Pharm final

Patient with emphysema is having difficulty breathing with audible wheezing. Albuterol is given three times in 12 hours. What assessment finding requires immediate interventions by nurse? a) throat irriation b) shaking uncontrollable c) irregular heart rate d) increased anxiety

C) Irregular heart rate.Albuterol is a fast acting inhaler.

When treating a patient with a hospital acquired infection with Vancomycin, what would you do? a) report the HAI to Medicare b) assess patient's response c) obtain WBC count d) ensure to obtain a peak and trough

d) ensure to obtain a peak and trough

Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication: 1. With 8 oz of milk 2. In the morning after arising 3. 60 minutes before breakfast 4. At bedtime on an empty stomach

1. With 8 oz of milkRationale:Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs should be given with milk or food to prevent gastrointestinal irritation. Options 2, 3, and 4 are incorrect.

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations

1. Tinnitus Rationale:Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.

A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply. 1. Call a code blue. 2. Contact the registered nurse. 3. Contact the client's family. 4. Assess the client's pain level. 5. Check the client's blood pressure. 6. Administer a second nitroglycerin, 0.4 mg, sublingually.

2. Contact the registered nurse. 4. Assess the client's pain level. 5. Check the client's blood pressure. 6. Administer a second nitroglycerin, 0.4 mg, sublingually. Rationale:The usual guideline for administering nitroglycerin tablets for a hospitalized client with chest pain is to administer one tablet every 5 minutes PRN for chest pain, for a total dose of three tablets. The registered nurse should be notified of the client's condition, who will then notify the health care provider as appropriate. Because the client is still complaining of chest pain, the nurse would administer a second nitroglycerin tablet. The nurse would assess the client's pain level and check the client's blood pressure before administering each nitroglycerin dose. There are no data in the question that indicate the need to call a code blue. In addition, it is not necessary to contact the client's family unless the client has requested this.

A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: 1. Hypercalcemia 2. Peripheral neuritis 3. Small blood vessel spasm 4. Impaired peripheral circulation

2. Peripheral neuritis Rationale:A common side effect of the TB drug INH is peripheral neuritis. This is manifested by numbness, tingling, and paresthesias in the extremities. This side effect can be minimized by pyridoxine (vitamin B6) intake. Options 1, 3, and 4 are incorrect.

A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report: 1. Impaired sense of hearing 2. Problems with visual acuity 3. Gastrointestinal (GI) side effects 4. Orange-red discoloration of body secretions

2. Problems with visual acuity Rationale:Ethambutol causes optic neuritis, which decreases visual acuity and the ability to discriminate between the colors red and green. This poses a potential safety hazard when a client is driving a motor vehicle. The client is taught to report this symptom immediately. The client is also taught to take the medication with food if GI upset occurs. Impaired hearing results from antitubercular therapy with streptomycin. Orange-red discoloration of secretions occurs with rifampin (Rifadin).

48.) A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to: 1. Drink alcohol in small amounts only. 2. Report yellow eyes or skin immediately. 3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during therapy.

2. Report yellow eyes or skin immediately. Rationale:INH is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately (which include yellow skin and sclera). For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish such as tuna, and foods containing tyramine because they may cause a reaction characterized by redness and itching of the skin, flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of INH therapy for TB.

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2. "These medications are only taken when I have pain from my ulcer." 3. "The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."

3. "The medications will kill the bacteria and stop the acid production." Rationale:Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan? 1. Reports not going to work for this past week 2. Complains of not being able to "do anything" anymore 3. Arrives at the clinic neat and appropriate in appearance 4. Reports sleeping 12 hours per night and 3 to 4 hours during the day

3. Arrives at the clinic neat and appropriate in appearance Rationale:Depressed individuals will sleep for long periods, are not able to go to work, and feel as if they cannot "do anything." Once they have had some therapeutic effect from their medication, they will report resolution of many of these complaints as well as demonstrate an improvement in their appearance.

A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication: 1. Should always be taken with food or antacids 2. Should be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months

3. Causes orange discoloration of sweat, tears, urine, and feces Rationale:Rifampin should be taken exactly as directed as part of TB therapy. Doses should not be doubled or skipped. The client should not stop therapy until directed to do so by a health care provider. The medication should be administered on an empty stomach unless it causes gastrointestinal upset, and then it may be taken with food. Antacids, if prescribed, should be taken at least 1 hour before the medication. Rifampin causes orange-red discoloration of body secretions and will permanently stain soft contact lenses.

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level

3. Liver enzyme levels Rationale:INH therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore, liver enzyme levels are monitored when therapy is initiated and during the first 3 months of therapy. They may be monitored longer in the client who is greater than age 50 or abuses alcohol.

A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now at risk for which of the following? 1. Insomnia 2. Weight gain 3. Seizure activity 4. Orthostatic hypotension

3. Seizure activity Rationale:Bupropion does not cause significant orthostatic blood pressure changes. Seizure activity is common in dosages greater than 450 mg daily. Bupropion frequently causes a drop in body weight. Insomnia is a side effect, but seizure activity causes a greater client risk.

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for: 1. Pupillary changes 2. Scattered lung wheezes 3. Sudden increase in pain 4. Sudden episodes of diarrhea

3. Sudden increase in pain Rationale:Naloxone hydrochloride is an antidote to opioids and may also be given to the postoperative client to treat respiratory depression. When given to the postoperative client for respiratory depression, it may also reverse the effects of analgesics. Therefore, the nurse must check the client for a sudden increase in the level of pain experienced. Options 1, 2, and 4 are not associated with this medication.

A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching? 1. "I will take my pills every day at the same time." 2. "I will be certain to avoid alcohol consumption." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." Rationale: Ecotrin is an aspirin-containing product and should be avoided. Aspirin displaces drugs like warfarin from the protein binding site causing increased anticoagulant levels. Alcohol consumption should be avoided by a client taking warfarin sodium. Taking prescribed medication at the same time each day increases client compliance. The Medic-Alert bracelet provides health care personnel emergency information.

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming 2. 15 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun

4. At least 30 minutes before exposure to the sun Rationale:Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.

A nurse has given the client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client immediately reports: 1. Impaired sense of hearing 2. Distressing gastrointestinal side effects 3. Orange-red discoloration of body secretions 4. Difficulty discriminating the color red from green

4. Difficulty discriminating the color red from green Rationale:Ethambutol causes optic neuritis, which decreases visual acuity and the ability to discriminate between the colors red and green. This poses a potential safety hazard when driving a motor vehicle. The client is taught to report this symptom immediately. The client is also taught to take the medication with food if gastrointestinal upset occurs. Impaired hearing results from antitubercular therapy with streptomycin. Orange-red discoloration of secretions occurs with rifampin (Rifadin).

Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy? 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat

4. Sore throat Rationale:Clients taking trimethoprim-sulfamethoxazole (TMP-SMZ) should be informed about early signs of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the health care provider if these symptoms occur. The other options do not require health care provider notification.

Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication? 1. A history of hyperthyroidism 2. A history of diabetes insipidus 3. When the last full meal was consumed 4. When the last alcoholic drink was consumed

4. When the last alcoholic drink was consumed Rationale:Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours before the initial dose of the medication is administered. The most important data are to determine when the last alcoholic drink was consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to the medication.

A healthcare provider prescrives cephalexin monhydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription? A. Penicillins B. Aminoglycosides C. Erythromycins D.Sulfonamides

A. Cross-allergies exist between penicillins and cephalosporines, such as keflex. so checking for penicillin allergy is a wise precaution

An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorlac (toradol) 30mg IV q6h. which action should the nurse implement? A. administer both medications according to the prescription B. Hold the ketorolac to prevent an antagonist effect C. Hold the morphine to prevent an additive drug interaction D. Contact the healthcare provider to clarify the prescription

A. Morphine and ketorolac can be administered concurrently and may produce additive analgesic effect resulting in ability to reduce the dose of morphine, as seen in this prescription

A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? A) Rash. B) Nausea. C) Headache. D) Dizziness.

A. Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the medication which could result in anaphylactic shock, a medical emergency. (B, C, and D) are common side effects of penicillins that should subside after the body adjusts to the medication. These would not require immediate medical care unless the symptoms persist beyond the first few days or become extremely severe.

Which method of medication administration provides the client with the greatest first-pass effect? A) Oral. B) Sublingual. C) Intravenous. D) Subcutaneous.

A. The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After oral (A) medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug. Alternative method of administration, such as sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-pass effect.

A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. which medication prescription decreases both preload and afterload a. nitroglycerin b. propranolol c. propranolol d. captopril

A. nitroglycerin is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing both preload and afterload

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A. Client states chest pain is relieved B. Client's pulse decreases from 120 to 90 C. Client's systolic blood pressure decreases from 180 to 90 D. Clients SaO2 level increases from 92% to 96%

A. nitroglycerin reduces mycocardial oxygen consumption which decreases ischemia and reduces chest pain

Which instructions should the nurse give to a female client who just recieved a prescription for oral metronidazole (flagyl) for treatment of trichomonas vaginalis (select all that apply) A. increase fluid intake, especially cranberry juice B. Do not abruptly discontinue the medication; taper use C. Check blood pressure daily to detect hypertension D. Avoid drinking alcohol while taking this medication E. Use condoms until treatment is completed F. Ensure that all sexual partners are treated at the same time

ADEF

The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1mg IV/hour basal rate with 1mg IV every 15minutes per PCA to toal 5mg IV max per hour. What assessment has the highest priority before initating the PCA pump A. The expiration date on the morphine syringe in the pump B. The rate and depth of the client's respirations C. The type of anesthesia used during the surgical procedure D. The client's subjective and objective signs of pain

ANS: B A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression (B). The PCA pump should be stopped and the healthcare provider notified if the client's respiratory rate falls below 12 breaths per minute, and the nurse should anticipate adjustments in the client's dosage before the PCA pump is restarted.

A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? A) Review the client's hemoglobin results. B) Notify the healthcare provider. C) Inquire about the reaction to sulfa. D) Record the client's vital signs.

B. Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies (B). Although (A, C, and D) are important assessments, it is most important to notify the healthcare provider for an alternate prescription.

While taking a nursing history, the client states, "I am allergic to penicillin." what related allergy to another type of anti-infective agent should the nurse ask the client about when taking nursing history. A. aminoglycosides B. Cephalosporins C. Sulfonamides D. Tetracyclines

B. Cross allergies exist between penicillins and cephalosporins

A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given. C) When the next blood glucose level is to be checked. D) Thirty minutes before the next antibiotic dose is given.

B. Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough level of an antibiotic.

When assessing an adolescent who recently overdosed on acetaminophen (tylonel), it is most important for the nurse to assess for pain in which area of the body a. flank b. abdomen c. chest d. head

B. acetaminophen toxicisty an result in liver damage; therefore, it is especially important for the nurse to assess for pain in the right upper quadrant of the abdomen (which might indicated liver damage)

Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A. Antacids. B. Benzodiasepines C. Antihypertensives D. Oral antidiabetics

B. respiratory depression increases with the concurrent use of opioid analgesics and other CNS depressant agents, such as alcohol, barbiturates, and benzodiasepines

The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? The client's A) statement that the chest pain is better. B) respiratory rate is 16 breaths/minute. C) seizure activity has stopped temporarily. D) pupils are constricted bilaterally.

B.Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression effects of opiate overdose, so assessment of a normal respiratory rate (B) would indicate that the respiratory depression has been halted. (A, C, and D) are not related to naloxone (Narcan) administration.

A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? Glaucoma. Hypertension. Heart failure. Asthma.

Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are indicated in heart failure (C), shock, atrioventricular block dysrhythmias, and cardiac arrest.

Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? A) Loperamide (Imodium). B) Probanthine (Propantheline). C) Bismuth subsalicylate (Pepto Bismol). D) Diphenoxylate hydrochloride with atropine (Lomotil).

C. Bismuth subsalicylate (Pepto Bismol) contains a subsalicylate that increases the potential for salicylate toxicity when used concurrently with aspirin (acetylsalicylic acid, another salicylate preparation). (A, B, and D) do not pose the degree of risk of drug interaction with aspirin as Pepto Bismol would.

A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the client? A. Discontinue the antibiotic because original symptoms have subsided. B. Continue taking medication until finished until the symptoms subside. C. Consult with healthcare provider about another treatment for this effect. D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions.

C. Consult with healthcare provider about another treatment for this effect. A superinfection with normal flora yeast may occur during antibiotic therapy. If suspected, the new onset of findings should be reported to the healthcare provider for another prescribed treatment to treat the superinfection.

A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. What intervention should the nurse implement? A) Alternate the two medications q4h PRN for pain. B) Alternate the two medications q2h PRN for pain. C) Administer only the Dilaudid q4h PRN for pain. D) Administer only the Stadol q4h PRN for pain.

C. Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an agonist-antagonist for the client who has been receiving opioid agonists may result in abrupt withdrawal symptoms, and should be avoided (C). (A, B, and D) do not reflect good nursing practice.

The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? A) The frequency of the dosing is necessary to increase the effectiveness. B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks. C) Another type of nonsteroidal antiinflammatory drug may be indicated. D) Systemic corticosteroids are the next drugs of choice for pain relief.

C. Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response. Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).

A postoperative client has been recieving a continuous IV infusion of meperidine (demerol) 35mg/hr for four days. The client has a PRN prescription for Demorol 100mg PO Q3H. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take FIRST? A. Administer a PRN dose of the PO meperidine (demorol) B. Administer naloxone (narcan) IV per PRN protocol C. Decrease the IV infusion rate of the demerol per protocol D. notify the healthcare provider of the clients confusion and hallucinations

C. The client is exhibiting symptoms of demerol toxicity, which is consistent with the large dose of demerol recieved over four days. C. is the most effective action to immediately decrease the amount of serum demerol.

The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action should the nurse implement? A) Refer the client to an audiologist for evaluation of her hearing. B) Advise the client that this is a common side effect of aspirin therapy. C) Notify the healthcare provider of this finding immediately. D) Ask the client to turn off her hearing aid during the exam.

C. Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be notified immediately (C), and the medication discontinued. (A and D) are not needed, and (B) is inaccurate.

Which client should the nurse identify as being at the highest risk for complications during the use of an opioid analgesic? A. an older client with type 2 diabetes B. A client with chronic rheumatoid arthritis C. A client with a open compound fracture D. A young adult with inflammatory bowel disease

D

Patient with ED reports congestion, dizziness, and nausea. Which nursing assessment takes priority? a) muscle and back pain b) breath sounds c) palpate for distention d) measure BP standing and lying down

D) measure BP standing and lying down. Test for orthostatic hypotension.

An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? A) Absorption. B) Metabolism. C) Elimination. D) Distribution.

D. A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased splanchnic blood flow, decreased gastrointestinal absorption surface areas and motility affect (A) in the older adult population. Decreased hepatic blood flow, decreased hepatic mass, and decreased activity of hepatic enzymes affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration rate, decreased tubular secretion, and decreased number of nephrons affects (C) in an older adult.

A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction?A) Notify the clinic of any changes in the color of urine. B) Avoid overexposure to the sun. C) Stop the medication after the diarrhea resolves. D) Take the medication with food.

D. Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be instructed to take the medication on a full stomach (D). Urine may be red-brown or dark from Flagyl, but this side effect is not necessary to report (A). Photosensitivity (B) is not a side effect associated with Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be taken for their entire course because stopping the medication (C) can increase the risk of resistant organisms.

A client is prescribed controlled-release oxycodone. Which dosing schedule is best for the nurse to teach the client? As needed. Every 12 hours. Every 24 hours. Every 4 to 6 hours.

Every 12 hours A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours provides the best around-the-clock pain management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule. Using a schedule of every 4 to 6 hours may jeopardize client safety due to cumulative effects of the medication.

After assessing a client, the nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication would be prescribed to the client? Caffeine Modafinil Atomoxetine Methylphenidate

Modafinil

What further teaching is needed when rifampin (rifordin) is given for TB?

Reduces effectiveness of oral contraceptives; Turns skin, sweat, tears, urine, feces, sputum, saliva, & tongue red/orange/brown; stains contacts.

The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids? A) Sedation. B) Constipation. C) Urinary retention. D) Respiratory depression.

b. The client should be prepared to implement measures for constipation (B) which is the most likely persistent side effect related to opioid use. Tolerance to opiate narcotics is common, and the client may experience less sedation (A) and respiratory depression (D) as analgesic use continues. Opioids increase the tone in the urinary bladder sphincter, which causes retention (C) but may subside.