Pharm last test prepu

A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is necessary?

"I am going on a cruise next week and plan to just lie in the sun all day and relax."

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?

"It's safest if you avoid drinking alcohol while you're taking this drug."

A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?

- "I will take three pills every 15 minutes until the pain subsides."

A nurse has been invited to speak to a support group for Parkinson's disease clients and families. Which statement addresses the chronic nature of the disease and the relevant drug therapies?

-"Drugs do not cure these disorders; they instead enhance quality of life."

A client asks the nurse how his COMT inhibitor medication works to treat his Parkinson's disease. Which of the following statements explains how COMT inhibitor medications work?

-COMT inhibitor medications prolong the effect of levodopa by blocking the enzyme that eliminates dopamine.

A nursing instructor is describing Parkinsonism to a group of nursing students. When discussing the underlying cause of the symptoms, the instructor explains the depletion of dopamine in which of the following?

-Central nervous system

The drug of choice to stop status epilepticus seizure activity is:

-Lorazepam given intravenously.

The nurse is caring for a patient receiving cardiotonic drugs. The patient has edema. Which of the following interventions should be taken to alleviate edema?

-Measurement of intake and output

A patient is going to be started on valproic acid (Depakote) for seizures and tells the nurse during the health history, "I drink a six-pack of beer daily and two to three six-packs on weekends." The priority nursing action would be to

-obtain liver function studies

A nurse has administered dopamine to a client taking phenytoin (Dilantin) for a seizure disorder. The nurse would closely monitor the client for which adverse reaction? Select all that apply.

A) Hypotension C) Bradycardia E) Seizures

A client is taking tolcapone for Parkinson's disease. What blood test will the nurse perform often on this client?

ALT

A client is prescribed a transdermal nitroglycerin system. The nurse educates the client on which of the following?

Apply the new transdermal system at the same time daily.

The administration of immunizations to a patient is a form of what type of immunity?

Artificial active immunity

A patient is administered amiodarone (Coradone) intravenously. Which of the following assessments is most important with this medication?

Assess blood pressure every 5 minutes

Which is the result of positive inotropic activity?

Increased cardiac ouput

A nursing student is scheduled to receive the hepatitis B series. What type of immunity will this immunization provide?

Passive immunity

The administration of immune globulins or antivenins to a patient is a form of what type of immunity?

Passive immunity

The pharmacology is discussing effects on the heart of different medications. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart?

Positive inotropic

The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?

Promotes the inactivation of clotting factors

Adrenergic drugs mimic the effects of stimulating what part of the nervous system?

Sympathetic

A 72-year-old woman is on long-term glucocorticoid therapy. It will be most important for the nurse to instruct the client to

Take measures to minimize the risk of falls

what is a diagnostic finding for a patient with paget's disease

alkaline phosphate of 165 IU/L

Cardiotonic drugs are used to treat which medical condition?

• Heart failure • Atrial fibrillation

A patient is taking atorvastatin calcium (Lipitor) to reduce serum cholesterol. Which aspect of patient teaching is most important?

Call the physician if you develop muscle pain

The nurse is assessing the client for left-sided heart failure. Which symptoms would the nurse identify as left-sided heart failure?

Dyspnea, tachycardia, cough

What assessment finding does the nurse determine is a therapeutic outcome of administering filgrastim (Neupogen) to the patient?

Elevation of white blood cell count

Which as an effect of epinephrine?

Increased heart rate

The nursing instructor explains to students that positive inotropic action affects the heart in which way?

Increased myocardial contraction

Use of St. John's Wort during warfarin therapy can result in which of the following?

Increased risk of bleeding

What values are used to monitor the effectiveness of warfarin therapy?

PT and INR

A nurse tells a patient to take a prescribed glucocorticoid in the morning based on the understanding that

this time mimics the peak diurnal concentration levels

The nurse is preparing an immunostimulant drug called oprelvekin to administer to a client 32 years of age who is diagnosed with chemotherapy-induced bleeding disorder. The nurse plans to teach the client about why the provider ordered the drug. What reason will the nurse give?

"The drug is used to increase platelet count associated with immunosuppression during chemotherapy."

The client is experiencing digitalis toxicity and presents with symptomatic bradycardia. The nurse knows which medication may be used to treat bradycardia?

- Atropine

Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes?

- Before meals and snacks with milk

A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which of the following modes of action helps losartan to bring about its antihypertensive effect?

- By blocking the angiotensin II receptors

The client presents to the health care provider with a new onset of bradycardia. The nurse recognizes that which antihypertensive can cause bradycardia?

- Diltiazem

Which herbal products should not be used during warfarin therapy?

- Garlic, ginger, gingko biloba, ginseng, green tea

When assessing a patient diagnosed with Paget disease focused in the skull, the nurse should anticipate which findings?

- Hearing loss, vertigo, intermittent tinnitus, headaches

The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?

- It directly relaxes smooth muscle, allowing dilation of peripheral arteries and veins.

A patient has been prescribed furosemide (Lasix). Because this drug causes potassium loss, what will the nurse instruct the patient to eat?

- Peaches

When planning care to a client who is receiving filgrastim (Neupogen) for a non myeloid malignancy, the nurse should formulate which of the following patient outcomes?

- The patient will not develop an infection, the patient will not experience bone pain, the patient will be able to self-administer filgrastim at home, the patient will not develop febrile neutropenia

What would a nurse keep in mind about glucocorticoids when teaching a patient?

- They promote fat storage

The nurse is preparing a male client for pacemaker surgery. The physician orders atropine to be given 30 minutes before the patient leaves for the operative room. The nurse knows that the physician ordered this medication for what reason?

- To dry up respiratory secretions to prevent aspiration during surgery

Which of the following is a true statement regarding allopurinol drug interactions?

- Use of allopurinol increases warfarin levels and increases theophylline levels

A patient presents to the emergency department with signs and symptoms of gabapentin overdose. Which of the following medications might be administered to treat gabapentin overdose?

-Activiated charcoal

The nurse is planning the care of a client diagnosed with Parkinson disease. What is the main purpose of this client's medication therapy?

-Adjust the balance of neurotransmitters in the client's CNS.

A client has been diagnosed with Parkinson's disease and the primary health care provider has prescribed levodopa(100 mg)-carbidopa(10 mg) PO q8h. What is the nurse's best action?

-Administer the medication as prescribed and monitor for therapeutic and adverse effects

An 18-year-old client has been taking phenytoin for the past 6 months for epileptic seizures. The client's phenytoin levels routinely fall within the therapeutic range. The client contacts the health care provider reporting nausea, headache, and diarrhea. What would be the most appropriate intervention based on the assessment of the client's symptoms and laboratory results?

-Advise the client to have his blood redrawn today to ensure that it is not at a toxic level.

While administering phenytoin, the nurse should observe the client what adverse reaction? Select all that apply.

-Ataxia, Lethargy, Nausea, gingival hyperplasia

A patient with diabetes reports increasing pain and numbness in his legs. "It feels like pins and needles all the time, especially at night." Which drug would the nurse expect to be prescribed for this patient?

-Gabapentin (Neurontin)

The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values?

-HDL 58 LDL 96 Cholesterol 178

The nurse is preparing to administer phenytoin (Dilantin) to a client. The nurse should notify the healthcare provider before administration based on which assessment finding?

-Heart rate 50 beats per minute on cardiac monitor.

A patient, newly diagnosed with a seizure disorder, has been prescribed valproic acid. What is an adverse effect of valproic acid that the nurse should include in the medication teaching plan?

-Liver toxicity

What should the nurse include as a possible adverse effect when teaching a client about phenytoin?

-Liver toxicity

A female client begins tolcapone therapy, and her physician arranges for laboratory testing to be completed on a routine basis. The nurse expects which laboratory study to be ordered by the physician?

-Liver transaminase enzymes

The client has been diagnosed with Parkinson's disease and has been prescribed levodopa. What should the nurse include in the care plan? Select all that apply.

-Monitor the client's vital signs each shift Monitor the client's urine output each shift Auscultate the client's bowel sounds once per shift Monitor the client's creatinine clearance whenever available

A 60-year-old client has developed a tremor of the right hand with a pill-rolling motion. Upon interviewing, the client states having sustained several head injuries. This information supports which possible diagnosis?

-Parkinson's disease

A nurse should review a client's medical conditions prior to administering a phenytoin (Dilantin) because its use is contraindicated in some clients. In what clients would its use be contraindicated? (Select all that apply.)

-Pregnancy -Sinus bradycardia

A male client is prescribed an anticholinergic drug by his physician. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect?

-Prevents sweating and heat loss and increasing the risk of heat stroke

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect?

-Rash

A 77-year-old man with a long history of absence seizures has been treated with ethosuximide for many years. The man is now in the process of moving to a long-term care facility and a nurse is creating a plan of care. The nurse understands the potential adverse effects of this drug and would consequently prioritize which nursing diagnoses?

-Risk for Falls

A nurse is making a care plan for a client with Parkinson's disease and has started on an antiparkinson medication. Which nursing diagnosis would be appropriate for this client's care plan? (Select all that apply.)

-Risk for Injury Altered Bowel Movements: Constipation Imbalanced Nutrition: Less than Body Requirements

The nurse is caring for a client who has taken hydantoins for several years. The nurse noted that the client has an unsteady gait, dizziness, nystagmus, acute confusion, a non-raised red rash on one arm, and has not been to the dentist for 2 years. Based upon the findings, what is the priority nursing diagnosis?

-Risk for injury related to untoward effect of hydantoin

Which of the following activities increases high-density lipoproteins?

-Smoking cessation -Weight loss -Regular aerobic exercise

The nurse, working in the emergency room, admits an 18-month-old toddler with influenza symptoms reported by the parents to have had a seizure. Further questioning of the parents indicates the toddler likely had a clonic-tonic seizure, which has never happened before. What is the nurse's priority action?

-Take the child's temperature.

The nurse is teaching a client newly-diagnosed with Parkinson disease about the appropriate use of levodopa-carbidopa. What should the nurse teach the client?

-Take the drug three times each day, at the times that are specified.

A client with a history of partial seizures has been taking lamotrigine for the past several days. The client calls the clinic and reports the development of a facial and torso rash to the nurse. What is the nurse's best action?

-Tell the client to take no further doses and come be assessed at the clinic immediately.

A client has a new diagnosis of a seizure disorder. What aspect of this client's health status would contraindicate the use of carbamazepine?

-The client's most recent blood work reveals pancytopenia.

A nurse is caring for a patient who requires antiparkinsonism drugs. What should the nurse confirm to ensure that the use of COMT inhibitors is not contraindicated in this patient?

-The patient is not lactating.

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms?

-There is an imbalance between dopamine and acetylcholine.

The nurse is caring for an older adult client who has been diagnosed with Parkinson disease and who will soon begin drug therapy. What nursing action will best promote safe and effective drug therapy?

-Thorough client and family teaching, supplemented with written materials

A female client is diagnosed with Parkinson's disease and is having difficulty performing her activities of daily living. Her physician orders pramipexole. Pramipexole may be used alone for which purpose?

-To improve motor performance and improve ability to participate in usual activities of daily living

A home health nurse is visiting an older male adult client with Parkinson disease. The nurse should assess this client for which signs or symptoms related to common adverse effects?

-Urinary retention

A client is taking levodopa. What should the nurse caution the client to avoid?

-Vitamin B6

A client has been prescribed an anticholinergic agent for treatment of Parkinson-related symptoms. What client education should be provided?

-Void before taking the medication.

A client with diagnoses of Parkinson's disease and hepatic disease is to begin tolcapone therapy. What monitoring intervention should be included in the client's plan of care?

-a baseline liver function test

Unwanted anticholinergic effects include:

-constipation and dry mouth.

A client has been prescribed benztropine as drug therapy for Parkinson disease. What assessment finding would suggest a therapeutic effect to the nurse?

-decreased rigidity and tremors

The nurse is caring for a client who has Parkinson disease. What should the nurse anticipate for this client?

-deficient levels of dopamine

A nurse is educating a client who has Parkinson's disease and family regarding possible adverse effects of carbidopa-levodopa. The nurse emphasizes which should be a closely monitored effect?

-involuntary movements.

A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize?

-monitoring the client's liver enzyme levels

A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of:

-muscle pain

A 23 year old patient has been taking gabapentin (Neurotin) for control of partial seizures. He is admitted to the emergency department with slurred speech, dyspnea, reports of double vision, and sedation. The admitting nurse suspects the patient has:

-taken an overdose of the drug

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which?

-use another form of birth control, such as condoms.

17. A nursing instructor is preparing a class discussion on the use of NSAIDs and interactions with other drugs. The instructor would emphasize that the effects of which of the following can increase with NSAID therapy? Select all that apply.

A) Lithium B) Cyclosporine E) Phenytoin

A client using a nitroglycerin patch should avoid

Alcoholic beverages

A nurse is caring for a patient with Paget's disease and is reviewing the patient's most recent laboratory values. Which of the following values is most characteristic of Paget's disease?

An elevated serum alkaline phosphatase level and a normal serum calcium level

An 80-year-old client has been brought to the emergency department in shock. The client is receiving dopamine. The nurse should prioritize the assessment for what potential serious adverse effect?

Cardiac arrhythmia

A patient is prescribed a cardiotonic medication. Which of the following pre-administration assessments should the nurse perform on this patient? .

Check for jugular vein distention

A nurse administering valproic acid to a client should monitor the client for increased effects of valproic acid when which of the following medications are initiated? Select all that apply.

Cimetidine (Tagamet) Amitriptyline (Elavil) Aspirin

A nurse is caring for a 25-year-old client who is being given an adrenergic drug for shock. Which action should the nurse do?

Continually assess the client for physiological changes and notify the primary care provider with changes

A client has been diagnosed with hypothyroidism and admits to the nurse that she has heard of her thyroid gland, but does not know the function of the thyroid hormone. The nurse should explain the fact that thyroid hormone is responsible for which action? -

Controlling the rate of cell metabolism throughout the body

A client who has taken diazepam for several months has developed physical dependence. The nurse has set up a schedule to taper drug doses to avoid a withdrawal syndrome. Which symptom would indicate that a withdrawal syndrome has occurred? Select all that apply.

Headache, Increased anxiety, Tremor

A nurse is caring for a client who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before drug therapy is started, the nurse will assess for? -

History of taking anticoagulant drugs

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this medication?

Hyperkalemia

A 49-year-old client is admitted with uncontrolled chest pain. He is currently taking nitroglycerin (Nitrostat). His physician orders nifedipine (Aldalat) added to his regimen. You should observe the client for which of the following adverse effects?

Hypotension

An adrenergic drug would be prescribed to produce what physiological effect?

Increased heart rate

A 42-year-old client is admitted to the hospital with severe back pain, intermittent tinnitus, constant headache, and vertigo. He states that the back pain has been a problem for a number of years, but the other symptoms are quite new. Upon further examination, it is noted that he has unexplained hearing loss, and his femur and tibia have begun to bow. What condition does this client most likely have?

Paget Disease

A student asks the pharmacy instructor what the difference is between the diuretics spironolactone (Aldactone) and furosemide (Lasix) . What would the instructor reply?

Potassium losses are less with spironolactone

A group of students are reviewing class material about immunizations and vaccines. The students demonstrate understanding of the topic when they state that immunizations and vaccines -

Provide the person with active immunity

A patient is being discharged from the hospital with warfarin (Coumadin) to be taken at home. Which of the following foods should the patient be instructed to avoid in his diet?

Spinach

The nurse is caring for a patient experiencing an acute angina attack. Sublingual nitroglycerin has been administered and the nurse begins to monitor vital signs. Why is this done?

To monitor blood pressure for hypotension

A A patient who is receiving warfarin (Coumadin) has blood in his urinary drainage bag. What medication will likely be ordered by the physician?

Vitamin K

A patient who has been treated with warfarin (Coumadin) after open heart surgery is involved in a car accident and has a laceration on her head. Which medication will be administered to assist in the development of clotting factors?

Vitamin K

The home care nurse is following a client discharged from the hospital with a prescription for diazepam. On the initial visit what is the nurse's priority related to this medication?

• Warning signs that may indicate serious adverse effects

A client is taking spironolactone (Aldactone) for edema. The nurse identifies that the client's level is 5.4 mEq/L. Which of the following questions would be appropriate for the nurse to ask the client?

"Do you use a salt substitute?"

A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction should the nurse provide the client's family about this drug?

"Don't stop this medication suddenly; you will have to taper dosage gradually."

After teaching about the action of spironolactone, the nurse determines that the teaching was successful when the patient states

"I need to make sure I don't eat too many high potassium foods."

The nurse provides client teaching about use of levodopa for treatment of Parkinson disease. What statement by the client would indicate a good understanding of levodopa?

"I should take this drug with food to avoid an upset stomach."

While preparing a patient for discharge, the nurse teaches about the proper use of warfarin, which has been prescribed by the physician. Which statement indicates that additional teaching is required?

"I should use aspirin to control my arthritis pain."

A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patient's knowledge of their drug, what would indicate that the patient needs further instruction concerning her drug therapy?

"I take aspirin for my arthritis."

The nurse knows that teaching about warfarin (Coumadin) is successful if the client states

"I will ask my doctor about herbal supplements"

A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education?

"I will take the medication when my blood pressure is elevated."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I'm glad that this medication will address all my symptoms."

The nurse is working with a group of caregivers of children diagnosed with asthma. Which of the following statements made by the caregivers is most accurate regarding the triggers that may cause an ashtmatic attack?

"My sister and her family love animals, and when we go to their house my daughter always has an asthma attack."

The client is a woman, age 42 years, who returns to the cancer treatment center diagnosed with chemotherapy-induced thrombocytopenia. The nurse knows that the interleukin drug oprelvekin is used to increase platelet production and explains to the client the need for the drug. The client will not sign the informed consent because she doesn't understand why she needs platelets. Which information would the nurse include in the explanation?

- "Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."

A client prescribed corticosteroids following a liver transplant asks if it will be necessary to take this medication indefinitely. How should the nurse respond?

- "Daily anti rejection drug therapy will continue as long as your transplanted liver is in place."

Which statement by the client leads the nurse to believe that the client needs additional instruction regarding the nasal decongestant?

- "I will use it only when I have nasal discharge."

A patient who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

-Antiepilepsy drugs are teratogenic

An older adult client diagnosed with Parkinson's disease will soon begin treatment with levodopa, carbidopa, and entacapone. Prior to starting this course of treatment, the nurse must ensure the implementation of which intervention?

-Assess renal function

A nurse is caring for a hospital client who has just been prescribed phenytoin for a seizure disorder. What assessment should the nurse prioritize when assessing for adverse effects?

-Assessment of respiratory rate and oxygen saturation

A client comes to the emergency department experiencing status epilepticus. Which medication would the nurse expect to administer?

-Lorazepam

An older adult client began treatment for Parkinson disease several months ago and the nurse is assessing the client. What assessment finding should suggest that the client's medications are becoming less effective?

-The client has begun drooling while they eat.

A client, newly diagnosed with Parkinson's disease, has been prescribed an anticholinergic drug. What assessment should the nurse perform when monitoring for adverse effects of anticholinergic agents used for the treatment of Parkinson disease?

-assessment of the client's bowel pattern

A client has a diagnosis of Parkinson disease, and the health care provider will prescribe carbidopa-levodopa. Before drug therapy, the client should be carefully assessed for the presence of:

-closed-angle glaucoma.

A 72-year-old man should be aware that the adverse effects of centrally acting anticholinergic drugs include:

-confusion.

A 26-year-old woman has been prescribed the suspension form of phenytoin. The nurse will inform the patient that she should

-shake the phenytoin suspension before pouring and measuring the dose.

Because of the black box warning for clients taking lamotrigine, the nurse should instruct a client to discontinue this medication immediately if he or she develops what unexpected reaction?

-skin rashes

A nurse administering carbidopa/levodopa (Sinemet) to a client should monitor the client for decreased effects of carbidopa/levodopa when which of the following medications are initiated? Select all that apply.

A) Phenytoin (Dilantin) C) Zonisamide (Zonegran)

A male patient is admitted to the emergency department (ED) with chest pain. The patient is diagnosed with angina pectoris. He is being discharged with an order for nitroglycerin SL PRN. What action should the nurse take when the patient reports chest pain? -

Administer a tablet under the patient's tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.

Kate is experiencing status epilepticus. The prescriber orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam?

Administer the drug very slowly, no faster than 5 mg/min.

The nurse has just administered the measles, mumps, and rubella vaccine to a female patient, how long should the nurse advise the patient to wait before trying to become pregnant?

At least 3 months

A patient has a history of smoking. Which agent would the nurse most likely expect to be ordered?

Atenolol

A nurse is preparing to administer phenytoin to a client. The nurse understands the need to administer this drug cautiously if the client has a history of which of the following? Select all that apply.

B) Hypotension E) Hepatic impairment

A patient is taking spironolactone (Aldactone) When providing patient teaching about this medication, what foods should the patient be instructed to avoid?

Bananas

A patient has received rubella immunization. The patient was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this patient?

Birth defects in the newborn

A female patient who takes ethosuximide for the treatment of absence seizures calls the clinic to report that she has developed a sore throat and a slight fever. The nurse will explain that she should come to the clinic to have what checked?

Blood cell count

Prior to administration of nitroglycerin, the nurse would assess which of the following?

Blood pressure

A client is newly diagnosed with Parkinson's disease. The client has been placed on an anticholinergic drug. Which symptom would cause the greatest concern for the nurse?

Blurred vision

Which symptoms will warrant the administration of atropine?

Bradycardia

The health care provider orders quinidine for a client who is receiving a common treatment for atrial fibrillation. The nurse would monitor this client for

Digoxin toxicity

When describing the possible adverse effects associated with nitroglycerin, what would the nurse include?

Dizziness

The nurse is educating a patient who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the patient?

Do not drive or operate machinery."

Discharge counseling for clients taking antiarrhythmic medications should include which of the following?

Do not take any nonprescription medications without permission of the physician, keep all appointments with the physician, to relieve dry mouth take frequent sips of water or chew gum

A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to

Don a pair of gloves

What is considered a possible trigger for an asthma attack? Select all that apply.

Exercise, allergens, pollutants, cigarette smoke

A client taking warfarin (Coumadin) tells the nurse she is having bleeding in the gums and teeth. When reviewing the client history, the client states she has decided to try an herbal remedy. Which of the following is most likely the cause of increased bleeding?

Ginger

While preparing a patient for discharge you teach her about the proper use of warfarin, which has been prescribed by the physician. Which of the following foods should you tell her to avoid?

Green leafy vegetables

The nurse should advise male patients taking spironolactone (Aldactone) that what may occur?

Gynecomastia-enlargement or swelling of breast tissue in males

Which condition(s) indicates target organ damage from untreated/undertreated hypertension? Select all that apply

Heart failure, retinal damage, stroke.

A nurse is caring for a 59-year-old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this patient?

Hypotension

The nurse is administering quinidine to a client who is also taking digoxin. The nurse will assess this client for which important adverse effect?

Increased digoxin level

Adrenergic drugs produce which effect?

Increased heart rate

A nurse is caring for a male patient receiving warfarin drug therapy. The patient informs the nurse that he is also taking chamomile, which is an herbal remedy. What effect of the interaction between warfarin and the herb should the nurse inform the patient about? -

Increased risk for bleeding

A nurse is caring for a patient who has been prescribed entacapone for the treatment of Parkinson's disease. The patient informs the nurse that he is taking MAOI antidepressants for the management of depression. What effect of the interaction of the two drugs should the nurse anticipate in the patient?

Increased risk of toxicity of both drugs

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma? -

Inhaled corticosteroid agents will reduce airway inflammation

A patient is receiving warfarin. Which would the nurse monitor to determine the effectiveness of the drug?

International normalized ratio, prothrombin time

A client diagnosed with hyperthyroidism is unsure about the need for prescribed propranolol, stating, "I looked this up online and it's for high blood pressure, not thyroid problems." What statement concerning beta-adrenergic blockers should the nurse use as a basis for the response?

It will block stimulation of the sympathetic nervous system

A patient is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the patient and family to

Keep the tablets in the original dark bottle

A client is being treated for Parkinson's disease and has been prescribed both levodopa (L-dopa) and carbidopa. Why is this course of treatment most effective?

Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of -levodopa.

A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify which of the following as an example of an angiotensin II receptor blocker?

Losartan

When educating patients on the immune system, the nurse identifies which of the following white blood cells to be involved in cell-mediated immunity along with T lymphocytes?

Macrophages

A client with cystic fibrosis may use which medication to reduce the viscosity of respiratory secretions? -

Mucolytic

Based on the nurse's knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder?

Myocardial infarction

A nurse is providing discharge instructions to a client who is taking atenolol (Tenormin) for hypertension. What should the nurse teach the client regarding the possible drug-to-drug interactions and what the client is advised to avoid?

NSAIDS

Which is an early sign of Paget disease?

Nipple erythema

Which of the following medications may be used to treat a hypertensive crisis? -

Nitroprusside

Proarrhytmia -

One problem with all antiarrhythmics is their ability to modify the rhythm of the heart; they can cause a new arrhythmia or exacerbate the arrhythmia that they are treating. This adverse effect is termed proarrhythmia.

A client is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for this client knows which occurrence is a potential side effect of this medication? -

Other arrhythmias (Proarrhythmia)

A patient taking warfarin (Coumadin) to prevent clot formation related to atrial fibrillation. How are the effects of warfarin (Coumadin) monitored?

PT and INR

The effects of warfarin (Coumadin) are monitored by what laboratory test(s)?

PT and INR

When discussing vaccines in class, a student asks the instructor what an antitoxin is. What is an example of an antitoxin?

Passive immunity

People receiving nifedipine (Aldalat) should be assessed for which adverse effects? -

Peripheral edema

A patient taking diltiazem (Cardizem) for hypertension has come to the clinic for a follow-up appointment. What adverse effects would the nurse assess the patient for? -

Peripheral edema and bradycardia

A client has received a dose of dopamine intravenously. The client's IV was infiltrated, and the dopamine was injected into the subcutaneous tissue. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?

Phentolamine mesylate (Regitine)

A patient with a history of heart failure is being treated with digoxin (Lanoxin). This medication increased the force of contractions of the heart. What effect improves the contractility of the heart?

Positive inotropic effect

The nurse is caring for a patient in the Emergency Department who is in pulmonary edema. The patient is treated with furosemide (Lasix). What should the nurse monitor?

Potassium levels

A nurse is caring for a patient who is going home on warfarin (Coumadin). The nurse will schedule the patient for what laboratory test to help evaluate therapeutic effects of the drug?

Prothrombin time (PT) and international normalized ratio (INR)

When counseling a client on the use of a transdermal nitroglycerin patch which of the following is true? -

Remove the old patch before applying the new patch, leave patch in place for 10-12 hour, apply patch to a dry, hair free area

A patient has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, his care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this patient? -

Respiratory assessment

A nurse is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which should the nurse assess before beginning drug therapy? -

Serum potassium levels

The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer?

Vitamin K

A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?

You might find yourself more congested than ever as your body compensates for your use of these drugs."

The nurse should exercise caution when administering antimetabolites to a client with

bone marrow suppression

An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen may create a risk for

falls

A nurse is caring for a client in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of

history of acute myocardial infarction

The nurse knows that the client will receive passive immunity to prevent organ rejection and explains how passive immunity works. Which of the following passive immunity agents would the nurse include in the family teaching session?

immune globulins

The nurse is preparing to administer a client's prescribed chemotherapy. The client has developed bone marrow suppression during treatment. What should the nurse include in the client's plan of care? Select all that apply.

implement falls prevention measures, place the client on protective isolation, monitor the client's laboratory values closely, allow sufficient time for rest between scheduled activities.

A client whose Parkinson's disease is being treated with tolcapone should concurrently take what drug?

levodopa/carbidopa

The nurse is giving intravenous infusion of amiodarone (Cordarone). The nurse should be aware of the

possible development of very serious cardiac arrhythmias.

A client reports experiencing severe nasal congestion since starting an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology supports what possible condition?

rebound congestion

What is an adverse reaction commonly experienced by people taking nasal decongestants?

rebound congestion

A clinic nurse is assessing a new patient prior to a patient seeing the physician. The patient has a history of hypertension and taking benazepril (Lotensin) to control the disease process. A priority nursing assessment in this patient would be to assess the patient for a history of

renal disease

Which finding indicates that hypertension is progressing to target organ damage? -

retinal blood vessel damage

Which of the following might a client complain of during treatment with an atorvastatin (Lipitor)? Select all that apply:

• Insomnia • Headache • Constipation

To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? Select all that apply.

• Low triglycerides • High HDL cholesterol • Low LDL cholesterol

When the client prescribed entacapone asks the nurse to describe exactly how this medication works, what response is most appropriate?

-"Entacapone inhibits COMT so that dopamine is active for a longer time."

Status epilepticus is a life-threatening condition that needs immediate treatment. What is the drug of choice in treating status epilepticus?

-Lorazepam

A physician has prescribed furosemide to a client with pulmonary edema. The client informs the nurse that he is also taking phenytoin as treatment for seizures. The nurse would assess the client closely for which of the following?

-decreases diuretic effect

A client with advanced Parkinson disease has undergone diagnostic testing and diagnostic imaging. What are the results most likely to reveal?

-degeneration of dopamine-producing nerve cells

Common side effects of anticholinergics include:

-dry mouth, urinary retention, constipation, and increased pulse rate.

A 75-year-old male patient is started on flavoxate, an anticholinergic drug used in the treatment of overactive bladder. When teaching the patient about the medication, the nurse should explain that the patient may be at increased risk of:

-falls related to visual effects.

What is a common risk for epileptic seizures during late infancy to early childhood?

-fever

A client is newly diagnosed with Parkinson disease, and levodopa has been prescribed. What health education should the nurse provide?

-identifying foods and supplements high in vitamin B6

The nurse is assessing a client who was prescribed levodopa 1 week earlier. What change in the client's status would suggest the effectiveness of drug therapy?

-improvement in handwriting

A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine (Synthroid). What assessment should the nurse prioritize?

- Monitoring the client for increased bruising

The pharmacology instructor is describing medications that increase the contractile force of the heart. Which term describes this effect?

- Positive inotropic

A nurse should screen clients of child-bearing age for pregnancy as the administration of which vaccines is contraindicated during pregnancy?

- Varicella, measles, mumps, rubella

After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify which of the following as a common allergen for asthma?

- Shellfish

A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?

"You may experience headaches as an adverse reaction to nitroglycerin."

A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understand proper self-administration?

- "I can take up to three tablets at five-minute intervals."

The nurse is teaching a client newly diagnosed with asthma about triggers. Which statement by the client indicates the teaching plan has been effective?

- "I will use my air conditioner."

Which client demonstrates the clearest indication for treatment with prednisone?

- A 70-year-old man whose rheumatoid arthritis has not responded to OTC relievers

The nurse is taking a health history on a 38-year-old male who is taking atorvastatin (Lipitor) for high cholesterol. The nurse will be sure to ask a specific group of questions regarding the patient's use of -

- Alcohol

A patient who was recently prescribed spironolactone calls the clinic. The patient states that they aren't going to the bathroom any more than before they started taking the spironolactone. What would be an appropriate question to ask this patient?

- Are you taking a salicylate?

The nurse is teaching post-administration cardiovascular system reactions to the immunostimulant drug oprelvekin. The nurse would include which cardiovascular system reactions in the client teaching plan?

- Arrhythmia resulting in stroke and pulmonary edema

A client with acute myeloid leukemia has been receiving mitoxantrone IV as part of the chemotherapeutic regimen. When assessing the client for the effects of bone marrow suppression, the nurse should perform what assessment?

- Assessment of the client's activity tolerance and energy level

The client is admitted with hyperglycemia. The nurse evaluates the client for which of the following medications?

- Atorvasatin

Cell-mediated immunity depends on which of the following?

- The action of T lymphocytes

A 15-year-old male client receiving phenytoin for treatment of epilepsy is being discharged from the hospital. What statement by Richard's mother leads you to believe she has understood your teaching related to his care and drug administration?

-"I will make sure he has routine visits to the dentist."

The nurse has been educating the client on the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication?

-"I'll make sure to take the drug with food."

A 30-year-old female client is diagnosed with seizure disorder, and the provider is considering the use of carbamazepine. What assessment question best addresses the safety and effectiveness of the medication regimen?

-"Is there any chance that you could be pregnant?"

A client diagnosed with Parkinson's disease asks if there are any holistic herbs or exercises that may help her balance. Which of the following would be the nurse's best response, based on previous clients' success using this approach?

-"Tai chi has been shown to help clients diagnosed with Parkinson's disease improve their balance."

What should the nurse teach an older adult client about the potential adverse effects of atorvastatin?

-"The most common side effects of atorvastatin involve some mild gastrointestinal upset."

One week ago, a client began taking ethosuximide (Zarontin) 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide?

-"Try taking your pills at the same time as you eat some food."

A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?

-2 hours

A pt with a hx of seizures has been admitted to the hospital for a minor infection. He has been taking lamotrigine (Lamictal) and volproic acid (Depakote). Pt has widespread lesions of the skin and moucous membranes and a temp of 102.9 & complains of malaise. The nurse should suspect:

-A hematologic reaction, Toxic levels of valproic acid, Steven-Johnson syndrome, Toxic epidermal necrolysis.

Which diuretic exerts its effect by inhibiting the enzyme carbonic anhydrase?

-Acetazolamide (Diamox)

Which diuretic has been administered to patients with epileptic seizures?

-Acetazolamide (Diamox)

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for which of the following?

-Bleeding

A nurse is treating a patient who is receiving carbamazepine for a seizure disorder. The nurse knows that carbamazepine is contraindicated in patients with which diseases or disorders?

-Bone marrow depression

While administering phenytoin, the nurse should observe the client for symptoms of which adverse reaction?

-Bradycardia

The nurse evaluates the client's latest serum phenytoin level which is revealed to be 16 mcg/mL. What is the nurse's best action?

-Document the fact that the client's phenytoin level is therapeutic.

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action?

-Document the fact that the nurse checked the client's phenytoin levels

One of the neurotransmitters can become decreased in the area of the corpus striatum. This results in the manifestations of Parkinson's disease. Which neurotransmitter will cause this?

-Dopamine

A client has been taking diazepam (Valium) for several months and remarks to the nurse it takes more and more of the medication to maintain the drug's effect. The nurse recognizes this response as what?

-Drug tolerance

A client has been prescribed carbamazepine for the prevention of seizures. What action should the nurse perform?

-Educate the client about the need to take the pills as scheduled

A client is prescribed a catechol-O-methyltransferase (COMT) inhibitor. Which drug would the nurse expect to administer?

-Entacapone

The nurse is providing care for a client with Parkinson's disease. Which of the client's medications will most directly affect catecholamine-O-methyl transferase (COMT) function?

-Entacapone

A child has been presented for care because he has episodes where he pauses what he is doing for a few seconds, is unresponsive, and then continues on with his activity. The nurse should anticipate the administration of what medication?

-Ethosuximide

What intervention may help the client increase HDL levels?

-Exercise

Clients with what disorder should not be given anticholinergic drugs?

-Glaucoma

A client who has been receiving long-term levodopa therapy tells the nurse, "I was making good progress and then it was like the drug stopped working." The nurse interprets this as which of the following?

-On-off phenomenon

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory?

The cell kill theory describes the process of giving multiple doses, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left

A client may administer a maximum of how many doses of sublingual nitroglycerin in a 15-minute period?

3

A nurse is educating a group of clients about immunizations. What benefit of immunization should the nurse describe?

They provide the person with active immunity

The nurse is administering sublingual nitroglycerin to a patient. Prior to administering the medication, the nurse informs the patients that immediately after administration, the patient may experience

Throbbing headache or dizziness.

Which is an adverse reaction associated with cardiotonic medications?

Visual disturbances

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed quickly and accurately?

Vital signs