Pharm II: Practice Questions

Cocaine (-the client who has cocaine toxicity typically has tachycardia, elevated blood pressure, dilated pupils, and displays delusions. this client's behavior and physiological data indicate cocaine intoxication.)

A client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me. and I require Zolpidem." The client's pupils are dilated. along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances?

"The dose should remain constant to prevent breakthrough pain." (Fixed or scheduled dosing around the clock offers the best pain control for clients who have severe and persistent pain.)

A client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has a prescription for morphine I5 mg orally every 4 hr. The clients adult children express concern that the client is receiving too much of the medication.

Document the notification of the clients provider (In the medical record of the client who received the zolpidem, the nurse should document the objective facts of the error, including follow-up actions and notification of the provider.)

A nurse erroneously administered zolpidem to the wrong client. Which of the following actions should:he nurse take?

I am allergic to neomycin (A hypersensitivity to neomycin is a contraindication for receiving the varicella vaccine.)

A nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chickenpox or its vaccine, The nurse should withhold the vaccine and collect additional data when the client makes which of the following statements?

Measles, mumps, and rubella (MMR) (Although most infants should receive the MMR vaccine between the ages of 12 months and 15 months, the nurse should identify that the MMR vaccine is composed of live viruses and is contraindicated for an infant who is immunocompromised.)

A nurse in a provider's office is reviewing the immunization records of a 12-month-old infant who is immunocompromised. which of the following vaccines should the nurse identify as contraindicated for this client?

Hyporeflexia (Magnesium sulfate depresses neuromuscular activity, causing muscle weakness and paralysis. Therefore, the nurse should identify hyporeflexia as an indication of magnesium toxicity and report it to the charge nurse.)

A nurse is assisting with collecting data (or a client who is in preterm labor and is receiving magnesium sulfate via continuous iv infusion. which of the following findings should the nurse identify as an indication of magnesium-toxicity?

Hypotension (-When using the urgent vs. non-urgent approach to client care, the nurse determines that the priority finding to report to the provider is hypotension. If the client's vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria.)

A nurse is assisting with the care of a client who has a methicillin-resistant Staphylococcus aureus(MRSA) infection and is receiving vancomycin via IV infusion. which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider?

Implement seizure precautions (The greatest risk to the client is injury from seizures and falls. Grand mal seizures can occur during severe alcohol withdrawal. Therefore, the nurse's priority is to implement seizure precautions to reduce the risk of injury if the client experiences a seizure.)

A nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority?

Inform the client to apply sunblock before going outside (-The nurse should inform the client to apply sunblock, which will counteract the adverse effects of photosensitivity. Chlorpromazine increases skin's sensitivity to ultraviolet light causing temporary pigmentation changes and increases the risk of sunburn.)

A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication?

Hyperkalemia (The nurse should identify that eplerenone can place the client at risk for increased potassium levels because eplerenone can cause potassium retention.)

A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. The nurse should monitor for which of the following adverse effects of this medication?

Fasting blood glucose level (The development of hyperglycemia can be an adverse effect of risperidone. The nurse should obtain a fasting blood glucose level prior to administration of the first dose and periodically during treatment.)

A nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia.which of the following laboratory tests should the nurse plan to obtain prior to administering the first dose?

Tremors (-Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. The client can experience tremors, confusion, and hallucinations.)

A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. The nurse should notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects?

"Your medication can't be given IV because it is not water-soluble."

A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make?

Hemoglobin rises 0.5g/dl (-Initial therapeutic effects, such as hemoglobin rising 0.5g/dl, can occur within the first 2 weeks of therapy. The client's hemoglobin should reach target levels of 10 to 11g/dl in 2 to 3 months. )

A nurse is caring for a client who has chronic kidney disease and has been receiving Epoetin for 2weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect?

Acyclovir (The client should receive acyclovir, an antiviral medication, to treat genital herpes by reducing manifestations and the rate of viral shedding.)

A nurse is caring for a client who has genital herpes. which of the following medications should the nurse expect to administer?

Decreased T4 (-The nurse should identify that methimazole inhibits the synthesis of thyroid hormone, reducing levels to provide a euthyroid state. Therefore, a decreased level of T4 is an indication of a therapeutic effect.)

A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following findings should indicate to the nurse that the medication has had a therapeutic effect?

Increased HGB (Epoetin is used to elevate the erythrocyte count for clients who have kidney failure. An increased Hgb is the desired therapeutic effect of this medication.)

A nurse is caring for a client who has kidney failure and has been taking epoetin. Which of the following is a therapeutic effect of this medication?

Decreased muscle spasticity (The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity in a client who has multiple sclerosis.)

A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect?

Improved social interactions (Clients who have schizophrenia typically have difficulty interacting with others and maintaining relationships. Manifestations can include dull affect and speech deficiency. Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.)

A nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective?

Determine the client daily alcohol intake (The nurse should instruct the client to reduce or avoid all use of alcohol because isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake.)

A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take?

Albuterol (According to evidence-based practice, the nurse should administer a short-acting beta2 agonist with a rapid onset when a client is experiencing an acute asthma attack. Therefore, the nurse should administer the albuterol prior to the other medications for prompt relief of airway constriction)

A nurse is caring for a client who is having an acute asthma attack. Which of the following medications

31.25 = 31 gtts/min

A nurse is caring for a client who is receiving 0.9% sodium :chloride,000 mL to infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtts/mL. The nurse should ensure that the manual IV infusion is set to deliver how many gtts/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

[] white blood cell count (Methylprednisolone can increase the client's risk for infection and leukocytosis) []serum potassium []blood glucose

A nurse is caring for a client who is receiving methylprednisolone which of the following laboratory values should the nurse plan to monitor? (select all that apply.)

Respiratory depression (When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is respiratory depression, which can indicate the client is experiencing acetaldehyde syndrome, a life-threatening event.)

A nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. which of the following adverse reactions is the priority finding to report to the provider?

Increased HR (Due to cardiac effects, phenylephrine can cause tachycardia and other cardiac dysrhythmias.) A nurse is caring for a client who is taking phenylephrine' The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication?

A nurse is caring for a client who is taking phenylephrine' The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication?

Dark Urine (-the nurse should identify that levodopa/carbidopa can cause a darkening of the client's urine, sweat, and saliva.)

A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/ carbidopa. The nurse should identify which of the following findings as an adverse effect of this medication?

Headache (The nurse should expect the client to have headaches as a common adverse effect of taking sublingual nitroglycerin because it causes vasodilation.)

A nurse is collecting data from a client who has angina and a new prescription for sublingual nitroglycerin. which of the following manifestations should the nurse expect as an adverse effect of this medication?

Clear bilateral breath sounds (The nurse should identify that tachycardia is a manifestation of pneumonia. This heart rate is above the expected reference range and, therefore, is not an indication that the medication has been effective.)

A nurse is collecting data from a client who has bacterial pneumonia and is taking ceftriaxone. Which of the following findings indicates a therapeutic effect of the medication?

Vomiting (The nurse should identify vomiting as an early manifestation of digoxin toxicity.)

A nurse is collecting data from a client who has been taking digoxin for I month The nurse should identify which of the following findings as a manifestation of digoxin toxicity?

The client is able to wash their face. (Levodopa works by activating dopamine receptors, restoring nerve transmission for clients who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the intestine and periphery. These therapeutic effects assist the client with moving freely and resuming ADLs. )

A nurse is collecting data from a client who has been taking levodopa/carbidopa. which of the following findings should indicate to the nurse that the medication is effective?

Sore throat (The nurse should monitor for sore throat and fever because these are early indications of agranulocytosis, which is an adverse effect of propulthiouracil.)

A nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication?

Drowsiness (The nurse should identify drowsiness as an adverse effect of baclofen. Other adverse effects include dizziness, weakness, and fatigue.)

A nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication?

History of myocardial infarction (Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease.)

A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain.The nurse should identify that which of the following findings is a contraindication to receiving celecoxib?

Oxygen saturation 87%

A nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider?

[] blurred vision --(The nurse should identify visual changes such as blurred vision, halos, and a yellow or green tinge to vision as adverse effects of digoxin.) [] Nausea --(The nurse should identify that nausea and vomiting are adverse effects of digoxin.) [] Dysrhythmias --(The nurse should identify that dysrhythmias are an adverse effect of digoxin.)

A nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication? (Select all that apply.)

Abdominal pain (The greatest risk to this client is the development of pancreatitis as an adverse effect of exenatide; therefore, the nurse should withhold the medication and immediately notify the provider of the client's abdominal pain. Manifestations of pancreatitis include severe, persistent abdominal pain with possible emesis.)

A nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately?

Increased tolerance to exercise (The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to be carried to the vital organs and tissues.)

A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect?

Slurred speech(The nurse should recognize that slurred speech is a manifestation of lithium toxicity and should be reported to the provider.)

A nurse is collecting data from a client who is taking lithium to treat bipolar disorder. which of the following findings should me nurse report to the provider?

Diarrhea (The nurse should monitor for diarrhea, which is an adverse effect of antibiotics, such as amoxicillin.)

A nurse is collecting data from a client who is taking oral amoxicillin to treat a respiratory infection The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

Oliguria (Oliguria indicates the client is at greatest risk for nephrotoxicity. Therefore, the nurse should report this finding to the provider immediately.)

A nurse is collecting data from a client who is taking tobramycin, which of the following findings should the nurse report to me provider immediately?

Respiration rate 11/min (When using the airway, breathing, and circulation approach to client care, the priority finding is a respiratory rate of 11/min., which indicates respiratory depression.)

A nurse is collecting data from a client who received morphine IV for pain relief. Which of the following findings is the nurse's priority to report to the provider?

Pulse 82/min (-Tachycardia is a manifestation of hyperthyroidism. The nurse should identify that a pulse of 82/min is within the expected reference range of 60 to 100/min, indication that the medication is effective)

A nurse is collecting data from a female client who has been taking Propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective?

Gelatin (The nurse should identify that a hypersensitivity reaction to either gelatin or neomycin is a contraindication for receiving the varicella vaccine because it contains both of these substances.)

A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization?

Apical pulse of 52 (The nurse should check the client's apical pulse prior to administering digoxin because it can cause bradycardia. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.)

A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?

Agranulocytosis

A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication?

Hypotension (The nurse should identify that amphotericin B is considered a high-alert medication due to potentially serious adverse effects, such as hypotension. therefore, the nurse should report this or other adverse effects of amphotericin, such as nephrotoxicity, hypokalemia, and cardiac dysrhythmias.)

A nurse is evaluating a client who is receiving amphotericin B Via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication?

Press the naso/lacrimal duct (The nurse should press the client's naso/lacrimal duct after instilling the eye drops to prevent the medication from absorbing into systemic circulation.)

A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops?

Hypokalemia (Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia due to excessive potassium excretion in the urine.)

A nurse is monitoring a client when has been receiving long-term hydrochlurothialide therapy for recurring episodes of heart failure. which of the following findings should me nurse identify as an adverse effect of this medication?

Glycosylated HBA1C (-The client's HBA1C value measures the average of blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long-term therapeutic effect of repaglinide.)

A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving Repaglinide. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of this medication?

Ask the client to rate their pain (According to evidence-based practice, the nurse should first ask the client to rate their pain level to provide a verbal report of pain, which is the priority indicator of the need for pain medication)

A nurse is monitoring a client who is 2 hr postoperative and has a prescription for opioid analgesics. which of the following actions provides the nurse with the priority data to determine the client's need for analgesia?

Stop the transfusion (-The greatest risk to this client is injury from a transfusion reaction that can cause acute intravascular hemolysis or anaphylaxis. Therefore, the first action the nurse should take is to stop the transfusion. )

A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1" C (102.4° F). Which of the following actions should the nurse take first?

Dispose of the medication with a second nurse as a witness. (The nurse is legally required to have a witness when disposing of a controlled substance.)

A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse they do not want to take the medication now. Which of the following actions should the nurse take?

Withhold the clients medication (The nurse should identify that metoprolol, a beta blocker medication, results in a decrease in heart rate and should withhold the medication for a heart rate less than 50/min. The nurse should also notify the client's provider of the client's heart rate.)

A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of48/min. Which of the following actions should the nurse take?

Your baby will receive the first hepatitis B vaccine before discharge. (The newborn should receive the first hepatitis B vaccine at birth, with the next dose at age 1 to 2 months.)

A nurse is planning to reinforce teaching about newborn immunizations with a client who is 24 hr postpartum. Which of the following information should the nurse plan to include?

A client who is attending postoperative physical therapy and requests pain medication

A nurse is preparing to administer a PRN medication to a group of clients. which of the following clients should the nurse administer medication to first?

50

A nurse is preparing to administer cefazolin 1 g in 100 mL 0.9% sodium chloride to infuse over 30 min. The drop factor of the manual IV tubing is 15 gtts/mL. The nurse should set the manual IV infusion to deliver how many gtts/min?(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Administer 25 ml syrup (This dose is higher than the client should receive. The correct dosage is 20 mL. Administering an incorrect amount of medication to a client requires completion of an incident report.)

A nurse is preparing to administer diphenhydramine 50 mg P0 at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5 mg/5 mL PO. Which of the following nursing actions requires the completion of an incident report?

15

A nurse is preparing to administer phenobarbital 3 mg/kg P0 twice a day to a school-age child who weighs 44 lbs., Available is phenobarbital elixir 20 mg/5 mL, How many mL should the nurse plan to administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies.Do not use a trailing zero.)

Yogurt (Clients taking phenelzine should avoid consuming tyramine, which can cause high blood pressure. Yogurt contains little or no tyramine. Therefore, the nurse should instruct the client that yogurt is an appropriate food choice.)

A nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine, which of the following foods should the nurse include in the teaching as an appropriate land choice?

"Take a slow, deep breath lasting 3 to 5 seconds after releasing the medication." (The client should take a slow, deep breath lasting 3-5 seconds to allow the medication to be distributed deeply into the lungs.)

A nurse is reinforcing discharge teaching with a client who has a prescription for a metered—dose inhaler (MDI). Which of the following information should the nurse include in the teaching?

Reye syndrome (-Aspirin is contraindicated for children and adolescents who have a viral illness because it increases the risk for the development of Reye syndrome.)

A nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions?

Muscle pain (-The nurse should instruct the client to notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis.)

A nurse is reinforcing teaching with a client about the adverse effects of simvastatin, For which of the following adverse effects should the nurse instruct the client to notify the provider?

Diphenhydramine (Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause CNS depression. Therefore, when a client uses the two medications together, the client is at increased risk for sedation, respiratory depression, and injury.)

A nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management The nurse should instruct the client that which of the following over-the-counter medications is contraindicated while taking oxycodone?

Chest tightness (The nurse should instruct the client to report chest pain or tightness to the provider because this can be a manifestation of a vasospastic response)

A nurse is reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

I will be sure to have my blood tested for anemia (-Zidovudine can cause severe anemia and neutropenia. The client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment. )

A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching?

Discard any solution that are cloudy

A nurse is reinforcing teaching with a client who has a new prescription for Etanercept to treat rheumatoid arthritis. which of the following instructions about self-administering this medication should the nurse include?

I will rinse my mouth after I use this inhaler (The client should rinse their mouth after using inhaled glucocorticoids to reduce the risk for the development of oral thrush. Therefore, the nurse should identify this statement as indicating an understanding of the teaching.)

A nurse is reinforcing teaching with a client who has a new prescription for a fluticasone inhaler. which of the following client statements indicates an understanding of the teaching?

Abdominal pain (The nurse should identify that metoprolol, a beta blocker medication, results in a decrease in heart rate and should withhold the medication for a heart rate less than 50/min. The nurse should also notify the client's provider of the client's heart rate.)

A nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty-arthritis, which of the following manifestations should the nurse include as an adverse effect of this medication?

"I will take the medication at the same time each day." (The client should take this medication at the same time each day to maintain a consistent level to reduce fertility and the chance of pregnancy.)

A nurse is reinforcing teaching with a client who has a new prescription for ethinylestradiol/norethindrone, an oral contraceptive. which of the following client statements should indicate to the nurse an understanding of the teaching?

Swallow the medication whole (The nurse should instruct the client to swallow the capsules or tablets whole and not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delayed-release tablets, as well as suspensions and powders.)

A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules.Which of the following instructions should the nurse include?

If your pulse rate is less than 50 beats per minute, notify your provider.

A nurse is reinforcing teaching with a client who has a new prescription for propranolol. which of the following information should the nurse include in the teaching?

"I should ensure that the Insulin is clear prior to drawing it up"

A nurse is reinforcing teaching with a client who has a new prescription for regular insulin. which of the following statements by the client indicates an understanding of the teaching?

Dilates Bronchioles

A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication?

I will look up when putting the medication into my eyes (The nurse should reinforce with the client to look up during administration of eye drops to protect the cornea and minimize blinking.)

A nurse is reinforcing teaching with a client who has a new prescription for timolol eye drops to treat glaucoma.which of the following client statements indicates an understanding of the teaching?

Massage your nose gently after medication administration (the nurse should instruct the client to massage their nose gently to increase absorption of the medication.)

A nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching?

I will take the medication with 8 ounces of water (-The client should take alendronate on an empty stomach with 240 ml (8oz.) of water to ensure it does not lodge in the esophagus, which can result in esophageal ulcerations.)

A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching?

I should place the patch behind my ear. (The nurse should reinforce with the client to place the scopolamine patch on a hairless area of skin behind the ear.)

A nurse is reinforcing teaching with a client who has a prescription for scopolamine transdermal patches to prevent motion sickness. which of the following statements by the client indicates an understanding of the teaching?

Maintain consistent sodium intake (-the client should maintain a consistent sodium intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline, which can lead to toxicity.)

A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. which of the following instructions should the nurse include in the teaching?

Restrict foods high in potassium (The nurse should instruct the client that spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium and salt substitutes that contain potassium.)

A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching?

Increase fluid intake (Clients who are taking methotrexate should increase fluid intake to reduce the risk for renal damage and to increase medication excretion.)

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate.which of the following information should the nurse include in the teaching?

Abdominal pain (The greatest risk to the client is hepatotoxicity and pancreatitis, which can cause abdominal pain. Therefore, the client should notify the provider immediately if experiencing a decrease in appetite, nausea, abdominal pain, or yellowing of the skin.)

A nurse is reinforcing teaching with a client who has seizures and a new prescription for Valproic Acid.The nurse should instruct the client to report which of the following adverse effects of Valproic Acid to the provider immediately?

The client wipes the cap with alcohol prior to filling the syringe. (The client should wipe the cap with alcohol prior to filling the syringe to reduce the risk for contamination.)

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self-administer NPH insulin' Which of the following client actions indicates an understanding of the teaching?

[] muscle pain (Clients taking metformin should monitor for manifestations of lactic acidosis such as muscle pain, hyperventilation, and dizziness. Lactic acidosis is a severe adverse effect of metformin that the nurse should report to the provider immediately) []hyperventilation (Clients taking metformin should monitor for manifestations of lactic acidosis such as a muscle pain, hyperventilation, and dizziness. Lactic acidosis is a severe adverse effect of metformin that the nurse should report to the provider immediately.) [] Dizziness (Clients taking metformin should monitor for manifestations of lactic acidosis such as muscle pain, hyperventilation, and dizziness. Lactic acidosis is a severe adverse effect of metformin that the nurse should report to the provider immediately.)

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis? (Select all that apply.)

Peripheral edema (The nurse should instruct the client to monitor for and report the development of peripheral edema because this can be an indication of heart failure, which is an adverse effect of metoprolol.)

A nurse is reinforcing teaching with a client who is newly diagnosed with hypertension and is taking metoprolol.The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

Dry cough (The nurse should identify that a persistent dry or nonproductive cough is an adverse effect of enalapril. the underlying cause of the dry cough is the accumulation of bradykinin from the medication. the client should notify the provider of this adverse effect. )

A nurse is reinforcing teaching with a client who is receiving enalapril 20 mg P0 daily, The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Place the patch on a different site for each application (-The client should place the patch on a different site for each application to prevent skin irritation.)

A nurse is reinforcing teaching with a client who is to start therapy using a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

While using this patch I will be careful when rising from a chair (Nitroglycerin can cause orthostatic hypotension, which can result in dizziness. The client should change positions slowly to reduce the risk for injury.)

A nurse is reinforcing teaching with a client who is to start therapy with a nitroglycerin transdermal patch. which of the following statements by the client indicates an understanding of the teaching?

Discontinue use in the left nostril, then in the right nostril (-Discontinuing the medication one nostril at a time can overcome rebound congestion.)

A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion?

Increase dietary potassium while taking the medication (The nurse should reinforce with the client to increase dietary intake of potassium because furosemide causes potassium to be excreted in the urine. Increasing dietary potassium will help prevent hypokalemia.)

A nurse is reinforcing teaching with a client who recently began taking furosemide. Which of the following instructions should the nurse include in the teaching?

[-] you will need to have liver enzymes monitored after 1 month. --The client should have their liver enzymes monitored 1 month after therapy and periodically thereafter because isotretinoin is metabolized in the liver. [-] you can nosebleed while taking this medication --Due to the drying effects of isotretinoin, nosebleeds are very common. [-] you should report any thoughts of harming yourself --Isotretinoin can cause depression, which can lead to suicide. The client or the client's family should report these thoughts to the provider. [-] you will need to have two negative pregnancy test prior to starting this medication --Due to the potential for severe birth defects, it is important to confirm the client is not pregnant.

A nurse is reinforcing teaching with a female client who has a new prescription for Isotretinoin. which of the following information should the nurse include in the teaching? (Select all that apply)

Bradycardia

A nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypertension. Which of the following conditions should the nurse include as a contraindication for this medication?

Give acetaminophen as needed for discomfort and fever.

A nurse is reinforcing teaching with the parent o fa preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching?

Benign prostatic hyperplasia (A client who has benign prostatic hyperplasia is at increased risk for developing acute urinary retention while taking opioids. Therefore, the nurse should notify the provider about this finding before administering hydromorphone.)

A nurse is reviewing a client's medical history before administering hydromorphone for postoperative pain. The nurse should notify the provider of which of the following findings before administering this medication

Furosemide 10.0 mg PO daily (-The nurse should avoid using a trailing zero following a whole number. This prescription can result in a medication error because the nurse can mistake the dosage as 100 mg instead of 10 mg because the decimal point is not always recognized. )

A nurse is reviewing medication prescriptions for a group of clients' The nurse should recognize that which of the following prescriptions can result in a medication administration error?

Penicillin allergy

A nurse is reviewing the history of a client who is to start taking Cefotetan to treat a bacterial infection which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medication?

Benign prostatic hyperplasia (Clients who have benign prostatic hyperplasia might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.)

A nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. which of the following conditions in the client's medical record should the nurse report to the provider?

Furosemide (Tobramycin is an amino-glycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time.

A nurse is reviewing the medication administration record for a client who has a new prescription for tobramycin to treat a pulmonary infection which. of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin.'

Furosemide (A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylerea-type oral hypoglycemic agents)

A nurse is reviewing the medication administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxalole-trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client?

What is your phone number (Acceptable client identifiers include the client's name, telephone number, facility identification number, date of birth, and other client-specific identifiers. The nurse must use at least two identifiers to verify the client's identity and should compare the information to what is on the client's wristband or in the medical record. )

A nurse on a medical-surgical unit is preparing to administer medications to a client which of the following questions should the nurse ask the client to verify the client's identity?

375

At 0800 a nurse assists with initiating a 1,000 mL IV infusion for a client, which is running at 125 mL/hr. How much fluid is left in the IV bag at 1300? (Round the answer to the nearest whole number. Use a leading zero if it applies' Do not use a trailing zero.)