PHARM ATI QUIZ BANK

A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? A. Regular insulin B. Insulin lispro C. Insulin aspart D. Insulin glargine

Correct Answer: A. Regular insulin Treatment for diabetic ketoacidosis is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.

A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care? A. The client must sign an agreement with the provider before beginning alosetron. B. The client must stop taking alosetron if diarrhea continues for 1 week after beginning the medication. C. The client should expect to have a slower heart rate while taking alosetron. D. The client should use a barrier birth control method because alosetron interacts with oral contraceptives.

Correct Answer: A. The client must sign an agreement with the provider before beginning alosetron. Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron.

A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. The nurse should identify which of the following laboratory results as supporting the administration of this medication? A. Thyroid-stimulating hormone (TSH) 8 microunits/mL B. Free triiodothyronine (T3) 300 pg/dL C. Free thyroxine (T4) 7 mcg/dL D. Thyroxine-binding globulin 2.3 mg/dL

Correct Answer: A. Thyroid-stimulating hormone (TSH) 8 microunits/mL The expected reference range for TSH is 0.3 to 5 microunits/mL. 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 providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Take ibuprofen as needed for headaches or other minor pains B. Carry a medical alert ID card C. Report to the laboratory weekly to have blood drawn for aPTT D. Increase intake of dark green vegetables

Correct Answer: B. Carry a medical alert ID card A client who is taking warfarin is at increased risk for bleeding. In the case of an emergency, any medical personnel must be aware of the client's medication history.

A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor the client? A. Insomnia B. Diarrhea C. Joint pain D. Polycythemia

Correct Answer: B. Diarrhea The most common adverse effects of acarbose, an alpha-glucosidase inhibitor, are gastrointestinal. They include diarrhea, abdominal distention and cramping, and flatulence.

A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together. B. Stop taking the herbal supplement while taking the medication. C. Take the herbal supplement and the medication at least 2 hr apart. D. Take an antacid with both the herbal supplement and the medication.

Correct Answer: B. Stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and the herbal supplement St. John's wort increases the client's risk of serotonin syndrome.

A nurse is teaching a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long-term therapy. The nurse should instruct the client to report which of the following as an adverse effect of prednisone? A. Thrombosis B. Immunosuppression C. Gastric ulceration D. Liver toxicity

Correct Answer: C. Gastric ulceration The nurse should instruct the client to monitor for gastric ulceration as an adverse effect of the long-term use of prednisone. Other adverse effects of this medication include osteoporosis and adrenal suppression.

A nurse is caring for a client who was recently diagnosed with Addison's disease and has been placed on long-term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy? A. Mineralocorticoids help the body metabolize carbohydrates, fats, and proteins. B. Mineralocorticoids support secondary sexual development. C. Mineralocorticoids maintain electrolyte and fluid balance. D. Mineralocorticoids reduce the risk of cardiac dysrhythmias.

Correct Answer: C. Mineralocorticoids maintain electrolyte and fluid balance. Mineralocorticoids (specifically aldosterone) are necessary for the regulation of fluid and electrolyte balance (particularly for sodium, potassium, and water). Addison's disease results in a deficiency of cortisol and aldosterone production and requires supplementation with glucocorticoids and mineralocorticoids. Fludrocortisone is the only mineralocorticoid available.

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect? A. Hypotension B. Tinnitus C. Urinary retention D. Chest pressure

Correct Answer: D. Chest pressure A client who takes sumatriptan can develop sensations of chest pressure and heavy arms. The nurse should monitor the client; if the chest pressure continues, the nurse should notify the provider. About 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve.

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse requires intervention? A. Instructing the client to administer a PCA dose prior to a dressing change B. Providing increased fluids while the client is using the PCA pump C. Informing the client's partner that only the client should administer the PCA doses D. Maintaining the client on bed rest while the PCA pump is in use

Correct Answer: D. Maintaining the client on bed rest while the PCA pump is in use Use of a PCA pump does not prevent ambulation following surgery. Early ambulation should be encouraged. The nurse should instruct the client to sit at the side of the bed prior to standing to reduce the risks of orthostatic hypotension and falls.