pharm exam 4
A nurse is caring for a client who is HIV positive and is started on zidovudine (AZT). The nurse should monitor the client for which of the following life-threatening side effects of this medication?
Aplastic anemia
A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?
"Crushing the medication might cause you to have a stomachache or indigestion."
A nurse is caring for a client diagnosed with thrombophlebitis who has a swollen and inflamed right calf. The client is started on a continuous heparin infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
"Heparin does not dissolve clots, it stops new clots from forming."
A nurse is assessing a client who has numerous bruises on his upper extremities. The client reports that he has taken warfarin (Coumadin) daily for the past 3 months. Which of the following statements by the client indicates the client needs further teaching?
"I have started taking ginger root to treat my joint stiffness."
A nurse is providing discharge teaching to a client who will be taking warfarin (Coumadin) at home. Which of the following statements indicates that the client understands the effects of this medication?
"I'll use my electric razor for shaving."
A nurse is teaching a client who is about to start therapy with alendronate (Fosamax) to treat osteoporosis. Which of the following adverse effects should the nurse instruct the client to report?
"Jaw pain, blurred vision, dysphagia"
A nurse at a family practice clinic receives a call from a client who is taking oral contraceptives but forgot to take one oral contraceptive pill. which of the following instructions should the nurse give her?
"Take the missed dose along with the next dose."
A nurse is caring for a client who is taking ferrous sulfate (Feosol) tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider suggested that she take the ferrous sulfate with orange juice. Which of the following is an appropriate response by the nurse?
"The orange juice will help you absorb the medication more efficiently."
A nurse is preparing to administer blood to a client. As the nurse begins to check the 1st unit with another nurse, she notices that the unit of blood is type B and the client's blood type is AB. Which of the following actions should the nurse take?
Administer the blood as ordered
A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?
Alendronate
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?
An excess amount of doxorubicin can lead to cardiomyopathy
A client who is postoperative following a transurethral resection of the prostate (TURP) has a new prescription for bethanechol (Urecholine) PRN. The nurse should administer this medication if the client reports?
An inability to void.
A nurse is discussing with a newly licensed nurse the information that should match on the requisition and the blood product prior to administration. Which of the following statements by the newly licensed nurse necessitates intervention? "Both the requisition and the blood product should identify the
Blood bank of origin
A nurse in a regional oncology center is recording the dose of doxorubicin (Adriamycin) that a client receives with each visit. The nurse should know that this medication has a maximum lifetime cumulative dose range due to the risk for irreversible
Cardiomyopathy
A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums?
Check the value of the client's current platelet count
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following techniques should the nurse use?
Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding.
A nurse is educating a group of clients about contraindications of warfarin therapy. which of the following statements is appropriate to include in the teaching?
Clients who are pregnant should not take coumadin
A nurse is teaching a patient who has rheumatoid arthritis about taking methotrexate (Rheumatrex). The nurse should tell the patient to
Drink 2 to 3 L of water per day to promote its excretion.
A nurse is completing a medication history for a client who reports using over-the-counter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?
Drink a glass of water after taking the medication
A nurse is providing discharge teaching for a client who has a new prescription for warfarin sodium (Coumadin). Which of the following should the nurse include in the teaching?
He should use an electric razor while on this medication.
A nurse is caring for a client who has a hip fracture. The nurse should expect the provider to prescribe which of the following medications for prophylactic anticoagulant therapy?
Heparin
A nurse is preparing to administer heparin to a client via the deep subcutaneous (intrafat) route. Which of the following is an appropriate action for administering this medication?
Inject the medication into the abdomen above the level of the iliac crest.
A nurse is caring for a client who has chronic renal disease and is receiving epoetin alfa (Epogen) therapy. The nurse should instruct the client to increase dietary consumption of
Iron
A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?
Isosorbide
A nurse is assessing a client who comes to the clinic for a seasonal influenza vaccine. The client says he read about an influenza vaccine that is given as a nasal spray and wants to receive it. Which of the following is a contraindication for the client to receiving the live attenuated influenza vaccine (LAIV)?
Just turned 62
A nurse is caring for a client who has prostate cancer. The nurse should expect the provider to prescribe which of the following medications for this client?
Leuprolide (Lupron)
Whenever a nurse is caring for clients who are receiving heparin, which of the following medications should the nurse have on hand in the event of an overdose?
Protamine
A nurse is caring for a client who has osteoporosis and is taking a calcium supplement. When the client tells the nurse she has been having some flank pain. which of the following adverse effects should the nurse suspect?
Renal stones
A nurse is talking with a group of young women about the use of oral contraceptives. The nurse should point out that taking which of the following herbal preparations reduces the effectiveness of this birth control method?
St. John's wort
A nurse is monitoring a client's transfusion of packed red blood cells and suspects that a hemolytic reaction is occurring. Which of the following is the priority intervention?
Stop the transfusion
Whenever a nurse is caring for clients who are receiving warfarin (Coumadin), which of the following medications should the nurse have on hand in the event of an overdose?
Vitamin K
A nurse is caring for a client who is hospitalized with deep vein thrombosis and has been on IV heparin for 5 days. The provider prescribes oral warfarin (Coumadin) without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate nursing response?
"The Coumadin takes several days to work so the IV heparin will be used until the coumadin reaches a therapeutic level."
A client is to receive a unit of packed red blood cells. The nurse should prime the blood administration tubing using which of the following IV solutions?
0.9% Sodium Chloride
A client who is postoperative is receiving IV fluids and a unit of whole blood. The nurse should observe the client for which of the following as an early sign of circulatory overload?
Dyspnea
A nurse is caring for a client who has thrombophlebitis and is receiving continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?
Protamine Sulfate
A client provides a nurse with a list of home medications. Which of the following should the nurse recognize as incompatible?
Warfarin sodium (Coumadin) and multivitamins
A nurse is caring for a client who reports occasionally self-medicating with an over-the-counter calcium carbonate antacid. To avoid the adverse effects of calcium carbonate, the nurse should recommend that the client take this medication with
Water
A nurse is teaching a client who is about to start therapy with methotrexate (Rheumatrex) to treat rheumatoid arthritis. Which of the following instructions should the nurse include? (Select all that apply.)
✓ Do not drink alcoholic beverages. ✓ Report unexplained bruising to the provider. ✓Avoid people who have infections.
A charge nurse is evaluating the care of a newly licensed nurse as he cares for a client who is receiving a transfusion of packed RBC. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the newly licensed nurse requires intervention by the charge nurse?
The nurse starts the transfusion of another unit of blood product.
