Pharm milestone

A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. Which medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging? A. Vitamin K1 B. Protamine sulfate C. Warfarin sodium D. Prothrombin

B. Protamine sulfate

When caring for a client on digoxin therapy which laboratory finding alerts the nurse to the potential for digoxin toxicity? A. Low serum sodium level B. High serum sodium level C. Low serum potassium level D. High serum potassium level

C. Low serum potassium level

The nurse is preparing to administer amphotericin B IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication? A. Serum potassium level B. Platelet count C. Serum creatinine level D. Hemoglobin level

A. Serum potassium level

A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline? A. Sodium bicarbonate B. Naloxone C. Phentolamine mesylate D. Atropine sulfate

A. Sodium bicarbonate

During the initial nursing assessment history, the client reports taking tetracycline hydrochloride for urethritis. Which concurrent medication will the nurse report to the health care provider? A. Sucralfate B. Hydrochlorothiazide C. Acetaminophen D. Phenytoin

A. Sucralfate

Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate? A. "Are you having difficulty hearing?" B. "Have you ever been diagnosed with cancer?" C. "Do you have any type of diabetes mellitus?" D. "Have you ever had anemia?

A. "Are you having difficulty hearing?"

Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate? A. "Are you having difficulty hearing?" B. "Have you ever been diagnosed with cancer?" C. "Do you have any type of diabetes mellitus?" D. "Have you ever had anemia?"

A. "Are you having difficulty hearing?"

A client is receiving antiinfective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection? A. "My mouth feels sore." B. "I have a headache." C. "My ears feel plugged up." D. "I feel constipated."

A. "My mouth feels sore."

Which instructions should the nurse provide to an adolescent female client who is initiating treatment with isotretinoin for acne vulgaris? (Select all that apply.) A. "Notify the health care provider immediately if you think you are pregnant." B. "If your acne gets worse, stop the medication and call the health care provider." C. "Take a daily multiple vitamin to prevent deficiencies and promote dermal healing." D. "Dermabrasion for deep acne scars should be postponed for 1 month after therapy is stopped." E. "If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F. "Before, during, and after therapy, two effective forms of birth control must be used at the same time.

A. "Notify the health care provider immediately if you think you are pregnant." E. "If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F. "Before, during, and after therapy, two effective forms of birth control must be used at the same time.

Which instructions should the nurse provide to an adolescent female client who is initiating treatment with isotretinoin for acne vulgaris? (Select all that apply.) A. "Notify the health care provider immediately if you think you are pregnant." B. "If your acne gets worse, stop the medication and call the health care provider." C. "Take a daily multiple vitamin to prevent deficiencies and promote dermal healing." D. "Dermabrasion for deep acne scars should be postponed for 1 month after therapy is stopped." E. "If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F. "Before, during, and after therapy, two effective forms of birth control must be used at the same time."

A. "Notify the health care provider immediately if you think you are pregnant." E. "If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F. "Before, during, and after therapy, two effective forms of birth control must be used at the same time."

The nurse is administering the early morning dose of insulin aspart, 5 units subcutaneously, to a client with diabetes mellitus type 1. The client's fingerstick serum glucose level is 140 mg/dL. Considering the onset of insulin aspart, when should the nurse ensure that the client's breakfast be given? A. 5 minutes after subcutaneous administration B. 30 minutes after subcutaneous administration C. 1 to 2 hours after administration D. At any time because of a flat peak of action

A. 5 minutes after subcutaneous administration

A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel chemotherapy. What symptom would indicate a need for an immediate response by the nurse prior to implementing another dose of this chemotherapeutic agent? A. A cough that is new and persistent B. Persistent nausea and vomiting C. Fingernail and toenail changes D. Increasing weakness and neuropathy

A. A cough that is new and persistent

The nurse performs a client assessment prior to the administration of a prescribed dose of dipyridamole and aspirin PO. The nurse notes that the client's carotid bruit is louder than previously assessed. What is the best nursing action related to this finding? A. Administer the prescribed dose as scheduled. B. Hold the dose until the health care provider is contacted. C. Advise the client to take nothing by mouth until further assessment is completed. D. Elevate the head of the bed and apply oxygen by nasal cannula

A. Administer the prescribed dose as scheduled.

The nurse performs a client assessment prior to the administration of a prescribed dose of dipyridamole and aspirin PO. The nurse notes that the client's carotid bruit is louder than previously assessed. What is the best nursing action related to this finding? A. Administer the prescribed dose as scheduled. B. Hold the dose until the health care provider is contacted. C. Advise the client to take nothing by mouth until further assessment is completed. D. Elevate the head of the bed and apply oxygen by nasal cannula.

A. Administer the prescribed dose as scheduled.

A client has started long-term corticosteroid therapy tells the nurse that the daily dose will be taken at bedtime with a snack of crackers and milk. Which is the best response by the nurse? A. Advise the client to take the medication in the morning, rather than at bedtime. B. Teach the client that dairy products should not be taken with her medication. C. Tell the client that absorption is improved when taken on an empty stomach. D. Affirm that the client has a safe and effective routine for taking the medication

A. Advise the client to take the medication in the morning, rather than at bedtime.

A client has started long-term corticosteroid therapy tells the nurse that the daily dose will be taken at bedtime with a snack of crackers and milk. Which is the best response by the nurse? A. Advise the client to take the medication in the morning, rather than at bedtime. B. Teach the client that dairy products should not be taken with her medication. C. Tell the client that absorption is improved when taken on an empty stomach. D. Affirm that the client has a safe and effective routine for taking the medication.

A. Advise the client to take the medication in the morning, rather than at bedtime.

Which nursing action has the highest priority during IV administration of mechlorethamine HCl and actinomycin? A. Assess for extravasation at the IV site during infusion. B. Premedicate with antiemetics 30 to 60 minutes before infusion. C. Monitor cardiac rate and rhythm during the IV infusion. D. Check the granulocyte count daily for the presence of neutropenia

A. Assess for extravasation at the IV site during infusion.

A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering? A. Butorphanol B. Hydromorphone C. Morphine sulfate D. Codeine sulfate

A. Butorphanol

Following the administration of sublingual nitroglycerin, which assessment finding indicates to the nurse that the medication was effective? A. Decrease in level of chest pain B. Clear bilateral breath sounds C. Increase in blood pressure D. Increase in urinary output

A. Decrease in level of chest pain

The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate, IM STAT. What is the primary purpose for administering this drug to the child at this time? A. Decrease the oral secretions. B. Reduce the child's anxiety. C. Potentiate the opioid effects. D. Prevent possible peritonitis

A. Decrease the oral secretions.

Which intervention is most important for a nurse to implement prior to administering atropine PO? A. Determine the presence of 5 to 35 bowel sounds/min. B. Provide oral care prior to administration. C. Verify that the client's tendon reflexes are 2+. D. Use the 0 to 10 scale to rate the pain.

A. Determine the presence of 5 to 35 bowel sounds/min.

A client who is hypertensive receives a prescription for hydrochlorothiazide. When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report? A. Fatigue and muscle weakness B. Anxiety and heart palpitations C. Abdominal cramping and diarrhea D. Confusion and personality changes

A. Fatigue and muscle weakness

A client receives a prescription for theophylline PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL. Based on this information, which action should the nurse take first? A. Hold the theophylline dose and notify the health care provider. B. Start the client on a half-dose of theophylline PO. C. The theophylline dose can be initiated as planned. D. The client is not ready to be weaned from the IV to the PO route.

A. Hold the theophylline dose and notify the health care provider.

The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is prescribed. Which finding should the nurse report to the health care provider? A. Hypokalemia B. Hyponatremia C. Hypercalcemia D. Hypomagnesemia

A. Hypokalemia

In addition to nitrate therapy, a client is receiving nifedipine, 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen? A. Hypotension B. Hyperkalemia C. Hypocalcemia D. Seizures

A. Hypotension

A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect to administer to this client? A. Isoniazid B. Carvedilol C. Acyclovir D. Griseofulvin

A. Isoniazid

During therapy with isoniazid, it is most important for the nurse to monitor which laboratory value closely? A. Liver enzyme levels B. Blood urea nitrogen (BUN) level C. Serum electrolyte levels D. Complete blood count (CBC)

A. Liver enzyme levels

The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? A. Naloxone hydrochloride B. Atropine sulfate C. Vitamin K D. Flumazenil

A. Naloxone hydrochloride

A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result should the nurse examine to assess the child's risk for infection? A. Neutrophil count B. Platelet count C. Reticulocyte count D. Lymphocyte count

A. Neutrophil count

A 21-year-old female client is receiving tetracycline for acne. Which client teaching should the nurse include? A. Oral contraceptives may not be effective. B. Drinking cranberry juice will promote healing. C. Breast tenderness may occur as a side effect. D. The urine will turn a red-orange color.

A. Oral contraceptives may not be effective.

Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) A. Report vaginal itching or discharge. B. Take the medication at 0800, 1500, and 2200 hours. C. Protect skin from natural and artificial ultraviolet light. D. Avoid driving until response to medication is known. E. Take with an antacid tablet to prevent nausea. F. Use a nonhormonal method of contraception if sexually active

A. Report vaginal itching or discharge. C. Protect skin from natural and artificial ultraviolet light. D. Avoid driving until response to medication is known. F. Use a nonhormonal method of contraception if sexually active

The health care provider prescribes oral contraceptives for a client who wants to prevent pregnancy. Which information is the most important for the nurse to provide to this client? A. Take one pill at the same time every day for the entire pack of pills. B. Use condoms and foam instead of the pill while on any antibiotics. C. Limit sexual intercourse for at least one cycle after starting the pill. D. Use another contraceptive if two or more pills are missed in one cycle.

A. Take one pill at the same time every day for the entire pack of pills.

The nurse plans to draw blood samples for the determination of peak and trough levels of gentamicin sulfate in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level? A. Thirty minutes after the dose is administered B. Immediately before giving the next dose C. When the next electrolyte levels are drawn D. When the client's temperature is 98.6°F/37°C

A. Thirty minutes after the dose is administered

A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious sedation. Which medication should the nurse explain as a sedative used during the procedure? A. Inhaled nitrous oxide B. Midazolam IV C. Ketamine IM D. Fentanyl and droperidol IM

B. Midazolam IV

A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB?" What information should the nurse provide? A. Antiretroviral medications decrease the efficacy of the TB drugs. B. Multiple drugs prevent the development of resistant organisms. C. Duration of the medication regimen is shortened. D. Potential adverse drug reactions are minimized

B. Multiple drugs prevent the development of resistant organisms

The nurse is teaching a student about the dynamics of medication administration. Which physiologic mechanism will the nurse include in the teaching which explains a drug's increased metabolism triggered by a disease process? A. Selectivity response B. Pharmacokinetics C. Pharmacodynamics D. Pharmacotherapeutics

B. Pharmacokinetics

When providing nursing care for a client receiving pyridostigmine bromide for myasthenia gravis, which nursing action has the highest priority? A. Monitor the client frequently for urinary retention. B. Assess respiratory status and breath sounds often. C. Monitor blood pressure each shift to screen for hypertension. D. Administer most medications after meals to decrease gastrointestinal irritation.

B. Assess respiratory status and breath sounds often

A client is receiving pyridostigmine bromide to control the symptoms of myasthenia gravis. Which assessment will the nurse include in the client's plan of care? A. Decreased oral secretions B. Clear speech C. Diminished hand tremors D. Increased ptosis

B. Clear speech

A 6-year-old child is admitted to the emergency department with status epilepticus. The parents report that the seizure disorder has been managed with phenytoin, 50 mg PO bid, for the past year. Which drug should the nurse plan to administer? A. Phenytoin B. Diazepam C. Phenobarbital D. Carbamazepin

B. Diazepam

n developing a nursing care plan for a 9-month-old infant with cystic fibrosis, because the nurse is concerned about adequate nutrition, which intervention would best meet this child's needs? A. Give aluminum hydroxide and magnesium hydroxide after meals. B. Give pancrelipase capsule mixed with applesauce before each meal. C. Administer cholestyramine resin before each meal and at bedtime. D. Administer omeprazole for gastroesophageal reflux.

B. Give pancrelipase capsule mixed with applesauce before each meal.

A child is being treated with mebendazole for pinworms. What dietary information will the nurse relay to the client's mother? A. Lactose-free foods B. High-fat diet C. Vitamin C-enriched foods D. High-fiber diet

B. High-fat diet

The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime? A. Gastric acid secreted at night is buffered, preventing pepsin formation. B. Hydrochloric acid secreted during the night is blocked. C. The drug relaxes stomach muscles at night to reduce acid. D. Ingestion of the medication at night offers a sedative effect, promoting sleep.

B. Hydrochloric acid secreted during the night is blocked.

A client is receiving acyclovir sodium IV for a severe herpes simplex infection. Which nursing action will the nurse include in the client's plan of care? A. Maintain respiratory isolation precautions. B. Increase daily fluids to 2000 to 4000 mL/day. C. Administer with meals to decrease gastric irritation. D. Assess for signs of severe liver dysfunction.

B. Increase daily fluids to 2000 to 4000 mL/day.

Dopamine is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response? A. Gain in weight B. Increase in urine output C. Improved gastric motility D. Decrease in blood pressure

B. Increase in urine output

The nurse is providing care to a client recently diagnosed with acute lymphocytic leukemia. The health care provider's prescription specifies that ondansetron is to be administered IV 30 minutes prior to the infusion of cisplatin. What is the most important information for the nurse to include in the client's teaching plan? A. Promotion of diuresis to prevent nephrotoxicity B. Reduction or elimination of nausea and vomiting C. Prevention of a secondary hyperuricemia D. Reduction in the risk of an allergic reaction

B. Reduction or elimination of nausea and vomiting

A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan? A. Take the medication in the morning before rising. B. Take and record radial pulse rate daily. C. Expect some vision changes caused by the medication. D. Increase intake of foods rich in vitamin K.

B. Take and record radial pulse rate daily.

A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain. Which instruction should the nurse include in the client's teaching plan? A. Take one tablet every 3 minutes, up to five tablets. B. Take one tablet at the onset of angina and stop activity. C. Replace nitroglycerin tablets yearly to maintain freshness. D. Allow 30 minutes for a tablet to provide relief from angina.

B. Take one tablet at the onset of angina and stop activity.

A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of phenobarbital elixir prescribed for his brother's seizure disorder. Which nursing action should the nurse take first? A. Place a nasogastric tube. B. Take the child's vital signs. C. Draw a blood specimen for a phenobarbital level. D. Teach the mother safe medication storage practices

B. Take the child's vital signs.

The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone. Which assessment finding reflects a problem related to this medication that should be included in the care plan? A. Persistent dry cough B. Temperature of 101.3°F/38.5°C. C. Dry mouth and gums D. Impaired gas exchange oxygen saturation of 94%

B. Temperature of 101.3°F/38.5°C.

A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator alteplase. The nurse would be correct in providing which explanation to the client regarding the purpose of this drug? A. This drug is a nitrate that promotes vasodilation of the coronary arteries. B. This drug is a clot buster that dissolves clots within a coronary artery. C. This drug is a blood thinner that will help prevent the formation of a new clot. D. This drug is a volume expander that improves myocardial perfusion by increasing output.

B. This drug is a clot buster that dissolves clots within a coronary artery.

A psychiatric client is discharged from the hospital with a prescription for haloperidol. Which instruction should the nurse include in the discharge teaching plan for this client? A. Take with antacids to reduce gastrointestinal irritation. B. Use sunglasses and sunscreen when outdoors. C. Eat foods low in fiber and salt. D. Count the pulse before each dose.

B. Use sunglasses and sunscreen when outdoors.

A nurse is assessing a client with heart failure who has presented to an outpatient clinic complaning of a 4lb wieight fain over 3 days, with increasing ankle swelling and shortness of breath. When reviewing the clinet's med list, the nurse anticipates the need to increase which of the following? A. isosorbide dinitrate B. furosemide c. lisinopril d. hydralazine e. bisoprolol

B. furosemide

Which statement indicates that client teaching regarding the administration of the chemotherapeutic agent daunorubicin HCl has been effective? . A. "I should use an astringent mouthwash after every meal." B. "I will eat high-fiber foods and drink lots of water." C. "I expect my urine to be red for the next few days." D. "I should use sunscreen when I spend time outdoors."

C. "I expect my urine to be red for the next few days."

Which statement indicates that client teaching regarding the administration of the chemotherapeutic agent daunorubicin HCl has been effective? A. "I should use an astringent mouthwash after every meal." B. "I will eat high-fiber foods and drink lots of water." C. "I expect my urine to be red for the next few days." D. "I should use sunscreen when I spend time outdoors."

C. "I expect my urine to be red for the next few days."

The charge nurse is reviewing the admission history and physical data for four clients newly admitted to the unit. Which client is at greatest risk for adverse reactions to medications? A. 30-year-old man with a fracture B. 7-year-old child with an ear infection C. 75-year-old woman with liver disease D. 50-year-old man with an upper respiratory tract infection

C. 75-year-old woman with liver disease

Which parameter is most important for the nurse to check prior to administering a subcutaneous injection of heparin? A. Heart rate B. Urinary output C. Activated partial thromboplastin time (aPTT) D. Prothrombin time (PT) and international normalized ratio (INR)

C. Activated partial thromboplastin time (aPTT)

Which assessment datum indicates to the nurse that a dose of granisetron administered IV prior to chemotherapy has had the desired effect? A. Oral mucosa pink and intact B. Scalp intact without alopecia C. Client denies nausea D. Client denies pain

C. Client denies nausea

To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, what is the best nursing action? A. Ask the client about the onset of any dizziness since taking the medication. B. Measure the client's blood pressure while the client is lying, sitting, and then standing. C. Compare the client's blood pressure before and after the client takes the medication. D. Interview the client about any past or recent history of high blood pressure.

C. Compare the client's blood pressure before and after the client takes the medication.

The health care provider prescribes the anticonvulsant carbamazepine for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs? A. Experiences dry mouth B. Experiences dizziness C. Develops a sore throat D. Develops gingival hyperplasia

C. Develops a sore throat

The nurse is providing care to a 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the diagnosis because of noncompliance with the prescribed medication regimen. The nurse anticipates a prescription for which medication? A. Chlorpromazine HCl B. Lithium carbonate C. Fluphenazine decanoate D. Diazepam

C. Fluphenazine decanoate

A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started on a terbutaline sulfate continuous IV infusion via pump. This therapy is ineffective, and the baby is delivered vaginally. For which complication should the nurse monitor in this infant during the first few hours after delivery? A. Hypokalemia B. Hypermagnesia C. Hypoglycemia D. Hypernatremia

C. Hypoglycemia

A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse how this medication works. Which pharmacophysiologic explanation should the nurse use to describe this class of drug? A. Promotes excretion of neurotoxins B. Slows nerve cell degeneration C. Improves nerve impulse transmission D. Stimulates nerve cell regeneration

C. Improves nerve impulse transmission

A client taking linezolid at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. What is the best nursing action for this client? A. Schedule appointments to obtain blood samples for drug peak and trough levels. B. Reassure the client that this is an expected side effect that will resolve in a few days. C. Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis. D. Advise the client to begin taking an over-the-counter antidiarrheal agent.

C. Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis.

The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel. What is the best schedule for drawing the trough level? A. Give the dose of medication and call the laboratory to draw the trough STAT. B. Arrange for the laboratory to draw the trough 1 hour after the dose is given. C. Instruct the laboratory to draw the trough immediately before the next scheduled dose. D. Give the first dose of medication after the laboratory reports that the trough has been drawn.

C. Instruct the laboratory to draw the trough immediately before the next scheduled dose.

A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which action should the nurse initiate? A. Instruct the client about the indications of opioid dependence. B. Monitor the client for symptoms of opioid withdrawal. C. Notify the health care provider of the need to increase the dose. D. Administer naloxone per PRN protocol for reversal.

C. Notify the health care provider of the need to increase the dose.

A client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl. Which assessment finding would require immediate intervention by the nurse? A. Dizziness when first getting up B. An unpleasant metallic taste in the mouth C. Parkinson-like symptoms D. Inability to see well at night

C. Parkinson-like symptoms

A client receives pancuronium, a long-acting, nondepolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication? A. Hepatitis B. Heart failure C. Renal insufficiency D. History of emphysema

C. Renal insufficiency

A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse take first? A. Assess for deep tendon reflexes. B. Observe urinary output. C. Review the medication administration record (MAR). D. Administer naloxone.

C. Review the medication administration record (MAR).

A client with metastatic cancer reports severe continuous pain. Which route of administration should the nurse use to provide the most effective continuous analgesia? A. Oral B. Intravenous C. Transdermal D. Intramuscular

C. Transdermal

The health care provider prescribes cisplatin to be administered in 5% dextrose and 0.45% normal saline with mannitol added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the therapy? A. Oral temperature B. Blood cultures C. Urine output D. Liver enzyme levels

C. Urine output

When providing client teaching about the administration of methylphenidate to a parent of a child diagnosed with ADHD, which instruction should the nurse include in the teaching plan? A. The doses should be given exactly 12 hours apart to sustain a therapeutic serum level. B. Doses should be scheduled at midmorning and midafternoon to achieve optimal benefit. C. Give the medication only on school days and when the child appears to be anxious. D. Offer the child the medication with breakfast and after the child eats lunch.

D. Offer the child the medication with breakfast and after the child eats lunch.

The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin. Which client statement indicates that further teaching is needed? A. "My bowel habits should not be affected by this drug." B. "This medication should be taken once a day only." C. "I will still need to follow a low-cholesterol diet." D. "I will take the medication every day before breakfast."

D. "I will take the medication every day before breakfast."

A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many milliliters per hour should the nurse program the IV pump? A. 20 B. 24 C. 60 D. 120

D. 120

Dopamine, 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of dopamine in 250 mL D5W for IV administration via an infusion pump. What is the hourly rate that the nurse should set on the pump? A. 5 mL/hr B. 10 mL/hr C. 15 mL/hr D. 20 mL/hr

D. 20 mL/hr

A mother brings her 18-month-old child to the community health center because the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave my child a half-ounce." The nurse sees that the bottle contains loperamide. What is the next nursing action? A. Tell the mother never to give this drug to her toddler. B. Ask if any other siblings have experienced diarrhea. C. Take the child's oral and tympanic temperatures. D. Ask the mother when the child last voided

D. Ask the mother when the child last voided

A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (XR) for depression. The medication comes in capsule form. What should the nurse include in the discharge teaching plan for this client? A. Capsule contents can be sprinkled on pudding or applesauce. B. Chew the medication thoroughly to enhance absorption. C. Take the medication with a large glass of water or juice. D. Contact the health care provider for another form of medication.

D. Contact the health care provider for another form of medication.

When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of chemotherapeutic agent would prompt the nurse to add this assessment? A. Vincristine B. Bleomycin sulfate C. Chlorambucil D. Cyclophosphamide

D. Cyclophosphamide

Prior to administering a scheduled dose of digoxin, the nurse reviews the client's current serum digoxin level, which is 1.3 ng/dL. Which action should the nurse take first? A. Administer Digibind to counteract the toxicity. B. Withhold the drug and notify the health care provider immediately. C. Withhold the dose and notify the health care provider during rounds that the dose was held. D. Give the dose of digoxin if the client's heart rate is within a safe range.

D. Give the dose of digoxin if the client's heart rate is within a safe range.

The nurse notes that the hemoglobin level of a client receiving darbepoetin alfa has increased from 6 to 10 g/dL over the first 2 weeks of treatment. Which is the best nursing action for this client? A. Encourage the client to continue the treatment, because it is effective. B. Advise the client that the dose will need to be increased. C. Assess the client's skin color for continued pallor or cyanosis. D. Notify the health care provider of the change in the client's laboratory values.

D. Notify the health care provider of the change in the client's laboratory values.

The nurse is reviewing prescribed medications with a client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid analgesic is higher than the IV dose received during hospitalization. Which response is best for the nurse to provide? A. A higher dose of analgesic medication may be needed after discharge. B. An error in the dose calculation may have occurred when the prescribed dose was converted. C. The doses should be the same unless the pain is not well controlled. D. Oral forms of drugs must pass through the liver first, where more of the dose is metabolized.

D. Oral forms of drugs must pass through the liver first, where more of the dose is metabolized.

The nurse is providing care to a client on heparin. Which laboratory test indicates to the nurse that the medication is effective? A. Prothrombin time (PT) B. Fibrin split products C. Platelet count D. Partial thromboplastin time (PTT)

D. Partial thromboplastin time (PTT)

Which response best supports the observations that the nurse identifies in a client who is experiencing a placebo effect? A. Beneficial response or cure for disease B. Behavioral or psychotropic responses C. Malingering or drug-seeking behaviors D. Psychological response to inert medication

D. Psychological response to inert medication

A client who is experiencing an acute attack of gouty arthritis is prescribed colchicine USP, 1 mg PO daily. Which information is most important for the nurse to provide the client? A. Take the medication with meals. B. Limit fluid intake until the attack subsides. C. Stop the medication when the pain resolves. D. Report any vomiting to the clinic.

D. Report any vomiting to the clinic.

An 80-year-old client who had a colon resection yesterday is receiving a constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump. Which finding requires immediate nursing action? A. The client is drowsy and complains of pruritus. B. Pupils are 3 mm; PERRLA. C. The area around the sutures is reddened and swollen. D. Respirations decrease to 10 breaths/min.

D. Respirations decrease to 10 breaths/min.

a nurse is caring for a client w/ congestive HF. when the nurse assesses the client apical pulse before administering 0.25mg of digoxin PO, she notes the HR is 53bpm. which of the following actions should the nurse take first a. the nurse should give the drug at a dose of 0.125 mg b. the nurse should obtain serum digoxin level before giving the drug c. the nurse should hold the prescibed dose and notify the HCP d. the nurse should order an ECG

c. the nurse should hold the prescibed dose and notify the HCP

before beginning a transfusion of a unit of PRBC that has also been checked by another nurse, which of the following items is a priority assessment? a. skin color b. hematocrit c. vital signs d. urine output

c. vital signs

a nurse is caring for a child who has cerebral palsy who is experiencing painful muscle spasms. which of the following medications whould the nurse expect to administer? a. baclofen b. diazepam c. oxybutynin d. oxcarbazepine

a. baclofen

a nurse is assessing a client who is taking lisinopril. the nurse should identify which of the following findings indicates a therapeutic effect of the medication? a. decreased BP b. increase serum NA levels c. improved renal function d. improved sexual function

a. decreased BP

a client is using PCA for pain control. he tells the nurse, " i don't think this is working, I keep pushing the button, but I still have pain" which of the following responses is most appropriate? a. I will push the button for you. it should be working b. let me see if it is working correctly; otherwise I will see if we can get you something else for the pain c. let me chnage the settings to add a bolus dose. that should take care of your pain d. just give it more time. you may not feel the effects immediately

b. let me see if it is working correctly; otherwise I will see if we can get you something else for the pain

a nurse is preparing discharge instructions for a client who has undergone a prosthetic valave replacement. the nurse should instruct the client to notify the healthcare provider before which of the following? a. blood drawn b. an IV inserted c. dental extraction and routine cleaning d. an x-ray

c. dental extraction and routine cleaning

a nurse is provididng information to a client w/ bipolar disorder who has a new prescription for valporic acid. which of the following side effects of valproic acid will the nurse discuss w/ the client? a. increased urination b. hair growth c. sedation d. weight loss

c. sedation

a nurse is administering an IV medication from an ampule. which of the following is a true statement regarding preparation and administration of the medication from an ampule? a. an ampule can be used for up to 3 diff doses b. ampules are typically made of glass or plastic c. ampules are sealed w/ metal caps to protect the liquid inside d. drawing from an ampule usually requires a filter needle to keep particles out of the syringe

d. drawing from an ampule usually requires a filter needle to keep particles out of the syringe

a nurse is caring client who had a cervical spinal injury 24 hour ago. which of the following prescribed med should the nurse clarfiy with the provider? a. calcium supplements b. plasma expanders c. H2 antagonists d. muscle relaxants

d. muscle relaxants

a nurse is reviewing the medication administration record of a client with type two diabetes mellitus at 1900. Which of the following interventions is most appropriate for the nurse to implement? a. provide orange juice b. ask the UAP to teach the client about symptoms of hypoglycemia c. perform a state beside fingerstick glucose check d. provide a bedtime snack for the client

d. provide a bedtime snack for the client

a nurse is providing discharge instruction for a client with a new prescription for clarithromycin. which expected outcome of the teaching plan is most appropriate for this client? a. the client will verbalize the s/s of seizure b. the client will verbalize the s/s of sleep apnea c. the client will verbalize s/s of hypoglycemia d. the client will verbalize the s/s of thrush

d. the client will verbalize the s/s of thrush