Pharm Mid Term

The student nurse is discussing administration of a unit of fresh frozen plasma (FFP) and displays understanding of the time frame for delivery. Which statement below is correct regarding delivery of FFP?

I will ensure to complete the unit of FFP within 45 minutes

A student nurse reviews instructions for use of an antitubercular medication. Which statement by the student nurse indicates further need for understanding?

A typical course of treatment involves 6 to 9 months of consistent medication use

The nurse is preparing discharge teaching for four clients. Which client should be advised by the nurse to avoid over-the-counter cold and allergy medications?

47 year old client with hypertension

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

"Heparin does not dissolve clots. It stops new clots from forming."

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

A nurse is preparing to give a client an initial dose of penicillin. What actions are appropriate by the nurse? (Select all that Apply)

*Ask the health care provider to order a skin test to assess for hypersensitivity to penicillin *Ask the client if there is an allergy history to penicillin *Ask the client if there is a history of anaphylaxis

The physician orders verapamil HCL (Calan) 40 mg PO three times per day. Available: Calan 80 mg tablets The nurse would administer ___________ tablet(s)?

0.5 tab

Order: Amoxicillin 200 mg, PO, every 8 hours. Drug available: 250 mg/5 mL Calculate how many mL should be given and label your answer.

4 mL

A pediatric patient has an IV infusing at 25 mL/hr. How many mL will the child receive in 8 hours?

200 mL

A client with hypotension has an order for 500 mL of plasma protein fraction to be infused over 2 hours. How many milliliters per hour will the nurse program the IV pump?

250 mL/hr

Give Tobramycin 15 mg IVPB over three hours in 100 mL of D5W using a microdrip. How many drops per minute are needed?

33 gtt/min

Which of the following would the nurse include in the teaching plan when describing all types of anemia to a client?

A decreased number of or abnormal RBCs

The student nurse is explaining proper usage for albuterol and beclomethasone inhalers for the control of asthma to the instructor. Which of the following statements by the student nurse is correct?

Administer the albuterol inhaler prior to using the beclomethasone inhaler

The nurse reviews newly written prescriptions for a client admitted with peptic ulcer disease. Which medical prescription should the nurse question?

Aspirin

febrile nonhemolytic reaction

Chills, flushing, anxiety, ha

The nurse evaluates the effectiveness of a newly prescribed medication. Which assessment finding is most concerning?

Difficulty breathing

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. What action should the nurse take?

Discard vial after removing one dose of the medication

How does the student nurse best describe drug efficacy and toxicity in pediatric clients?

Drug dosage is altered by disease state and weight in children

The nurse is preparing to a dose of heparin for a client newly admitted to the ICU. What is a priority safety concern the nurse should understand?

Heparin dosages should be verified with another nurse

The student nurse voices the following knowledge of the use of heparin. Which of the following statements is appropriate concerning heparin administration management.

Heparin has its effects reversed with the administration of protamine sulfate

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take?

Measure the client's apical pulse

A nurse is teaching a client regarding a new prescription for erythromycin. The nurse should include which information?

Monitor of ringing in your ears

Which would alert the nurse to suspect that a client receiving HMG-CoA reductase inhibitors is developing rhabdomyolysis?

Muscle pain and weakness

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect?

Muscle weakness

The instructor is lecturing about diuretics and notes the difference between spironolactone and hydrochlorothiazide as which of the following?

Potassium losses are greater with hydrochlorothiazide than with sprinolactone

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?

Prothrombin time (PT)

The nurse is preparing to administer morning medications and has been sent the wrong dose of a medication from the pharmacy. What actions should the nurse take?

Return the medication to the pharmacy

The nurse prepares to administer a prescribed dose of digoxin to a client with heart failure. In which situation should the nurse hold the medication?

The client complains of seeing "yellowish halo's"

The nurse assess a client who is receiving aspirin. The client reports having stomach pain. What could be occurring?

The client could be experiencing GI ulceration or bleeding

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

The hematocrit (Hct)

The nurse assess a client receiving warfarin (Coumadin). The nurse notes an elevated PT and INR level. What should the nurse expect next?

The nurse should expect an order to withhold the dose

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take?

The nurse should not expel the air bubble in the prefilled syringe

A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed RBC. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse?

The nurse starts the transfusion of another unit of blood product

acute hemolytic reaction

chills, fever, LOW BACK PAIN, tachycardia, tachypnea, hypotension

Circulatory overload

crackles, dyspnea, confusion, seizures

The low-molecular-weight (LMW) heparin of choice for preventing DVT after hip replacement therapy is which of the following medications?

enoxaparin

A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the first prenatal visit. Which immunizations can the nurse safely administer?

inactivated influenza vaccine

active natural

long lasting immunity after having a disease

A nurse is planning to administer IV alteplase (tPA) to a client. What intervention should the nurse expect to take?

obtain the client's weight

Medications prescribed for hypertension may cause vasodilation. What safety concerns will the nurse have with vasodilation?

risk of falling

Evaluating a client who is taking an anticoagulant for blood loss would usually include assessing for which of the following conditions?

*presence of petechiae *bleeding gums while brushing teeth *dark or blood tinged urine *presence of ecchymosis

A client is prescribed atorvastatin (Lipitor) for high cholesterol and high lipid levels. Client teaching should include which of the following? (Select all that Apply)

*The importance of exercise *The need for dietary changes and cholesterol intake *That stopping smoking may also help to lower lipid levels

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? (Select all that Apply)

*Use an electric razor while on this medication *Monitor your intake of Vit K (green leafy veggies, etc)

The student nurse is studying and notes which clients are at risk of developing an infection? (Select all that Apply)

*a client with an impaired immune system *an elderly client with a chronic disease

A bile acid sequestrant is the drug of choice for a client who has which conditions?

A high LDL concentration

A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three recommended doses daily. The nurse should expect to see which result?

A increase in the expected therapeutic effect of blood medications

Which action is an indication the newly hired nurse understands medication error prevention?

Checking the prescription when a single dose requires administration of multiple tablets

A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction?

Client report of low back pain

A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?

Systolic blood pressure is increased

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

Vitamin K

passive natural

a mother to fetus

A nurse is reconciling a newly admitted client's medications noting an allergy to penicillin. Which prescription should the nurse question?

amoxicillin-clavulanate

passive artifical

antibody shot to protect against a disease (rabies after a bite) temporary immunity

Anaphylactic Reation

anxiety, urticaria, wheezing

A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. What assessment should the nurse expect with this medication?

increased urine output

A nurse is caring for a client who has a new prescription for propranolol. Which of the following is a safety concern the nurse should monitor?

postural hypotension

A nurse review newly written prescription for a client admitted with bronchial asthma. Which prescription should the nurse question?

propranolol (Inderal)

A nurse is preparing to administer a new prescription for dextromethorphan to suppress a cough. The nurse should monitor for what adverse effect?

sedation

The nurse would expect the physician to prescribe epoetin alfa (Epogen) as the drug of choice for which of the following conditions?

treatment of anemia associated with renal failure

A client has experienced permanent extrapyramidal effects caused by a previous medication. The nurse assesses which following signs and symptoms?

tremors and unsteady gait

active artificial

vaccines-long lasting immunity

A nurse is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the nurse plan to take?

Remain with the client for the first 15 minutes of the transfusion.

A nurse is teaching a client about taking tetracycline to treat a GI infection due to H pylori. What statement identifies the client understands the instructions? (Select all that Apply)

*I will let my doctor know if I start having diarrhea *I should wear protective clothing and sunscreen while outdoors

The student nurse is discussing Ivabradine (Corlanor) with the instructor. Which of the following statements reveals the student nurse has an understanding to the medication? (Select all that Apply)

*It is prescribed for chronic stable heart failure to prevent rehospitalization *It works to decrease heart rate but has no effect on muscle contraction

A nurse assessing the IV catheter insertion site for a client receiving a nonvesicant solution and notes swelling at the site with decreased skin temperature. Which actions should the nurse take? (Select all that Apply)

*stop the infusion *apply warm compresses to the insertion site *elevate the client's arm *obtain a specimen for culture at the insertion site and send the catheter to the lab for culture

The nurse is preparing a client's medications. Which actions should the nurse take in following legal practice guidelines? (Select all that Apply)

*teach the client about the medication *monitor for adverse effects *lock compartments for controlled substances

Place the following steps for administration of a unit of whole blood in the appropriate order.

1. Obtain baseline lab values and assess 2. Obtain baseline vital signs 3. Obtain blood product from blood bank to initiate infusion 4. Prime IV tubing with 0.9% NaCl and tubing with filter 5. Initiate and complete blood product administration within 4 hours 6. Stay with client to observe from reaction 7. Document blood type, blood bank number, total volume infused, vital signs, time of start and completion, and any adverse effects

A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Asthma

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

I feel nauseated and have no appetite

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

Check the client's vital signs

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching?

I will avoid drinking grapefruit juice

Since 0600, your patient has had 1300mL dark green emesis with particulate matter. Her IV infused for 8 hours at 166mL/hour. Nasogastric tube intermittent suction resulted in 730mL of light green drainage. She voided 100mL. What was her I&O at 1400?

Intake 1328 mL Output 2130 mL

For dinner the client drank two 8 oz cups of coffee and had a 12 ounce soft drink at 2100. The client voided 4 times on your shift (100mL, 250mL, 300mL, and 550mL). At 1700 the client had 100mL emesis. Calculate I and O from 1500 to 2300 when your shift ends.

Intake: 840 mL Output: 1300 mL

A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

Iron

Warfarin, an oral anticoagulant acts in which of the following mechanisms.

It decreases the production of vitamin K clotting factors in the liver

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

You might have to stop taking this medication 5 days before any planned surgeries

A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include?

You should avoid grapefruit juice

What assessment finding should the nurse identify as an adverse effect of gemfibrozil (Lopid)?

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