when getting out of bed." The nurse should identify that isosorbide mononitrate is an antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects of orthostatic hypotension.

A nurse is providing teaching about benzodiazepines to a client who is discontinuing long-term alprazolam use. Which of the following pieces of information should the nurse include in the teaching? a. "You might experience somnolence." b. "Plan to taper the dose slowly over several months." c. "Call the provider if you have muscle weakness." d. "Confusion is common during this process."

b. "Plan to taper the dose slowly over several months." The nurse should instruct the client to plan to taper the alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal.

A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this medication? a. Reduces the frequency of attacks b. Reverses bronchospasm c. Prevents inflammation d. Decreases chronic manifestations

b. Reverses bronchospasm The nurse should identify that the expected outcome of a short-acting beta2-agonist is reversal of bronchospasm. Short-acting beta2-agonists bind to beta2-adrenergic receptors in the lungs, resulting in relaxation of bronchial smooth muscles.

*The nurse is caring for a client who has a suspected adrenal insufficiency. Which of the following medications should the nurse anticipate the provider using to determine the presence of adrenal insufficiency? a. Prednisone b. Cosyntropin c. Dexamethasone d. Ketoconazole

b. cosyntropin The nurse should expect the provider to use cosyntropin to determine if the client has adrenal insufficiency. The client is monitored after the provider injects cosyntropin to see if the cortisol level rises above 20 mcg/dL. If the adrenal response causes the cortisol level to elevate, the response is considered to be within the expected reference range. If the cortisol level does not elevate, the provider should determine that the client has adrenal insufficiency.

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? a. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." b. "I can develop lithium toxicity if I eat foods with lots of sodium." c. "I can develop lithium toxicity if I experience vomiting or diarrhea." d. "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

c. "I can develop lithium toxicity if I experience vomiting or diarrhea." Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decrease, lithium is retained by the kidneys, and the risk of lithium toxicity increases.

A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication? a. GFR < 60 b. ALT 82 units/L c. Anorexia and weakness d. Varicose veins in the lower extremities

c. Anorexia and weakness The nurse should identify adrenal insufficiency as an adverse effect of the long-term use of an inhaled corticosteroid such as fluticasone. Manifestations can include anorexia, weakness, nausea, hypotension, and hypoglycemia.

*A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests? a. Platelet count b. Electrolyte levels c. Thyroid function d. Liver function

d. Liver function Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function.

A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg 3 times daily PO and gabapentin 1,800 mg 3 times daily PO to manage pain. The client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." Which of the following additions should the nurse anticipate to the client's medication regimen? a. Oral meperidine b. Parenteral naloxone c. Parenteral diazepam d. Oral oxycodone

d. Oral oxycodone The client's current pain regimen consists of a nonopioid analogies (naproxen) and an adjuvant medication for neuropathic pain (gabapentin). According to the WHO analgesic ladder for cancer pain management, the next addition to the pain regimen is an opioid for moderate pain. Oxycodone is an oral opioid that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client's pain regimen

A nurse in an acute care facility is preparing a reconciled list of medications for a client who is being discharged home. Which of the following actions should the nurse take? a. Give the client a handwritten medication list to take to the next care provider following discharge b. Include a list of medications the client received during care at the facility c. Inform the client that he can get a complete list of his medications from the provider who will be caring for him after discharge d. Provide the client and the next care provider with a list of medications the client will take after discharge

d. Provide the client and the next care provider with a list of medications the client will take after discharge The nurse should provide a reconciled medication list that includes any medications the provider prescribes at the time of discharge for the client to take after discharge. The list should also include any other medications the client will be takin, including over-the-counter medications and supplements. If the client was taking other prescription medications before admission to the acute-care facility and did not receive them during treatment in the facility, the provider should confirm whether the client should resume taking them after discharge.

A nurse is preparing to administer 8,000 units subcutaneously every 8 hr. Heparin 10,000 units/1 mL is available. How many mL should the nurse administer per dose?

0.8 mL

A nurse is preparing to administer digoxin 0.2 mg via IV bolus to a client. The amount available is digoxin 0.25 mg/1 mL. How many mL should the nurse administer?

0.8 mL

A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 mL. How many mL should the nurse plan to administer per dose?

10 mL

A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose?

2 tablets

The nurse is preparing to administer verapamil 5.5 mg via IV bolus to a client who has hypertension. The amount available is verapamil 2.5 mg/mL. How many mL should the nurse administer?

2.2 mL

A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose?

5 mL

*A nurse is providing teaching to a client with asthma who has a new prescription for a short-acting beta-2 agonist (SABA) bronchodilator. Which of the following pieces of information should the nurse share? a. The SABA will provide prolonged control of asthma attacks b. SABAs are also available in an oral form c. The SABA will have to be taken with an inhaled glucocorticoid d. Notify the provider if the SABA is needed more than twice per week

SABA bronchodilators are used as a PRN rescue medication to stop an ongoing asthma attack. If the client requires the SABA more than twice per week, the provider should be notified because a prescription for a long-acting beta-2 agonist (LABA) might be required. Using a SABA more than twice per week can lead to serious adverse effects.

A nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. Which of the following findings should the nurse identify as an adverse effect of receiving this medication? a. Bleeding b. Increased clot formation c. Shortness of breath d. Blockage of the central venous catheter

a. Bleeding The nurse should identify that an adverse effect of alteplase is bleeding. Severe bleeding can occur as a result of the alteplase-plasminogen complex, which catalyzes the conversion of other plasminogen molecules that digest fibrin clots. This action of the medication can contribute to hemorrhage.

A nurse is caring for a client who has a prescription for a QT interval medication. Which of the following conditions should the nurse identify as an adverse effect of this medication? a. Bradycardia b. Jaundice c. Low blood pressure d. Dark urine

a. Bradycardia The nurse should identify that an adverse effect of a QT interval medication is bradycardia. This medication should be used with caution for clients who have hypotension or heart failure, older adult clients, or clients who have low potassium or magnesium levels.

A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? a. Nitroglycerin b. Aspirin c. Morphine d. Metoprolol

b. Aspirin Aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect. The client should chew the first dose of aspirin to allow rapid absorption.

*A nurse is caring for a client who receives gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously? a. 0600 b. 0630 c. 0645 d. 0730

c. 0645 Lispro is a rapid-acting insulin with an onset of 15 minutes. The nurse should administer the insulin dose 15 minutes prior to the feeding.

*A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? a. Ibuprofen b. Naproxen c. Aspirin d. Acetaminophen

d. Acetaminophen Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding.

*A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe UTI. The client asks why both medications are needed. Which of the following responses should the nurse make? a. "Phenazopyridine decreases the adverse effects of ciprofloxacin hydrochloride." b. "Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy." c. "The use of phenazopyridine allows the doctor to prescribe a lower dosage of ciprofloxacin hydrochloride." d. Ciprofloxacin hydrochloride treats the infection, and phenazopyridine treats pain."

d. Ciprofloxacin hydrochloride treats the infection, and phenazopyridine treats pain." Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic, and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation.

*A nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. Which of the following pieces of information should the nurse include? a. "A full therapeutic response may take several months to happen." b. "The medication should be taken with high-protein foods." c. "A full therapeutic response might cause vivid dreams." d. "The medication is given at the onset of mild symptoms."

a. "A full therapeutic response may take several months to happen." The nurse should inform the family member that although levodopa is the most effective medication for Parkinson's disease, a full therapeutic response might not occur for several months.

A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? a. Aspirin EC 325 mg per NG tube daily b. Atorvastatin 40 mg per NG tube daily c. Propranolol 20 mg per NG tube daily d. Sucralfate 2 g oral suspension per NG tube BID

a. Aspirin EC 325 mg per NG tube daily The nurse should clarify the prescription for aspirin EC 325 mg per NG tube daily, as enteric-coated tablets should not be crushed.

A nurse is completing the admission history for a client who reports drinking 1 pint of whiskey every day for 6 years. The client's last drink was 10 hr ago. Which of the following medications should the nurse plan to administer upon admission? a. Chlordiazepoxide b. Disulfiram c. Naloxone d. Acetaminophen

a. Chlordiazepoxide The nurse should anticipate the client will experience manifestations of alcohol withdrawal. Benzodiazepines are the most effective medications used to facilitate alcohol withdrawal, and chlordiazepoxide is preferred because it has a longer half-life than other benzodiazepines. Benzodiazepines are safe and can stabilize vital signs, reduce the intensity of symptoms, and decrease the risk of seizures and delirium tremens.

A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority? a. Paresthesia b. Alopecia c. Stomatitis d. Constipation

a. Paresthesia The greatest risk to this client is neurotoxicity. Vincristine, a cell-cycle specific chemotherapy agent, interrupts cellular reproduction at mitosis and can cause neurotoxicity. An early finding of neurotoxicity is paresthesia (numbing) of the peripheral extremities. As neurotoxicity progresses, the client can develop autonomic and central nervous system dysfunction. The nurse should report paresthesia immediately, as the provider might change the dosage or the therapy.

*A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta2-agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? a. Restricted dosage flexibility b. Complicated delivery device c. Serious systemic effects d. Limited efficacy over time

a. Restricted dosage flexibility The nurse should identify that a disadvantage of an inhaled glucocorticoid and a long-acting beta2-agonist being combined is that the dosages of these medications are fixed, so the dose cannot be adjusted.

A nurse is caring for a school-aged child who has cystic fibrosis and has been using a corticosteroid inhaler for long-term treatment. Which of the following findings should then nurse identify as an adverse effect of long-term use of this medication? a. Small stature for age b. Decreased weight c. Poor dentition d. Atrophied muscles

a. Small stature for age The nurse should identify that an adverse effect of the long-term use of inhaled glucocorticoids can be a slowing in the rate of growth in children.

A nurse is providing teaching for a client who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus. Which of the following instructions should the nurse include in the teaching? a. "Take both medications together for 72 hr and then stop taking the cyclosporine." b. "Stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus." c. "Alternate taking the medications for 48 hr and then take only the tacromilus." d. "If adverse reactions to the tacromilus occur, stop taking it and restart the cyclosporine."

b. "Stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus." The nurse should instruct the client that these medications should not be taken concurrently due to the increased risk of developing nephrotoxicity. The client should stop cyclosporine for 24 hours prior to beginning the tacrolimus prescription.

A nurse is teaching about taking donepezil with a client who was recently diagnosed with early Alzheimer's disease. Which of the following instructions should the nurse include in the teaching? a. "You should chew the medication thoroughly prior to swallowing." b. "You should take this medication late in the evening." c. "You should take this medication with food." d. "If you miss taking a dose for a day, take 2 doses the following day."

b. "You should take this medication late in the evening." The nurse should instruct the client to take donepezil late in the evening, just before going to bed.

*A nurse is performing a preoperative assessment of a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? a. Soy b. Garlic c. Black cohosh d. Green tea

b. Garlic Many dietary supplements can affect clotting or interact with other medications that affect clotting, thereby increasing the client's risk of bleeding. Examples of these dietary supplements include garlic, ginger, and ginkgo blob. The nurse should notify the provider immediately about this potential risk.

*A nurse is reviewing the medical record of a client who has been taking a vitamin D supplement. Which of the following findings from the client's record should the nurse identify as a risk factor for developing vitamin D deficiency? a. Middle-age b. Obesity c. Dark-colored eyes d. Light-pigmented skin

b. Obesity Then nurse should identify that a client who is obese is at risk for vitamin D deficiency. A screening can be prescribed to determine if a deficiency is present.

*A nurse is caring for a client who is taking glucocorticoids. Then nurse should monitor the client for which of the following adverse effects of the medication? a. Weight loss b. Peptic ulcer c. Hyperkalemia d. Diplopia

b. Peptic ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black or tarry stools occur.

*A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? a. "I will administer a spray into each nostril daily." b. "I should expect nasal bleeding for the first week." c. "I will need to depress the side arms to activate the pump." d. "I should expect to take this medication for a short-term course of treatment."

c. "I will need to depress the side arms to activate the pump." The nurse should instruct the client to activate the pump for the initial use by holding the bottle upright and depressing both white side arms toward the bottle 6 times.

A nurse is assessing an infant during a routine checkup. The parent asks the nurse about the infant's immunization schedule. Which of the following responses should the nurse make? a. "Immunizations for children are recommended to start at the age of 2." b. "If your child misses an immunization, she should restart a new schedule." c. "It is recommended that your infant receives 6 immunizations at 2 months of age." d. "The recommended immunization schedule can be customized to fit your child's needs.

c. "It is recommended that your infant receives 6 immunizations at 2 months of age." An infant who is 2 months of age should receive 6 immunizations, followed by 5 immunizations at 4 months of age. The monovalent hepatitis B vaccine is administered within 12 hours of the infant's birth.

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and has been prescribed omeprazole. Which of the following statements should the nurse include in the teaching? a. "You will need to take this medication for the next 6 months." b. "Taking this medication will decrease your risk of acquiring pneumonia." c. "You should take this medication before breakfast every day." d. "Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medication."

c. "You should take this medication before breakfast every day." Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food.

*A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? a. Thirst b. Nocturia c. Headache d. Heart palpitations

c. Headache Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.

*A nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly. Which of the following findings should the nurse plan to evaluate first? a. Pain at the injection site b. Prolonged motor dysfunction c. Laryngeal edema d. Temperature 37.6 C (99.7 F)

c. Laryngeal edema When using the urgent vs non urgent approach to client care, the nurse should determine that the priority finding is laryngeal edema, which can indicate the client is experiencing an allergic reaction to penicillin G. The nurse should also consider that the client is experiencing an anaphylactic reaction, which can be life-threatening. Anaphylaxis is an immediate hypersensitivity reaction that requires the primary treatment of epinephrine in addition to respiratory support.

*A nurse is caring for a client who was brought to the emergency department by friends after a reported heroin overdose. Which of the following findings should the nurse expect to assess? a. Temperature 39.2 C (102.6 F) b. RR 30/min c. Pinpoint pupils d. Severe abdominal cramping

c. Pinpoint pupils Pinpoint pupils are an expected finding in opioid toxicity. Increased pupil size is seen in opioid withdrawal.

*A nurse is providing teaching to the parents of a child who has a new prescription for lamotrigine for a seizure disorder. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? a. Diplopia b. Dizziness c. Rash d. Headache

c. Rash The greatest risk to this client is an injury from Stevens-Jonson syndrome or toxic epidermal necrolysis, which are life-threatening reactions that manifest initially as a rash in the first 2 to 8 weeks of treatment with lamotrigine. The nurse should instruct the parents to report a rash immediately to the provider.

A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following laboratory values related to this medication should indicate to the nurse that the treatment is effective? a. Increased AST b. Decreased ALT c. Increased PTT d. Decreased serum ammonia

d. Decreased serum ammonia The nurse should identify that lactulose is a laxative that can be used for chronic liver disorders such as cirrhosis. Lactulose improves the client's condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that it can be eliminated from the body.

A nurse is teaching a client who has severe chronic gout and a new prescription for pegloticase. The client has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase? a. "You will take this medication along with allopurinol." b. "You will take this medication by mouth." c. "There are very few adverse effects of this medication." d. If you experience a flare-up, you can take an NSAID while receiving this medication."

d. If you experience a flare-up, you can take an NSAID while receiving this medication." The nurse should instruct this client who has chronic gout that, during the first few months of treatment, an increase in gout manifestations is expected. To reduce the intensity of these manifestations, clients are instructed to take an NSAID such as naproxen.

A nurse is caring for a client who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should identify that which of the following is the therapeutic effect of this medication? a. Improves oxygen saturation rate b. Decreases elevated blood pressure c. Reduces heart rate d. Improves cardiac output

d. Improves cardiac output The nurse should identify that dobutamine is a vasopressor that improves cardiac output and hemodynamic status in clients.

*A nurse is teaching a client who has a prescription for a transdermal estradiol patch. In which of the following locations should the nurse instruct the client to apply the patch? a. Abdomen b. Breast c. Forearm d. Back of the thigh

a. Abdomen The nurse should instruct the client to apply the transdermal estradiol patch to the skin of the trunk but not the breasts. This allows the estrogen from the patch to be absorbed through the skin directly into the client's blood.

A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for isoniazid. Which of the following laboratory values should be monitored while the client is taking isoniazid? a. TSH b. AST c. Potassium d. Sodium

b. AST Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colors urine, or other findings indicating hepatitis.

A nurse is teaching to a client who has systemic lupus erythematosus about a new prescription for oral glucocorticoid therapy. Which of the following client statements indicates an understanding of the teaching? a. "I should take a calcium supplement while on this medication." b. "Regular liver function studies will have to be done while I am taking this medication." c. "I can take NSAIDs to treat mild pain while using this medication." d. "I will be sure to eat 6 small meals a day to prevent hypoglycemia from this medication."

a. "I should take a calcium supplement while on this medication." An adverse effect of systemic glucocorticoid therapy is osteoporosis. Increasing calcium-rich foods in the diet and adding calcium and vitamin D supplements should be encouraged to prevent osteoporosis and decrease the risk of fractures.

*A nurse is teaching a client who has osteoporosis about a new prescription for risedronate. Which of the following client statements indicates an understanding of the teaching? a. "I will take this medication with a full cup of water." b. "I will lie down after I take this medication. c. "I will take this medication with food." d. "I will take this medication at bedtime."

a. "I will take this medication with a full cup of water." The nurse should instruct the client that risedronate should be taken with at least 180 to 240 mL of water.

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? a. Increases blood pressure b. Prevents esophageal bleeding c. Decreases heart rate d. Reduces ammonia levels

d. Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.