Pharm final
A client has been prescribed methotrexate 30 mg intramuscularly once weekly. The medication is supplied as 200 mg/8 mL. How many milliliters should the nurse administer? ________mL Round to the nearest tenth. Numerical value only.
1.2
The client asks the nurse why COX-2 inhibitors should be used in the lowest dose possible for the shortest amout of time. Which response by the nurse provides an accurate explanation?
"COX-2 inhibitors increase the risk of myocardial infarction, stroke, and other cardiovascular events."
A client with an extensive cardiac history is prescribed omeprazole. The nurse reviews the medication history and the client is also prescribed clopidogrel, metoprolol, and furosemide. Which instructions should the nurse provide to the client regarding the medications.
"Clopidogrel should be taken 12 hours apart from the omeprazole."
Metformin has been prescribed for a client newly diagnosed with type 2 diabetes mellitus. Which client statement about this medication validates to the nurse that the client understood the teaching?
"Decreases production of glucose by the liver."
A client who was prescribed nitrofurantoin for a urinary tract infection 1 week ago calls to report the symptoms have returned. What is the most appropriate response by the nurse?
"Did you complete the full course of antibiotic as directed?"
A new nurse graduate is discussing the use of epinephrine with the nurse manager. Which statement by the new nurse demonstrates an understanding of this medication?
"Epinephrine given intravenously requires continuous cardiac monitoring related to an increased risk of arrhythmias and hypertension."
A nurse from another area is shadowing on the bone marrow transplant and chemotherapy nursing units. Which statement by the shadow nurse is appropriate regarding the clients and medications used in this area?
"I noticed that there are special procedures for administering the drugs here."
Which reported statement by the client is of greatest concern when taking a medication to treat glaucoma?
"I was taking dorzolamide and developed conjunctivitis."
A female client with genital herpes simplex becomes pregnant. What statement by the client concerning her prescribed acyclovir would indicate that teaching by the nurse has been effective?
"I may continue the acyclovir throughout the course of my pregnancy."
A nurse is preparing to administer interferon beta-1b to the client with multiple sclerosis. Which nursing intervention is performed prior to the administration of the medicaiton?
Administer acetaminophen or ibuprofen as prescribed.
Which laboratory value for a client who has recently been prescribed misoprostol for peptic ulcer disease would require immediate action by the nurse?
Hma chorionic gonadotropin 30 mlU/mL
The nurse is caring for a 46 year old client who reports continuous vaginal bleeding for the past 14 days. The client does not take any medications and has been menopausal for 2 years. Which statement by the client would indicate that teaching was effective?
"I will schedule an appointment for an ultrasound and biopsy."
A client asks why they should not give their 10 month old child ibuprofen after receiving vaccinations. Which response by the nurse is correct?
"Ibuprofen and other NSAIDs blunt the effect of the vaccination by decreasing the production of antibodies necessary to mount the immune response desired by the vaccination."
A client with diabetes and peptic ulcer disease has been prescribed clarithrmycin for the treatment of Helicobacter pylori. Which statement made by the client indicates teaching by the nurse was effective?
"If I develop hearing loss while taking this medication, it is reversible."
When providing discharge teaching regarding beta agonists for a client newly diagnosed with asthma, which information is the most important to give to clients?
"It is essential that you contact your health care provider should you find yourself needing to use a short-acting beta2 agonist rescue inhaler more than twice weekly."
A nurse is caring for a client who has been prescribed ondansetron prior to administration of etoposide. What statement should the nurse include prior to administration of ondansetron?
"It will assist in preventing nausea and vomiting."
A client is receiving testosterone for replacement therapy. Which statement by the client indicates the client needs additional instruction?
"The medication does not need laboratory testing."
The nurse educates a palliative care client about starting an appetite stimulant. Which statement indicates that the client has correctly understood the education?
"The medication is a short-term measure to help me increase my appetite."
A client presents with chronic renal failure with dialysis. The client's blood pressure (BP) is 180/110 mmHg. The prescriber orders an intravenous line to be placed and administration of sodium nitroprusside. Which statement is included in the instructions to the client the medication?
"The medication will assist to bring down your blood pressure."
The nurse sees that a hospice client, who is taking haloperidol, is grimacing an lip smacking. The client's family asks the nurse why this is happening. What is the correct response by the nurse?
"This is called tardive dyskinesia. It is a side effect of haloperdol."
A nurse is reviewing a client's most recent hemoglobin A1c level of 8.7%. What instruction will the nurse provide to the client based upon this finding?
"This result indicates that your diabetes is not well controlled. Your provider may adjust your medication regimen."
A client arrives to the emergency department with the following signs/symptoms: BP 186/102, HR 144 beats/minute, temperature 102.8oF (39.3oC), oxygen saturation 99%. The client, who has a history of hypertension and hyperthyroidism, reports flu-like symptoms for the past week. Which prescribed order is the priority nursing action based on these findings?
Administer propylthiouracil (PTU) 200 mg PO.
An 8 year old client with acute otitis media and a penicillin allergy is prescribed clarithromycin 7.5 mg/kg twice daily for 10 days. The client weighs 56 pounds. How many milligrams of clarithromycin will the client receive with each dose? _________mg.
190.5
Piperacillin/tazobactam is available as 1,200 mg in 100 mL normal saline. Calculate the drop rate (gtt/min) for this medication on microtubing to be infused over 30 minutes. Round answer to the nearest whole number. (provide numerical value only) Remember microtubing always has a drop factor of 60 gtt/mL.
200 gtt/min.
The nurse is caring for a client who is experiencing increasingly worse indigestion. Which medication prescribed to the client would be of greatest concern to the nurse?
Alendronate
A nurse is caring for a client with challenges in memory recall. The client is being treated with a N-methyl-D-aspartate (NMDA) receptor antagonist medication. Which disease is part of the client's history?
Alzheimer disease
The nurse is preparing to administer morning medications to four clients. Which client has the greatest risk of medication toxicity?
A 67 year old client receiving three medications that are highly protein bound.
Which client would be an appropriate candidate for treatment using a muscarinic agonist?
A client with urinary retention following a total knee replacement.
The client is receiving quetiapine for sleep and for agitation. Which assessment finding would require immediate intervention by the nurse?
A red, blistering rash
A nurse is preparing to administer a Rho (D) immune globulin injection to the client. Which information in the client's chart would cause the nurse to question the order?
A+ blood type
Based upon current recommendations for the influenza vaccine, which clients should receive the immunization? Select all that apply.
A. 58 year old woman who cares for her husband with cancer B. 32 year old client with asthma C. 28 year old pregnant woman D. 19 year old college student E. 45 year old client on prednisone for rheumatoid arthritis
The nurse is preparing to administer etanercept to a client with rheumatoid arthritis. Which assessment finding(s) would alert the nurse to potential contraindications to this medication? Select all that apply.
A. A tuberculin skin test with induration measuring 10 mm B. 2+ pitting edema of the right lower extremity C. Platelet count of 135,000 x 103/mcgL D. Hyperactive bowel sounds in all four abdominal quadrants E. Bilateral crackles in the lung bases
A nurse is caring for a client with Parkinson disease (PD). The client is prescribed levodopa. Which are expected assessments of a client with PD? Select all that apply.
A. Altered level of consciousness B. Motor weakness C. Confusion of person, place, and time D. Postural rigidity E. Tremors to hands at rest F. Sexual dysfunction
A client who has been in the hospital for an extended stay to receive chemotherapy is planning for discharge. For which signs and symptoms does the nurse teach the client to seek medical evaluation? Select all that apply.
A. White spots on the tongue B. Unexplained weight loss C. A persistent cough D. Dry patches on the skin of the feet E. Difficulty swallowing
A client with severe chronic obstructive pulmonary disease has been taking prednisone for several years. Which assessment findings noted by the nurse would indicate an insufficient dose of prednisone? Select all that apply.
A. Hypotension Correct B. Tachycardia C. 2+ pitting edema D. Hyperglycemia E. Hyponatremia
A client presents to the emergency department with chest pain. The ECG reveals ST-segment elevation. Vital signs are: BP 142/78 mmHg, pulse 98 beats/minute, respirations 18 breaths/minute, temperature 100.6oF, and oxygen saturation 98%. The nurse should prepare to perform which actions? Select all that apply.
A. Prepare to infuse diltiazem IV. B. Administer aspirin 325 mg PO C. Obtain blood for laboratory testing. D. Administer 2 L oxygen via nasal cannula. E. Provide the client with 3 tablets of sublingual nitroglycerin immediately.
A client with osteoporosis and a urinary tract infection is prescribed calcium supplements and ciprofloxacin to be administered at 0800. What is the priority action by the nurse?
Contact the prescriber to change the dosing schedule for the calcium
A nurse is caring for a client that has been admitted for myelosuppression secondary to breast cancer treatment. Which diagnostic indicator does the nurse expect to observe in the client's electronic health record?
Decreased neutrophils
The client is prescribed morphine to be taken postoperatively. Which condition in the client's past medical history might be a contraindication to taking this medication?
Emphysema
The nurse has administered the prescribed dose of an analgesic medication to a client. When considering the nursing process, what is the nurse's next responsibility to the client?
Evaluating effectiveness of therapy
A client is admitted to the medical unit and is prescribed allopurinol and ciprofloxacin. Following administration of the medications, the client's temperature is 101.2oF (38.4oC). What is the priority nursing action?
Hold the allopurinol and notify the provider.
A client has been prescribed diphenhydramine 500 mg for the treatment of a mild allergic reaction. After reviewing a drug reference manual, hte nurse identifies that the dose is incorrect. What is the priority action by the nurse at this time?
Hold the medication and notify the prescriber.
A client with major depressive disorder is prescribed phenelzine by a provider. Which client teaching is the highest priority?
Phenelzine interacts with many foods and medications.
A client with chronic kidney disease and anemia has been prescribed erythropoietin alfa for a current hemoglobin level of 13 mg/dL. What is the priority action of the nurse?
Question the order.
A client given lidocaine as local anesthetic for a surgical procedure reports tinnitus and a metallic taste in the mouth. What is the appropriate action of the nurse?
Recognize the symptoms of systemic toxicity, notify hte prescriber, and prepare to provide airway support if needed.
A client is diagnosed with complex partial seizures and is prescribe phenobarbital. After 1 hour, the nurse assesses the client. Which assessment finding requires immediate action?
Respiratory rate of 8 breaths/minute
A nurse is caring for a client diagnosed with seizure disorder. Which laboratory value would the nurse assess prior to administration of phenytoin?
Sodium level
A client prescribed losartan calls the nurse to report muscle weakness and palpitations. What is the priority action by the nurse?
Tell the client to report to the emergency department for evaluation.
A client with schizophrenia is starting clozapine therapy. Which information is highest priority to include in client teaching?
The client must have regular white blood cell count (WBC) levels drawn.
A client is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would the nurse provide?
The oral administration of a prescription for fluoroquinolone.
