Pharm final unit 4

A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?

"Estrogen and progesterone diminish."

The nurse needs to evaluate the effectiveness of a teaching session with a client diagnosed with peptic ulcer disease about taking mepenzolate. Which client statements indicate the need for further clarification? Select all that apply.

"I should drink at least 2 liters of beverages of my choice each day." "If my bowel movement is black or dark, it is because of the drug I take."

The nurse is completing a health history on a client experiencing menopause. What assessment findings indicated menopause? Select all that apply.

Mood changes Painful intercourse Hot flashes Sleep problems

A nursing instructor is conducting a teaching session about the parasympathetic nervous system. The instructor determines the session is successful when the students correctly choose which receptors are involved with stimulating smooth muscles?

Muscarinic

A client with biliary colic has been prescribed atropine. The nurse should question this order after discovering which disorder in the client's past history?

Myocardial infarction

A client with benign prostatic hypertrophy is questioning the nurse about saw palmetto. Which is the best response from the nurse related to the use of this herb?

Need to be reevaluated after 6 months of use.

A pregnant woman at 40 weeks gestation has been prescribed oxytocin IV. Which interventions would the nurse prioritize before administering the oxytocin?

Obtain an obstetric and general health history.

A nurse is assessing a client prior to giving a cholinergic drug for treatment of urinary retention. Which nursing assessments should be completed prior to administration of a cholinergic? Select all that apply.

Palpate the abdomen in the pelvic area. Assess blood pressure and pulse rate. Scan the bladder to determine if urine retention present.

A nurse is caring for a client with an arrhythmia. Which assessment would the nurse prioritize for a client with a life-threatening arrhythmia who is receiving an adrenergic blocking drug intravenously?

Perform continuous cardiac monitoring.

A nurse has administered estrogen and phenytoin to a client. Which reaction should the nurse plan to monitor the client carefully for?

Possibility of breakthrough bleeding

A 31-year-old pregnant woman has been prescribed a tocolytic drug. The nurse will explain to the client that this drug class is used primarily for which reason?

Preterm labor

A client receiving magnesium sulfate shows signs of dyspnea, tachycardia, increased respiratory rate and rales, and a frothy sputum on the ongoing assessment. Which condition should the nurse suspect the client is developing?

Pulmonary edema

A client in the PACU has been administered scopolamine in preparation for surgery. Which action is most appropriate for the nurse to complete after the administration?

Raise the side rails of the bed

A client has been prescribed a transdermal patch of estrogen. Which adverse effect should be included in the teaching plan about the medication?

Redness at the application site

A nurse is preparing to administer a centrally acting adrenergic blocker to a group of clients. The nurse would be especially cautious when administering the drug to the client with which disorder?

Renal function impairment

The nurse is scheduled to administer testosterone transdermal patch to a client admitted with primary hypogonadism. What is the priority teaching that would be provided regarding this medication?

Report to primary care provider any leg pain, redness, and swelling right away.

Administration of estrogen is different in women who have an intact uterus or a hysterectomy. Which statement is correct?

Estrogen is administered alone after a hysterectomy.

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: Blood Urea Nitrogen (BUN), creatinine, and Liver Function Tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs?

"The labs will identify your body's ability to filter and excrete medications."

After explaining the various contraceptive options with a client, the client opts for the etonogestrel/ethinyl estradiol vaginal ring. After teaching the client about this choice, the nurse determines that the teaching was effective when the client states which statement?

"The ring should stay in place for 3 weeks."

A client is asking how alpha adrenergic blocking medications work. Which is the nurse's best response?

"They relax the smooth muscle of blood vessels by vasodilatation."

The nurse administers bethanechol to a client with urinary retention at 9:30 AM. The nurse would notify the primary health care provider if the client has not voided by which time?

11 a.m.

A client has a levonorgestrel implant contraceptive system inserted. The nurse understands that this type of contraceptive provides protection for how long?

5 years

A nurse is preparing to administer a cholinergic medication. To prepare to administer the medication, the nurses is assessing the client for anticholinergic effects. Cholinergic medications act like which neurotransmitter?

Acetylcholine

A client with hypertension is prescribed clonidine. The nurse should question this order if which disorder is noted in the client's history?

Active hepatic disease

The nurse is preparing a client scheduled for abdominal surgery to begin at 0730. The client is to receive a preoperative medication of meperidine and scopolamine. The client also has an antibiotic to be administered prior to surgery. The nurse's first action should be?

Administer the preoperative medication intramuscular (IM) as ordered.

A nurse is caring for a client who is prescribed darifenacin. Which activity should the nurse prioritize in the ongoing assessment?

Evaluation of symptoms related to the client's diagnosis

A client with motion sickness is prescribed transdermal scopolamine. The nurse would instruct the client to apply the patch at which frequency?

Every 72 hours

The nurse has administered dicyclomine to an elderly client. Which finding on the ongoing assessment should the nurse prioritize?

Blurred vision

A client is admitted for tocolytic therapy for preterm labor. The client states, "I'm so afraid that I'm so early. Is my baby okay? What if the drug doesn't help?" Which nursing diagnosis should the nurse prioritize for this client?

Anxiety

A client with delayed puberty has been advised to undertake transdermal androgen therapy. Which instructions should the nurse prioritize?

Apply immediately after removing the cover.

A nurse is caring for a client who has been prescribed propranolol for angina. After administering the drug, which action would the nurse do?

Ask about relief of symptoms and record responses on the chart.

A nurse is caring for a client with peptic ulcer disease who has been prescribed a cholinergic blocking drug. Which nursing interventions should the nurse prioritize before administering the drug if the client has been experiencing prolonged diarrhea?

Assess weight of the client.

A client is reporting diarrhea, rigidity and spasm after receiving pyridostigmine. Which medication is appropriate to suggest to the prescriber?

Atropine

A client with urinary retention is prescribed bethanechol. The nurse will administer this cautiously if which disorder is noted in the client's medical record?

Bradycardia

A nurse is preparing to administer goserelin to a client with prostate cancer. Which assessment findings should the nurse prioritize on the ongoing assessment?

Breast atrophy, sexual dysfunction

The nurse is scheduled to administer an oral contraceptive to a client admitted with adult onset diabetes. What is the priority teaching that would be provided regarding this medication?

Call the primary care provider for any sudden onset of chest pain, shortness of breath, or redness, swelling, and pain in a leg.

An 80-year-old client with chronic renal insufficiency is prescribed anabolic steroid therapy for the management of anemia associated with renal insufficiency. The nurse will carefully monitor the client for which potential disorder?

Cancer of the prostate

A client has been prescribed pyridostigmine for myasthenia gravis. The nurse would be alert for the development of which adverse reaction following the administration?

Cardiac arrhythmias

A client is prescribed tamsulosin and atenolol. Which assessment would the nurse prioritize when conducting the ongoing assessment?

Blood pressure

A client receiving mepenzolate is reporting a cotton-mouth feeling. Which action by the nurse is most appropriate?

Check the oral cavity daily for soreness or ulcerations.

A client with myasthenia gravis who is prescribed pyridostigmine comes to the emergency department reporting abdominal cramping, excessive diarrhea, and severe muscle weakness. The nurse would suspect which situation is occurring?

Cholinergic crisis

A nurse is caring for a client with advanced breast cancer who is receiving androgen therapy. Which signs might alert the nurse to the possibility of liver toxicity?

Clinical jaundice

A nurse is preparing to administer a transdermal adrenergic blocker. Which medication would the nurse be preparing to administer?

Clonidine

A nurse is preparing to administer an ophthalmic cholinergic drug to a new client. The nurse should question this administration of the drug if which past history is noted in the client's medical record?

Corneal abrasion

A nurse is concerned that a client may be having a cholinergic crisis. What signs and symptoms would the nurse assess for a cholinergic crisis? Select all that apply

Excessive salivation Spasms Abdominal cramping Jaw clenching

A client with cardiac arrhythmia is treated with a centrally acting antiadrenergic drug. The nurse would assess the client for which sign or symptom as a possible adverse reaction?

Malaise

A client was emergently administered bethanechol. Which finding on ongoing assessment should the nurse prioritize and notify the health care provider immediately?

Failure to void

A nurse determines a nursing diagnosis of Impaired Oral Mucous Membranes for a client receiving appropriate drug therapy for urge incontinence. The nurse would most likely choose this nursing diagnosis related to which drug?

Fesoterodine

The nurse monitors the antepartum client receiving oxytocin for induction of labor and should report which as an adverse reactions? Select all that apply.

Fetal bradycardia Uterine hypertonicity

A nurse is conducting a teaching session with a client who is prescribed scopolamine during the summer. The nurse determines the session is successful when the client correctly chooses which sign to report immediately to the health care provider which may indicate the client is experiencing heat prostration?

Fever

The nurse is caring for a client in an outpatient clinic who plans to take an oral contraceptive. The nurse should perform which pre-administration assessment(s) before the client sees the primary care provider? Select all that apply

Gather client history of any breast, uterine, or ovarian cancers, cardiovascular, or thromboembolism disorders. Determine menstrual history, including age of onset of menses, pattern of menses, and any changes to the pattern. Assess sexual history, including number of partners, sexual practices, and reason for wanting the contraceptive. Obtain an assessment of using tobacco products, smokeless tobacco, or any attempts to quit using tobacco.

A nurse is preparing a presentation for a young adult women's group about oral contraceptives and the risks. Which conditions would the nurse include as having an increased risk of developing when prescribed contraceptives?

Hepatic adenoma

A 30-year-old pregnant woman has been prescribed oxytocin. After assessing the client's drug regimen and noting the client is also prescribed, vasopressors, the nurse will carefully monitor the client for which potential adverse reaction?

Hypertension

The nurse is preparing to administer solifenacin to a client with an overactive bladder. Which potential reaction should the nurse prioritize after noting the client is also prescribed digoxin?

Increased serum levels of digoxin

A nurse is caring for a pregnant client in the third stage of labor. The nurse would prepare to administer?

Intramuscular

The nurse notes a client who is receiving a tocolytic has a blood pressure reading of 82/50. The nurse's priority is to notify the primary health care provider and place the client in which position?

Left lateral

A female client receiving fluoxymesterone for metastatic breast cancer is disturbed by the physical changes seen in her body. The nurse provides support to the client based on assessment of which features the client is experiencing related to this therapy?

Deepening of the voice

Which nursing diagnosis is related to myasthenia gravis diagnosis?

Diarrhea

The nurse is caring for a client with myasthenia gravis and has been administering edrophonium. The nurse suspects the client needs an increased dose based on which assessment finding?

Difficulty breathing

After teaching a group of nursing students about drugs that affect the uterus, the instructor determines that the teaching was successful when the students correctly choose which drug as being used for cervical ripening?

Dinoprostone

After teaching a group of nursing students about cholinergic drugs, the instructor determines a need for additional teaching when the students choose which drug as being administered orally?

Edrophonium

A client taking oral contraceptive drugs reports occasional abdominal bloating. Which instruction should the nurse point out may be beneficial to help alleviate the condition?

Limit fluid intake with meals.

A client is experiencing photophobia secondary to the administration of a cholinergic blocking drug. Which action would be most appropriate?

Limiting the use of overhead lights

What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?

Endometrial cancer

A nurse is preparing to administer oxybutynin to a client and discovers the client is also prescribed haloperidol. The nurse predicts the client has the increased risk of which reaction related to the concomitant use of both drugs?

Decreased effect of haloperidol

A client with Parkinson disease has been using levodopa. The client is now prescribed labetalol for hypertension. Which finding should the nurse prioritize if noted on assessment?

Decreased effect of levodopa

A client who is receiving a beta blocker tells the nurse that he also takes ibuprofen for arthritis pain. The nurse would be alert for which reaction?

Decreased effect of the beta blocker

The nurse is preparing a teaching plan for a client and caregiver concerning the cholinergic drug therapy which has been prescribed. Which teaching point should the nurse prioritize?

Review of the purpose of the drug therapy with the client and family

A client is beginning therapy with terazosin. Based on the action of this drug, which nursing diagnosis should the nurse prioritize?

Risk for Injury

A client with hypertension has been receiving nadolol and is now reporting dizziness on standing. The nurse notes a significant drop in blood pressure when checking it lying, sitting, and standing. Which nursing diagnoses should the nurse conclude is most appropriate for this client's plan of care?

Risk for Injury

A client is prescribed oxytocin for intranasal use. The nurse will explain to the client this will achieve which result?

Stimulation of the milk ejection reflex

A client with a peptic ulcer is prescribed glycopyrrolate. Which physical assessment should the nurse prioritize in the preadministration assessment?

Stools

A client comes to the emergency department and reports extreme pain. Physical assessment reveals an erection. When obtaining the client's medication history, which drug would the nurse expect the client to report using?

Tadalafil

A client diagnosed with myasthenia gravis is being discharged home after a crisis. Which should be included in the teaching plan?

Teach the client to adjust the dosage based on their needs.

A nurse is preparing to administer propranolol. Which are safety concerns that would alert the nurse to hold the medication? Select all that apply.

The pulse is less than 60 beats per minute. The systolic blood pressure is less than 90 mmHg. There is irregularity in the client's heart rate or rhythm.

When caring for a client receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis of Ineffective Tissue Perfusion. Which condition is the nurse prioritizing in the diagnosis?

Thromboembolism

A client with a cardiac problem is treated with beta-adrenergic blocking drugs. Which reaction should the nurse point out as a cardiac reaction that impacts the body when a beta-adrenergic blocking drug is given to the client?

Vertigo

A nurse is preparing to administer propranolol to a client for the treatment of cardiac arrhythmias. The nurse checks the client's apical pulse rate and blood pressure before administration and notes that the pulse rate is 58 bpm. Which action would the nurse prioritize?

Withhold the drug and contact health care provider.

Prior to administration of adrenergic blocking drug for hypertension, which should the nurse assess first?

blood pressure

A nurse is caring for a female client who states she has a 28-day cycle. Which two hormones are influential in the female fertility cycle?

estrogen and progesterone