Pharm Final
7. The nurse is giving an intravenous dose of levothyroxine. The order reads: "Give 0.1 mg IV push now." What is the ordered dose in micrograms?
100
Which information would the nurse provide to a patient who will self-administer an antiepileptic agent for the first time at home? 1 "Do not take the medication if you have a fever." 2 "Lie in bed for at least an hour after taking your medication." 3 "Wait to see how you react to the medication before driving." 4 "Take the antiepileptic agent with milk or juice to prevent stomach upset."
3
7. A patient is to receive filgrastim after therapy with carmustine and radiation therapy for treatment of a brain tumor. The patient weighs 132 lb. The protocol that the oncologist has written states that the filgrastim will be dosed at 5 mcg/kg/day. Filgrastim comes in a 300-mcg/mL vial. What dose will the patient receive? How many milliliters will the patient be given?
300 1
A nurse is teaching a client who is receiving methotrexate for non-Hodgkin lymphoma. Which of the following instructions should the nurse include? A "Drink 2 to 3 L of fluid per day." B "Avoid grapefruit juice while taking this medication." C "Expect bruising while taking this medication." D "Weigh yourself 2 times per week."
A
A nurse is caring for a client who requests information on the use of feverfew. Which of the following responses should the nurse make? A "It is used to treat skin infections." B "It can decrease the frequency of migraine headaches." C "It can lessen the nasal congestion in the common cold." D "It can relieve nausea of morning sickness during pregnancy."
B
A nurse is reviewing a client's current medications. The client states, "I also take ginkgo biloba." Which of the following medications has the potential to interact with ginkgo biloba? A Acetaminophen B Warfarin C Digoxin D Lisinopril
B
1. A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? a. A beta agonist, such as albuterol b. A leukotriene receptor antagonist, such as montelukast c. A corticosteroid, such as fluticasone d. An anticholinergic, such as ipratropium
a
2. After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is which of these? a. An expected adverse effect of the medication. b. An allergic reaction to the medication. c. An indication that he has received an overdose of the medication. d. An idiosyncratic reaction to the medication.
a
3. Which response would the nurse expect to find in a patient with a phenytoin level of 25 mcg/mL? a. Ataxia b. Hypertension c. Seizures d. No unusual response; this level is therapeutic.
a
A client came to the walk-in clinic stating he was very depressed. The client stated he was taking St. John's Wort and wanted a prescription for depression to take with his herbal medication. What is the best response by the nurse? a. "You should never mix herbal and prescription medications for depression." b. "The healthcare provider will prescribe you something to take for depression along with your herbal medication." c. "How long have you taken St. John's Wort?" d. "How long have you experienced depression?"
a
A client is asking the nurse about some of the most common adverse reactions associated with taking glipizide. Which adverse reaction would the nurse emphasize as one of the most common? a. Hypoglycemia b. Aplastic anemia c. Liver failure d. Weight loss
a
A client presents with mild joint pain and has been taking over the counter acetaminophen for his symptoms. The client has a history of alcohol abuse. Based on the current medication and social history of the client, which of the following is the client at risk of developing? a. Hepatotoxicity b. Reye's Syndrome c. Nephrotoxicity d. Diarrhea
a
A nurse is admitting a client to the hospital following acetaminophen toxicity. Which of the following medications should the nurse expect to administer to this client? A Acetylcysteine B Pegfilgrastim C Misoprostol D Naltrexone
a
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 in the bases of the lungs. D Auscultate the chest to listen for a heart murmur.
a
A nurse is reviewing the medical record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A Asthma B Glaucoma C Hypertension D Tachycardia
a
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 result by 2. C Increase intake of sodium. D Take with food if nausea occurs.
a
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 for at least 10 hr daily. B Cut each patch in half if angina attacks are under control. C Take off the nitroglycerin patch for 30 min if a headache occurs. DApply a new patch every 48 hr.
a
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
A nurse is teaching a client who is starting simvastatin. Which of the following information should the nurse include? A Take this medication in the evening. B Change position slowly when rising from a chair. C Maintain a steady intake of green leafy vegetables. D Consume no more than 1 L/day of fluid.
a
The 65 year old client with long term prednisone use presents to the clinic with complaints of blurry vision and sensitivity to light. Which side effect of prednisone is the client exhibiting? a. Steroid induced cataracts b. Steroid induced macular edema c. Steroid induced conjunctivitis d. Steroid induced hordeolum
a
The nurse is caring for a client in hypertensive crisis who has an order for nitroprusside. Which action should the nurse take first? a. Obtain an accurate weight b. Assess the client's ability to swallow c. Auscultate the client's lungs d. Obtain the client's temperature
a
The nurse is caring for a client receiving nitroglycerin. Which statement indicates that the client understands an important safety consideration related to this medication? a. "I cannot take my sildenafil while I am taking nitroglycerin." b. "This medication may increase my risk for bleeding." c. "I should call my doctor right away if I have a headache." d. "I will chew my nitroglycerin tablet if I experience chest pain."
a
The nurse is caring for a client who takes digoxin daily. Which client statement alerts the nurse to a potential problem related to digoxin? a. "It was harder for me to read the daily paper this morning." b. "I hear a high-pitched ringing sound in both of my ears." c. "My skin is itchy, and it seems to have a yellow tint." d. "My feet turn really pale when I elevate them in the bed."
a
What statement by the registered nurse (RN) best explains the action of alendronate to the client prescribed this for osteoarthritis? a. "This drug prevents bone breakdown and increases bone density." b. "This drug repairs all the decades of bone damage and makes the bones like new." c. "This drug will prevent the bones from breaking from any type of fall." d. "This drug inhibits osteoclast-mediated bone resorption."
a
What statement made by the client prescribed buspirone for the treatment of anxiety will the registered nurse (RN) provide further education? a. "This drug will begin relieving my anxiety within two days of beginning it." b. "This drug will work best if I take it with food instead of on an empty stomach." c. "It is not necessary for me to avoid the intake of alcohol while taking this drug." d. "This drug is safe to take as it does not cause increased sedation after taking."
a
What statement presented by the client prescribed albuterol for asthma will the registered nurse (RN) identify as an unexpected clinical manifestation of this drug? a. "I seem to have blurred vision anytime that I administer this drug to myself." b. "I have noticed that my heart feels like it is racing away after I take this drug." c. "Whenever I take this drug I notice that I just cannot fall asleep at night." d. "My hands get a little shaky after I take this drug, even if I take it just once."
a
When teaching a client how to take metoclopramide, which of the following should the nurse include? a. The client should take the medication 30 minutes to 1 hour before meals. b. The client should take the medication 1-2 hours after meals. c. The client should take the medication first thing in the morning after arising. d. The client should take the medication with meals and at bedtime.
a
When teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression? a. In the morning b. At lunchtime c. At dinnertime d. At bedtime
a
Which is the most appropriate timing regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient? a. Give it 15 minutes before the patient begins a meal. b. Give it ½ hour before a meal. c. Give it 1 hour after a meal. d. The timing of the insulin injection does not matter with insulin lispro.
a
Which laboratory result best indicates that lovastatin therapy has produced the most desired effect? a. HDL level of 95 mg/dL b. LDL level of 125 mg/dL c. Cholesterol level of 275 mg/dL d. Triglyceride level of 268 mg/dL
a
Which nursing action is priority for a teenage girl seeking isotretinoin treatment for severe acne? a. Obtain a pregnancy test b. Check for risks of epistaxis c. Perform hearing and balance tests d. Assure the client has plenty of contact lenses
a
Which of the following pharmacological therapies, used to treat clients with gastrointestinal reflux disease (GERD), reduces acid by blocking the histamine receptors in parietal cells? a. Famotidine b. Pantoprazole c. Magnesium hydroxide d. Sodium bicarbonate
a
Which of the following statements regarding the effects of antacids is an accurate description? a. Antacids work immediately to neutralize gastric acid and relief is short. b. Antacids take 1-2 days to neutralize gastric acid and relief is short. c. Antacids take 2-5 days to neutralize gastric acid and relief lasts one week. d. Antacids take one week to neutralize gastric acid and relief lasts one month.
a
Which teaching should the nurse include during client education about isotretinoin? a. Wear long sleeves when outdoors b. Discoloration of contacts can occur c. Report darkening of teeth d. Rotate injection sites each week
a
While obtaining a health history of a client diagnosed with breast cancer, what assessment finding will prompt the registered nurse (RN) to notify the healthcare provider (HCP) prior to initiation of tamoxifen drug therapy? a. past history of deep vein thrombosis b. current history of seasonal allergies c. current history of glaucoma d. past history of renal calculi
a
During an overdose of acetaminophen, which of the following labs must the nurse monitor? Select all that apply. a. Alanine transaminase (ALT) b. Aspartate transaminase (AST) c. Creatinine d. Glucose e. Erythrocytes
a,b
After obtaining a lab value of 26 mcg/dL for a phenytoin blood level, which clinical manifestation will the registered nurse (RN) identify as a sign of phenytoin toxicity? Select all that apply. a. incoordination with walking b. onset of slurred speech c. arm and hand tremors d. change in sense of taste e. increased hair growth
a,b,c
A 28-year-old female client was prescribed penicillin for a respiratory tract infection at the clinic today. What discharge teaching is imperative to provide to the client regarding penicillin? Select all that apply. a. Take all the medication prescribed even when you feel better. b. Use additional contraception while taking penicillin. c. Ensure the client is not allergic to penicillin. d. Take antibiotics with food or immediately after meals. e. Take each dose of the medication with grapefruit juice.
a,b,c,d
While assessing a client that has a diagnosis of bipolar disorder- manic episode whose drug plan includes haloperidol, which clinical manifestation requires the registered nurse (RN) to notify the healthcare provider immediately? Select all that apply. a. hyperpyrexia b. diaphoresis c. hypertension d. confusion e. hyporeflexia
a,b,c,d
The nurse is caring for a client with bacterial pneumonia. The healthcare provider ordered penicillin to be administered intravenously. Which of the following is important to monitor if the client has never taken penicillin in the past? Select all that apply. a. Monitor the client for an allergic reaction. b. Monitor the client for bleeding. c. Monitor vital signs especially respirations. d. Auscultate lung sounds. e. Keep epinephrine on hand.
a,b,c,d,e
While providing education to a client prescribed tamoxifen, the registered nurse (RN) will include which point? Select all that apply. a. "This drug is given over 5 to 10 years." b. "This drug must be taken each day as prescribed." c. "Stop the drug immediately if you experience weight gain." d. "Report if heavy vaginal bleeding occurs." e. "Report pain, tenderness, or hot area on the calves."
a,b,d,e
A nurse is caring for a client who has breast cancer. The client asks why the treatment plan contains a combination therapy of three different medications. Which of the following responses should the nurse make? Select all that apply. A "Combination chemotherapy decreases the risk of medication resistance." B "Combination chemotherapy attacks cancer cells at different stages of cell growth." C "Combination chemotherapy increases production of platelets." D "Combination chemotherapy stimulates the immune system." E "Combination chemotherapy reduces the risk of injury to healthy cells."
a,b,e
A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? Select all that apply. A Headache B Diarrhea C Shortened PR interval D Hyperglycemia E Prolonged QT interval
a,b,e
Which clinical manifestation assessed in a client taking methotrexate for the treatment of rheumatoid arthritis will the registered nurse (RN) report promptly to the healthcare provider? Select all that apply. a. a temperature of 100.8 F (38.2 C) b. petechiae noted on the lower legs bilaterally c. vomitus that is yellowish green in color d. lack of bowel movement for 48 hours e. presence of purpura on the low back and flanks
a,b,e
Which education point will the registered nurse (RN) provide the client prescribed an immunosuppressant? Select all that apply. a. "Use a soft bristled toothbrush and be gentle when brushing your teeth." b. "Notify the healthcare provider if you maintain a fever of 100.3 F (38 C) for more than 2 days." c. "Notify the healthcare provider if you notice blood in stool or from gums." d. "As long as the fresh flowers have been dipped in sugar water, you can keep them in your home." e. "It is important to remain current with all vaccinations, even while on this drug."
a,c
Mary is monitoring Ms. Young for manifestations of a potential allergic reaction to the nafcillin. For which of the following manifestations should Mary observe as an indication of anaphylaxis? Select all that apply. A Rash B Fever C Pruritis D Wheezing E Pain at injection site
a,c,d
Which educational point will the registered nurse (RN) provide to the client prescribed disulfiram after completion of alcohol withdrawal? Select all that apply. a. "This drug is beneficial in helping you not start drinking again." b. "This drug is also beneficial in helping you stop smoking." c. "Exposure to alcohol can cause you to experience nausea and vomiting." d. "Avoid exposure to any form of alcohol, even in common substances." e. "Exposure to alcohol can cause you to feel your heart rate slowing down."
a,c,d
A nurse is teaching 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 digoxin toxicity? Select all that apply. A Headache B Constipation C Anorexia D Rash E Blurred vision
a,c,e
A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following instructions should the nurse provide? Select all that apply. A Take medication in the morning before eating. B Chew tablets to increase bioavailability. C Drink an 8 oz glass of water with each tablet. D Take medication with an antacid if heartburn occurs. E Avoid lying down after taking this medication
a,c,e
After completing education to a client prescribed phenytoin, which statement made by the client indicates the need for further education by the registered nurse (RN)? Select all that apply. a. "It is good to know that once I don't have any seizures for 4 weeks, I can then stop the drug." b. "It will be necessary for me to use a different form of birth control other than oral contraceptives while on this drug." c. "I understand that I need to take calcium, folic acid, and vitamin D supplements while on this drug." d. "It is important that I brush my teeth with a hard bristle toothbrush so that I can toughen up the gums to prevent bleeding." e. "It is very important that I keep all appointments for blood draws and healthcare provider visits to regulate this drug."
a,d
While providing an education class, the registered nurse (RN) identifies which medical diagnosis as an indication for administration of antipsychotics? Select all that apply. a. bipolar disorder- manic episode b. eating disorder c. dissociative disorder d. schizophrenia e. personality disorder
a,d
While providing care for a client with a history of asthma and prescribed albuterol, the registered nurse (RN) is aware that which drug classification is contraindicated for this client? Select all that apply. a. beta blockers b. calcium channel blocker c. angiotensin-converting enzyme inhibitor d. nonsteroidal anti-inflammatory drug e. antihistamines
a,d
The registered nurse (RN) provides which education point to the client prescribed albuterol for the treatment of an asthma attack? Select all that apply. a. "This drug is indicated as the first drug for treatment of an asthma attack." b. "It is important to wash the mouthpiece of the device at least twice monthly." c. "This drug works best by preventing the occurrence of an asthma attack." d. "Take 2 to 4 puffs every 20 minutes for 3 treatments during an asthma attack." e. "If this drug is not beneficial in stopping the attack, seek medical attention immediately."
a,d,e
Which of the following are possible side effects of levothyroxine? Select all that apply. a. Shortness of breath b. Constipation c. Cold sensitivity d. Edema e. Joint pain
a,d,e
3. While teaching a patient who is about to receive cyclophosphamide (Cytoxan) chemotherapy, the nurse will instruct the patient to watch for potential adverse effects, such as: a. cholinergic diarrhea. b. hemorrhagic cystitis. c. peripheral neuropathy. d. ototoxicity.
b
4. A patient who is taking disulfiram as part of an alcohol treatment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome? a. Insomnia b. Copious vomiting c. Hypertension d. No ill effect because of the small amount of alcohol in the cough syrup
b
4. A patient with a history of renal problems is asking for advice about which antacid he should use. The nurse will make which recommendation? a. "Patients with renal problems cannot use antacids." b. "Aluminum-based antacids are the best choice for you." c. "Calcium-based antacids are the best choice for you." d. "Magnesium-based antacids are the best choice for you."
b
5. A patient is currently taking a statin. The nurse considers that the patient may have a higher risk for developing rhabdomyolysis when also taking which product? a. NSAIDs b. A fibric acid derivative c. Orange juice d. Fat-soluble vitamins
b
5. A patient received a double dose of intravenous heparin after surgery and is bleeding through the incision site. The surgeon is assessing the bleeding incision, and the nurse will prepare to take what action? a. Give IV vitamin K as an antidote. b. Give IV protamine sulfate as an antidote. c. Call the blood bank for an immediate platelet transfusion. d. Obtain an order for packed red blood cells.
b
8. A patient is taking an aminoglycoside antibiotic for pneumonia and will also be taking the loop diuretic furosemide because of fluid overload. The nurse will monitor carefully for which potential effect from the interaction of these two drugs? a. Nephrotoxicity b. Ototoxicity c. Pulmonary fibrosis d. Hepatotoxicity
b
A client is prescribed antacids for acute acid reflux. Which of the following must the nurse educate the client on the safety of the drug? a. The medication is safe to take with other medication. b. Avoid taking with other medications. c. Take the medication 30 minutes before a meal for greater absorption of the medication. d. Take the medication before a meal for greater absorption of the medication.
b
A client was brought to the emergency department with a heart rate of 42, RR of 30, and BP of 80/50. The client's skin is pale, cool and clammy, with confusion and irritability. Which action is priority for the nurse to implement? a. Warfarin b. Atropine c. Cardioversion d. Defibrillation
b
A client was given metoclopramide for nausea and vomiting. How does the nurse determine the medication has been effective? a. Blood pressure has decreased. b. Nausea and vomiting have been relieved. c. Abdominal cramping has been relieved. d. Muscle tremors are gone.
b
A nurse is assessing a client who recently began taking haloperidol. Which of the following findings is the priority for the nurse to report to the provider? A Shuffling gait B Neck spasms C Smacking of the lips D Hand tremors
b
A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should identify that concurrent use of which of the following medications increases the client's risk for developing digoxin toxicity? A Phenytoin B Verapamil C Warfarin D Aluminum hydroxide
b
A nurse is providing instructions to a client who has a new prescription for oral albuterol. Which of the following instructions should the nurse include? A "You can take this medication to abort an acute asthma attack." B "Tremors are an adverse effect of this medication." C "Prolonged use of this medication can cause hyperglycemia." D "This medication can slow skeletal growth rate."
b
A nurse is providing teaching with a client, who has schizophrenia, about strategies to minimize the anticholinergic effects of fluphenazine. Which of the following instructions should the nurse suggest for the client? A Take the medication in the morning to prevent insomnia. B Chew sugarless gum to moisten the mouth. C Use cooling measures to decrease fever. D Take an antacid to relieve nausea.
b
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 nitroglycerin 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 for emergency medical assistance." C "Take a sustained-release nitroglycerin capsule." D "Wait another 5 minutes then take a second sublingual tablet."
b
The health care provider prescribes a slightly lower dosage of prednisone each week for the client who has been taking a high dosage of prednisone. The nurse teaches the client that tapering off this medication gradually is done to prevent which condition? a. Hypertension b. Adrenal insufficiency c. Hyperglycemia d. Venous insufficiency
b
The nurse is caring for a client with a new prescription for digoxin. Which statement indicates that the nurse's teaching has been effective? a. "I will check my blood pressure at the same time each day and record the values." b. "I will drink plenty of water each day and take my medicine on an empty stomach." c. "I will take this medication any time I feel that my heart might be skipping beats." d. "I will take this medication with my antacid so that it does not upset my stomach."
b
The nurse is caring for a client with an order for vasopressin. The nurse is aware that this medication may be indicated for the management of which condition? a. Unstable angina b. Diabetes insipidus c. Migraine headaches d. Epilepsy
b
The nurse is caring for a client with cardiogenic shock. The health care provider orders that the client be placed on a dobutamine drip. The nurse understands that the goal of this medication is to produce which outcome? a. Resolution of atrial fibrillation b. Increased cardiac output c. Return to normal sinus rhythm d. Decreased heart rate and blood pressure
b
The nurse is educating a client newly prescribed lisinopril for the treatment of hypertension and heart failure. Which of the following educational statements by the nurse should be a priority for this client? a. "Take this medication 1 hour before meals to aid absorption." b. "The first dose may cause a low BP, be careful getting up from bed!" c. "Take the medication with milk to prevent stomach upset." d. "Stop taking the medication immediately if you develop a cough."
b
The nurse is preparing to give a maintenance dose of digoxin to an elderly client with atrial fibrillation and systolic heart failure. Which action is most important for the nurse to take prior to administration? a. Assess the client's blood pressure b. Review the client's creatinine level c. Auscultate the client's lungs d. Obtain the client's weight
b
What response by the registered nurse (RN) to the client best explains the why of remaining upright after administration of alendronate? a. "The reason for sitting upright for 30 minutes is to help the drug absorb." b. "The reason for sitting up for 30 minutes will help prevent irritation to your food pipe." c. "The reason for sitting up for 30 minutes is because this is what the drug maker recommends." d. "The reason for sitting up for 30 minutes is to prevent the occurrence of nausea and vomiting."
b
What statement made by the client receiving filgrastim after the administration of chemotherapy will the registered nurse (RN) identify as a need for further education? a. "I realize that I will still need to protect myself from infection and monitor for fever." b. "I know this drug will help my blood count, but I am worried it will cause my cancer to grow." c. "I understand that this drug is going to decrease my risk of developing infections." d. "I understand that this drug works to bring up my white blood cell counts that help fight infection."
b
What statement made by the client receiving tamoxifen for the treatment of breast cancer, will require further education by the registered nurse (RN)? a. "I realize that I must eat healthy to decrease the weight gain that comes with this drug." b. "I am concerned that the drug dose is too strong as I am now having hot flashes daily." c. "I realize that the mood changes I am experiencing are related to the drug and the stress I have been through." d. "I need to keep all my appointments with the healthcare provider to monitor my progress."
b
Which client report is most concerning to the nurse in a client who has been taking rosuvastatin for 6 weeks? a. Nausea and drowsiness b. Headaches and muscle pain c. Decreasing LDL and increasing HDL d. Insomnia and abdominal cramping
b
Which common side effect does the nurse caution the client about when starting a new bile-acid sequestrant for hypercholesterolemia? a. Bleeding b. Diarrhea c. Leg pain d. Facial flushing
b
Which of the following hospitalized clients taking prednisone should the nurse prioritize follow up care? a. The client with asthma b. The client with diabetes mellitus c. The client with Crohn's disease d. The client with depression
b
The nurse is caring for a client with heart failure who is receiving a prescribed angiotensin-converting enzyme inhibitor (ACE inhibitor). The client is asking how the drug works for heart failure. What will the nurse include in teaching the client about this medication? Select all that apply a. The ACE inhibitor reduces fluid volume b. The ACE inhibitor relaxes blood vessels and lowers blood pressure c. The ACE inhibitor reduces workload on the heart d. The ACE inhibitor decreases pulmonary venous pressure. e. The ACE inhibitor prevents vasoconstriction and secretion of aldosterone.
b,c
Mary is preparing to administer nafcillin IM to Ms. Young, a client who has meningitis. Which of the following actions should the nurse plan to take? Select all that apply. A Select a 25-gauge, ½-inch needle for the injection. B Administer the medication deeply into the ventrogluteal muscle. C Ask the client about an allergy to penicillin before administering the medication. D Monitor the client for 30 min following the injection. E Tell the client to expect a temporary rash to develop following the injection.
b,c,d
The nurse is caring for a client with suspected digoxin toxicity. Which finding(s) support this problem? Select all that apply. a. Pruritus b. Nausea and vomiting c. Confusion d. Digoxin level of 2.8 ng/mL e. Potassium level of 4.0 mg/dL
b,c,d
8. A patient has been taking simvastatin for 6 months. Today he received a call that he needs to come to the office for a "laboratory check." The nurse expects which laboratory studies to be ordered at this time? (Select all that apply.) a. PT/INR b. Total cholesterol c. Triglycerides d. Liver function studies e. Complete blood count f. HDL and LDL levels
b,c,d,f
1. The nurse is preparing to give medications. Which is an appropriate nursing action for intravenous (IV) phenytoin? (Select all that apply) a. Give IV doses via rapid IV push. b. Administer in normal saline solutions. c. Administer in dextrose solutions. d. Use a filter for IV infusions. e. Ensure continuous infusion of the drug.
b,d
6. Which drugs have an action similar to that of the naturally occurring antidiuretic hormone? (Select all that apply.) a. cosyntropin b. desmopressin c. somatropin d. vasopressin e. octreotide
b,d
While providing care for the client receiving phenytoin for the last 3 weeks as treatment for seizures, which lab value will the registered nurse (RN) promptly report to the healthcare provider? Select all that apply. a. alanine transaminase (ALT) 33 units/L b. phenytoin level of 8 mcg/dL c. phenytoin level of 15 mcg/dL d. phenytoin level of 22 mcg/dL e. aspartate transaminase (AST) 32 units/L
b,d
Which educational point will the registered nurse (RN) provide the client prescribed risedronate for the treatment of osteoarthritis? Select all that apply. a. "Take all of your regularly scheduled drugs at the same time as this drug." b. "Take this drug first thing in the morning on an empty stomach." c. "Immediately eat breakfast after taking this drug." d. "Take this drug with a full glass of water (8 ounces)." e. "Remain upright for 30 minutes after taking the drug."
b,d,e
When monitoring for a therapeutic response to prednisone, the nurse will look for which potential outcomes? (Select all that apply.) a. Increased lymphocyte levels b. Decreased inflammation c. Increased growth characteristics d. Decrease in Cushing's syndrome characteristics e. Prevention of organ rejection in a patient who had an organ transplant
b,e
1. A patient has a new prescription for transdermal nitroglycerin patches. The nurse teaches the patient that these patches are most appropriately used for which reason? a. To relieve exertional angina b. To prevent palpitations c. To prevent the occurrence of angina d. To stop an episode of angina
c
2. A nurse with adequate knowledge about the administration of intravenous nitroglycerin will recognize that which statement is correct? a. The intravenous form is given by intravenous push injection. b. Because the intravenous forms are short-lived, the dosing must be every 2 hours. c. Intravenous nitroglycerin must be protected from exposure to light through use of special tubing. d. Intravenous nitroglycerin can be given by gravity drip infusions.
c
2. During assessment of a patient who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as a. apical pulse rate of 62 beats/min. b. digoxin level of 1.5 ng/mL. c. serum potassium level of 2.0 mEq/L. d. serum calcium level of 9.9 mEq/L.
c
2. The nurse is performing an assessment of a patient who is asking for a prescription for sildenafil. Which finding would be a contraindication to its use? a. 65 years of age b. History of thyroid disease c. Medication list that includes nitrates d. Medication list that includes saw palmetto
c
3. Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the statin class? a. The drug must be taken on an empty stomach before meals. b. A low-fat diet is not necessary while taking these medications. c. It is important to report muscle pain immediately. d. Improved cholesterol levels will be evident within 2 weeks.
c
4. In caring for a patient receiving therapy with a myelosuppressive antineoplastic drug, the nurse notes an order to begin filgrastim after the chemotherapy is completed. Which statement correctly describes when the nurse will begin the filgrastim therapy? a. It can be started during the chemotherapy. b. It will begin immediately after the chemotherapy is completed. c. It will be started 24 hours after the chemotherapy is completed. d. It will not be started until at least 72 hours after the chemotherapy is completed.
c
5. Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternative medication? a. A patient with a fever of 103.4° F (39.7° C) b. A patient admitted with deep vein thrombosis c. A patient admitted with severe hepatitis d. A patient who had abdominal surgery 1 week earlier
c
A 70 yo female client taking prednisone for an extended period of time is at most risk for developing which of the following conditions? a. Hypoglycemia b. Asthma c. Osteoporosis d. Hypotension
c
A client is prescribed antacids for dyspepsia. Which of the following correctly describes the mechanism of action of the drug? a. Decreases gastric acid by inhibiting the proton pump in the parietal cells of the stomach. b. Reduces the amount of gastric acid production by blocking histamine H2-receptors of parietal cells within the lining of the stomach. c. Neutralizes gastric acid, reduces pepsin levels, and stimulates prostaglandin production. d. Coats the gastrointestinal (GI) lining and protects from erosion and ulcers.
c
A client who was given metoclopramide to increase gastric emptying begins lip smacking, sucking lip motion, puffing of cheeks, and chewing movements. Which priority action should be implemented by the nurse? a. Stop the medication immediately. b. Ask the client when these symptoms began. c. Notify the healthcare provider about the symptoms. d. Administer the next dose of the medication as ordered.
c
A nurse is assessing a client who is taking gemfibrozil. Which of the following findings should the nurse identify as an adverse effect of this medication? A Mental status changes B Tremor C Diarrhea D Pneumonia
c
A nurse is caring for a client who is receiving IV nitroprusside for hypertensive crisis. Which of the following conditions should the nurse monitor as an adverse effect of this medication? A Intestinal ileus B Neutropenia C Delirium D Hyperthermia
c
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 prepare to administer? A Vitamin K1 B Atropine C Protamine D Calcium gluconate
c
A nurse is reviewing laboratory results of 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
The nurse is caring for a client who is receiving desmopressin for diabetes insipidus. Which result indicates that the medication has been effective? a. Increased platelet count b. Increased serum potassium c. Increased urine osmolality d. Increased serum creatinine
c
The nurse is caring for a client with a pulmonary embolism who is receiving heparin. The nurse checks the IV site and observes blood pouring from the site. When preparing an antidote, which of the following would be used? a. Vitamin K b. Argatroban c. Protamine sulfate d. Idarucizumab
c
The nurse is preparing to administer a dose of digoxin to multiple clients. For which client should the nurse withhold the medication and contact the health care provider? a. The client with a history of systolic heart failure and an ejection fraction of 32% b. The client with a history of atrial fibrillation with a blood pressure of 110/60 mmHg c. The client with a history of atrial flutter with a heart rate of 52 beats/minute d. The client with a history of paroxysmal atrial tachycardia with a creatinine of 1.1
c
The registered nurse (RN) knows what diagnostic testing will provide data to support the effectiveness of alendronate? a. x-rays of long bones b. positron emission tomography c. bone density study d. bone scan
c
What clinical manifestation will the registered nurse (RN) identify as a result of vincristine administration in a client diagnosed with leukemia? a. frequent skin bruising and easy bleeding b. occurrence of a febrile infection c. neuropathy in the hands and feet d. increased hunger and weight gain
c
5. A patient is asking about the use of saw palmetto for prostate health. The nurse tells him that drugs that interact with saw palmetto include which of these? (Select all that apply.) a. Acetaminophen b. Nitrates c. Immunostimulants d. Nonsteroidal antiinflammatory drugs e. Antihypertensive drugs
c,d
While providing education to the client prescribed phenytoin for the treatment of seizures, which clinical manifestation will the registered nurse (RN) instruct the client to report promptly to the healthcare provider? Select all that apply. a. heart rate of 56 beats/minute b. bleeding from the oral gums c. thoughts of harming self d. appearance of a rash on the body e. enlargement of oral gums
c,d,e
A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? Select all that apply. A Expect therapeutic effects in 24 to 48 hr. B Discontinue the medication after a week of improved mood. C Change positions slowly to minimize dizziness. D Decrease dietary fiber intake to control diarrhea. E Chew sugarless gum to prevent dry mouth.
c,e
After the administration of albuterol during an asthma attack, the registered nurse (RN) is aware of what clinical manifestations indicate that the drug has been effective? Select all that apply. a. presence of irregular heart rate b. increase in alertness to surroundings c. increase in the productive cough d. decrease in alertness to surroundings e. a decrease in anxiousness
c,e
A nurse is providing teaching to a client who has been newly prescribed buspirone for treatment of anxiety. Select all that should be included A. "This medication has a high risk for dependency." B. "Expect optimal therapeutic effects within 24 hours." C. "Take this medication on a scheduled basis." D. "Take this mediation on an empty stomach." E. "Avoid drinking grapefruit juice." F. "Avoid activities that require alertness when initially taking." G. "Herbal preparations can be combined with this medication." H. "Increase fiber and fluid in your diet."
c,e,f,h
4. A patient is receiving dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. What will the nurse do next? a. Monitor for other signs of a therapeutic response to the drug. b. Titrate the drug to a higher dose to reduce the palpitations. c. Discontinue the dobutamine immediately. d. Assess the patient's vital signs and cardiac rhythm.
d
A client hospitalized with a deep vein thrombosis is placed on a heparin drip. A partial thromboplastin time was completed 4 hours later and the results were 80 seconds. Which of the following should the nurse implement immediately? a. Slow the heparin drip by 10 units/hour per protocol. b. Increase the heparin drip by 5 units/hour per protocol. c. Check the intravenous site for infiltration. d. Stop the heparin drip and notify the healthcare provider.
d
A client is prescribed cimetidine for peptic ulcer disease. Which of the following is an adverse effect that the nurse must inform the client? a. A decrease in bowel movements. b. An increase in bowel movements. c. An increase in libido. d. A decrease in libido.
d
A client is prescribed dexamethasone by the healthcare provider, based on the nurse's knowledge, what instructions should be given to the client? a. The medication can be stopped at anytime b. The medication can be taken with coffee c. The medication should be taken at bedtime d. The medication should be taken with breakfast
d
A client is prescribed magnesium hydroxide for dyspepsia. Which of the following is an adverse effect that the nurse must inform the client? a. Gynecomastia b. Vomiting c. Constipation d. Diarrhea
d
A client is receiving chemotherapy every Monday. Which of the following should the nurse prepare to administer to the client prior to taking her chemotherapy? a. Dexamethasone b. Morphine sulfate c. Promethazine d. Ondansetron
d
A nurse is caring for a 5-year-old client with influenza. The client has symptoms of a fever and muscle aches. Which of the following pharmacological agents is recommended for the client? a. Ibuprofen b. Morphine c. Codeine d. Acetaminophen
d
A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client? A The client will start at a high dosage, and the amount will be tapered as needed. B The client will remain on the initial dosage during the course of treatment. C The client's dosage will be adjusted daily based on blood levels. D The client will start on a low dosage, which can be gradually increased.
d
A nurse is preparing to administer filgrastim intravenously 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 mass to prevent injury. B Ensure that the 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
A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which of the following findings is an adverse effect of desmopressin? A Hypovolemia B Hypercalcemia C Agitation D Headache
d
The nurse is caring for a client who has been receiving a vasopressin infusion for diabetes insipidus. Which client statement is most concerning to the nurse? a. "I woke up in a sweat in the middle of the night." b. "I needed to go to the bathroom all throughout the night." c. "I have been burping so much after eating my breakfast." d. "I noticed that my left arm is sore and my fingers are numb."
d
The nurse is caring for a client who has right-sided heart failure, and is scheduled to receive the second dose of furosemide. Prior to administration of the drug, assessment of the client reveals a marked decrease from 4+ to 1+ ankle edema, neck distention is less than earlier, and the client lost 3 pounds in 24 hours. What action should the nurse take? a. Hold the furosemide b. Give the furosemide early c. Notify the physician d. Give the scheduled dose
d
What statement made by the client receiving tamoxifen for the treatment of breast cancer, will alert the registered nurse (RN) to notify the healthcare provider? a. "I have noticed that my monthly menstrual cycle remains the same as before beginning this drug." b. "I am going to need some help paying for this drug if I need to take it for more than 1 year." c. "I am really nervous that this drug is not going to keep my cancer from coming back." d. "It really hurts in my right calf when I try to walk even across the room."
d
What statement will the registered nurse (RN) implement to best explain the action of tamoxifen in the client diagnosed with breast cancer? a. "This drug blocks estrogen receptors which helps decrease the size of the breast and area of the cancer." b. "This drug blocks estrogen receptors to help prepare the breast for surgery to remove the cancer." c. "This drug is an estrogen receptor modulator that is given to prevent or treat breast cancer." d. "This drug helps prevent or stop breast cancer that feeds off of estrogen (a female hormone)."
d
Which follow-up lab is priority due to potential adverse effects for the client taking atorvastatin? a. Creatinine level b. High density lipid level c. C-reactive protein level d. Alanine transaminase level
d
While obtaining a drug history from a client, the registered nurse (RN) identifies what purpose for the prescription alendronate? a. Fibromyalgia b. Psoriatic c. Rheumatoid d. Osteoporosis
d
While reviewing the lab values of a female client receiving chemotherapy, what lab value will the registered nurse (RN) identify as an indication of the need for the administration of filgrastim? a. a hemoglobin 13 g/L b. a hematocrit 37% c. a platelet count 120,000/mcL d. a white blood cell count of 2400/mcL
d
