Pharm Exam 3 ATI questions

A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse plan to administer? A. Vitamin K B. Atropine C. Protamine D. Calcium gluconate

C. Protamine

A nurse caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications? A. uncontrolled bleeding B. myocardial infarction C. respiratory depression D. decreased renal perfusion

A. uncontrolled bleeding

A nurse is assessing a client who has chronic neutropenia and has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim? A. Assess for bone pain B. Assess for right lower quadrant pain C. Auscultate for crackles at the base of the lungs D. Auscultate the chest to listen for a heart murmur

A. Assess for bone pain

A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? A. Avoid driving until the drug's effects are evident B. Stop taking the drug immediately if headache occurs C. Take the drugs as needed for spasticity D. Take the drug with antacids to reduce gastric effects

A. Avoid driving until the drug's effects are evident

A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? A. Begin taking the drug at a low dosage B. Discontinue the drug immediately if diarrhea occurs C. Have serum glucose levels checked regularly D. Take on an empty stomach

A. Begin taking the drug at a low dosage

A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? A. Change position slowly to prevent orthostatic hypotension B. Eat a high-protein snack to increase absorption C. Take the drug at bedtime to avoid daytime drowsiness D. Expect eye twitching to develop with long-term therapy

A. Change position slowly to prevent orthostatic hypotension

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than 60/min B. Check pulse rate for 30 seconds and multiply by 2 C.Increase intake of sodium D.Take with food if nausea occurs

A. Contact provider if heart rate is less than 60/min

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug? A. Headache B. Constipation C. Hypertension D. Hyperglycemia

A. Headache

A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following adverse effects? A. Hypertension B. Muscle pain C. Edema D. Dry mouth

A. Hypertension

A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin. Which of the following findings should the nurse identify as a possible indication of hemorrhage? A. Rapid pulse B. Yellowing of the sclera C. Elevated blood pressure D. Pale-colored stools

A. Rapid pulse

a nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions? A.Acute myocardial infarction B.Peripheral vascular disease C.Ulcerative Colitis D.Ventricular tachycardia

A. acute myocardial infarction

A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A."Remove the prior dose before applying a new dose" B."Rub the ointment directly into your skin until it is no longer visible" C."Cover the applied ointment with a clean gauze pad" D."Apply the ointment to the same skin area each time"

A."Remove the prior dose before applying a new dose"

A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A.Remove the patch each evening B.Cut each patch in half if angina attacks are under control C.Take off the nitroglycerin patch for 30 min if headache occurs D.Apply a new patch every 48 hrs

A.Remove the patch each evening

A charge nurse is planning a staff education session to discuss the medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? SELECT ALL THAT APPLY A.Lorazepam B.Diazepam C.Disulfiram D.Naltrexone E.Acamprosate

AB A.Lorazepam B.Diazepam

A nurse is teaching a client about taking ferrous sulfate to treat iron-deficiency anemia. Which of the following instructions should the nurse include? (SELECT ALL THAT APPLY) A. Eat iron-enriched food B. Spread the dosage across each day C. Take the drug on an empty stomach D. Report dark green or black stools E. Increase dietary fiber intake

ABCE A. Eat iron-enriched food B. Spread the dosage across each day C. Take the drug on an empty stomach E. Increase dietary fiber intake

A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client to have which of the following blood laboratory tests completed periodically? (SELECT ALL THAT APPLY) A. Thrombocyte count B. Glucose C. Amylase D. Liver function tests E. Potassium

ACD A. Thrombocyte count C. Amylase D. Liver function tests

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? SELECT ALL THAT APPLY A. Fatigue B. Constipation C. Anorexia D. Rash E. Blurred Vision

ACE A. Fatigue C. Anorexia E. Blurred Vision

A nurse is providing instructions to a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (SELECT ALL THAT APPLY) A.Incoordination B.Hypertension C.Pruritus D.Sleep driving E.Amnesia

ADE A.Incoordination D.Sleep driving E.Amnesia

A nurse is administering epoetin intravenously to a client who has renal failure. Which of the following actions should the nurse take? A. Shake the vial before using B. Administer IV bolus over 1-3 minutes C. Dilute the drug first with D5W D. Save the used vial for the next dose

B. Administer IV bolus over 1-3 minutes

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which of the following actions is the nurse's priority? A. Administer flumazenil B. Identify the client's level of orientation C. Infuse IV fluids D. Prepare the client for gastric lavage

B. Identify the client's level of orientation

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring? A. Serum potassium B. Liver function C. Serum sodium D. Thyroid function

B. Liver function

A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid an phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs? A. Hyperammonemia B. Phenytoin toxicity C. Hypertension D. Peptic ulcer disease

B. Phenytoin toxicity

A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The client asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A."Take two more sublingual tablets at the same time" B."Call the emergency response team" C."Take a sustained-release nitroglycerin capsule" D."Wait another 5 minutes, then take the second sublingual tablet"

B."Call the emergency response team"

A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEq/L

C. Potassium 3.4 mEq/L

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take A.Expel the air bubble from the prefilled syringe before injecting it B.Insert the needle completely into the client's tissue C.Administer the injection in the client's thigh D.Aspirate carefully after inserting the needle into the client's skin

B.Insert the needle completely into the client's tissue

A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity A.Phenytoin B.Verapamil C.Warfarin D.Aluminum hydroxide

B.Verapamil

A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? SELECT ALL THAT APPLY A. "This medication can be safely taken during pregnancy" B. "Eliminate grapefruit juice from you diet" C. "You will need to have a complete blood count and carbamazepine levels drawn periodically" D. "Notify your provider if you develop a rash" E. "Avoid driving for the first few days after starting this medication"

BCDE B. "Eliminate grapefruit juice from you diet" C. "You will need to have a complete blood count and carbamazepine levels drawn periodically" D. "Notify your provider if you develop a rash" E. "Avoid driving for the first few days after starting this medication"

A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (SELECT ALL THAT APPLY) A. Hypertension B. Coffee-ground emesis C. Tinnitus D. Paresthesias of the extremities E. Nausea

BCE B. Coffee-ground emesis C. Tinnitus E. Nausea

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (SELECT ALL THAT APPLY) A. Leukocytosis B. Hypertension C. Edema D. Blurred Vision E. Headache

BE B. Hypertension E. Headache

A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider? A. Pancreatic cancer B. Hypotension C. Cirrhosis D. Osteoporosis

C. Cirrhosis

A nurse is monitoring a client following ferrous sulfate administration. The nurse should monitor the client for which of the following adverse effects? A. Phlebitis B. Dark, orange-colored stools C. Constipation D. Injection site pain

C. Constipation

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects? A. Slow heart rate B. Cough C. Diarrhea D. Hearing loss

C. Diarrhea

A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effets? A. Dusky nail beds B. Petechiae C. Enlarged spleen D. Swollen calf

C. Enlarged spleen

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective A. PT B. WBC C. Hgb D. Platelets

C. Hgb

A nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? A. Hirsutism B. Depression C. Jaundice E. Gum irritation

C. Jaundice

A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? A. Neostigmine B. Succinylcholine C. Naloxone D. Dantrolene

C. Naloxone

A nurse is caring for a client who is taking donezepil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? A. Confusion B. Dry mouth C. Nausea D. Double vision

C. Nausea

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? A. Migraine headaches B. Pancreatitis C. Second-degree AV block D. Angina pectoris

C. Second-degree AV block

A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein rich food B. Expect muscle twitching to occur C. Take this medication with food D. Anticipate relief of manifestations in 24 hrs

C. Take this medication with food

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is over-sedated. Which of the following medications should the nurse expect to administer to the client? A.Ketamine B.Naltrexone C.Flumazenil D.Fluvoxamine

C.Flumazenil

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following should the nurse include (SELECT ALL THAT APPLY) A. "Apply a new patch at the onset of anginal pain" B."Apply the patch to dry skin and cover the area with plastic wrap" C."Apply the patch to a hairless area and rotate sites" D."Apply a new patch when you start your day" E."Remove patches for 10-12 hours each day

CDE C."Apply the patch to a hairless area and rotate sites" D."Apply a new patch when you start your day" E."Remove patches for 10-12 hours each day

A nurse is teaching a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects. (SELECT ALL THAT APPLY) A. Hirsutism B. Drowsiness C. Headache D. Ataxia E. Rash

CE C. Headache E. Rash

A nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include? A. Increase fluid intake to improve renal excretion B. Report memory loss or confusion C. Watch for signs of liver impairment, such as jaundice and abdominal pain D. Avoid taking over-the-counter antacids

D. Avoid taking over-the-counter antacids

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? A. Monitor for constipation B. The dosage will be increased weekly to provide optimum therapeutic effect C. Administering the drug first thing in the morning promotes effectiveness D. Avoid the use of NSAIDS for pain

D. Avoid the use of NSAIDS for pain

A nurse is caring for a client who is taking ferrous sulfate to treat iron-deficiency anemia and develops iron toxicity. Which of the following drugs should the nurse expect to use to treat this complication? A. Flumazenil B. Acetylcysteine C. Naloxone D. Deferoxamine

D. Deferoxamine

A nurse is teaching a client who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug? A. Sleep modifications B. Fluid modifications C. Driving modifications D. Dietary modifications

D. Dietary modifications

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following actions should the nurse take? A. Administer IM in a large muscle to prevent injury B. Ensure that medication is refrigerated until just prior to administration C. Shake vial gently to mix well before withdrawing dose D. Discard vial after removing one dose of the medication

D. Discard vial after removing one dose of the medication

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levadopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? A. Increases available acetylcholine int he brain B. Inhibits norepinephrine metabolism in the brain C. Inhibits serotonin metabolism in the brain D. Increases available dopamine in the brain

D. Increases available dopamine in the brain

A nurse who is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? A. Activating thromboxane A2 B. Blocking adenosine diphosphate receptor agonists C. Suppressing specific clotting factors D. Inhibiting cyclooxygenase action in platelets

D. Inhibiting cyclooxygenase action in platelets

A nurse is in an emergency department assessing a client who has been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer? A. Filgrastim B. Deferoxamine C. Protamine D. Vitamin K

D. Vitamin K

A nurse is caring for a client who has a prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? A.Tachycardia B.Dehydration C.Diarrhea D.Hypotension

D.Hypotension

A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A.Bruising B.Report of metallic taste C.Muscle Pain D.Report of anorexia

D.Report of anorexia