Pharm Module 4

When reviewing the various types of antinausea medications, the nurse recognizes that prokinetic drugs are also used for: A. motion sickness B. vertigo C. delayed gastric emptying D. GI obstruction

C. delayed gastric emptying

When evaluating the medication list of a patient who will be starting therapy with an H2 receptor antagonist, the nurse is aware that which drug may interact with it? A. codeine B. penicillin C. ketoconazole D. acetaminophen

C. ketoconazole

The nurse would teach a client prescribed simethicone (Mylicon) to avoid which substance? Over-the-counter antacids Histamine2-receptor antagonists Carbonated beverages Milk and dairy products

Carbonated beverages Simethicone is used to decrease gas and belching, both of which can be aggravated or caused by ingesting carbonated beverages. It may be given in combination with other medications used to decrease acidity.

Magnesium hydroxide (Milk of Magnesia) alleviates constipation by which action? By direct irritation of intestinal mucosa Causes water absorption into the colon Absorbs water to increase bulk within the colon Allows more fat to be absorbed into the stool

Causes water absorption into the colon Milk of magnesia is a saline laxative that increases osmotic pressure to draw water into the colon, producing a watery stool, usually within 3 to 6 hours of ingestion.

The nurse will instruct the patient to treat hypoglycemia with which drug? Bumetanide (Bumex) Glucagon (GlucaGen) Acarbose (Precose) Propranolol (Inderal)

Glucagon (GlucaGen) Glucagon stimulates glycogenolysis, raising serum glucose levels.

Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 AM, he or she is at highest risk of hypoglycemia after an 8:00 AM dose of NPH insulin at what time? 5:00 PM 2:00 PM 10:00 AM 8:00 PM

5:00 PM Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.

A patient has been instructed to use an OTC form of the bulk-forming laxative methylcellulose (Citrucel) to prevent constipation. The nurse will advise the patient of potential adverse effects, including: A. fluid and electrolyte disturbances B. decreased absorption of vitamins C. gas formation D. darkened stools E. discolored urine

A. fluid and electrolyte disturbances C. gas formation

The nurse would question a prescription for somatropin (Genotropin) in a patient with which condition? Growth failure Hypopituitarism Acromegaly Dwarfism

Acromegaly Somatropin is a synthetic form of human growth hormone. Acromegaly is caused by excessive growth hormone, and thus this drug would be contraindicated.

The nurse should question a prescription for aminoglutethimide (Cytadren) in a patient with which condition? Metastatic breast cancer Addison's disease Cushing's syndrome Adrenal malignancy

Addison's disease Aminoglutethimide suppresses the adrenal cortex. Addison's disease presents with decreased adrenal secretion; thus, you would not want to exacerbate this by administering aminoglutethimide. All of the other choices are indications for use for aminoglutethimide.

When teaching a patient who is taking oral contraceptive therapy for the first time, the nurse relates that adverse effects may include which of the following? A. Dizziness B. Nausea C. Tingling in the extremities D. Polyuria

B. Nausea

Simethicone (Mylicon) is often combined with calcium carbonate antacids because: an increased antacid effect will result when these drugs are given in combination. simethicone helps to reduce the gas that is caused by the calcium antacids. simethicone reduces the diarrhea that is caused by the calcium. simethicone improves the taste of the calcium tablets, which must be chewed.

Calcium carbonate neutralization will produce gas and possibly belching, so the addition of simethicone is intended to reduce this effect. Simethicone alters elasticity of mucus-coated gas bubbles, breaking them into smaller ones, resulting in decreased gas pain and increased expulsion via mouth or rectum.

The nurse is administering oral methylcellulose (Citrucel) and keeps in mind that a major potential concern with this drug is A. dehydration B. tarry stools C. renal calculi D. Esophageal obstruction

D. Esophageal obstruction

In developing a plan of care for a client receiving an antihistamine antiemetic drug, which nursing diagnosis would be the highest priority? Deficient fluid volume related to nausea and vomiting Impaired physical mobility related to adverse effects of drugs Deficient knowledge regarding medication administration Risk for injury related to adverse effects of medication

Deficient fluid volume related to nausea and vomiting Although all of the options are appropriate nursing diagnoses, fluid volume deficit is the highest priority because it has the highest associated mortality rate. Although a fall or injury could also prove fatal, this diagnosis is a risk; actual nursing diagnoses have priority over potential diagnoses.

The nurse would question the administration of testosterone (Androderm) to a patient with which condition? Hyponatremia Hypovolemia Hyperkalemia Hypocalcemia

Hyperkalemia Testosterone can cause increased serum potassium levels.

A patient will be receiving somatropin. The nurse expects that the patient has which disorder? Adrenocortical insufficiency Hypopituitary dwarfism Esophageal varices Septic shock

Hypopituitary dwarfism Somatropin is human growth hormone that is used for the treatment of hypopituitary dwarfism. Cosyntropin is used for the diagnosis of adrenocortical insufficiency. Octreotide is used for esophageal varices. Vasopressin is indicated for septic shock.

Patients prescribed sildenafil (Viagra) should be instructed regarding the potential life-threatening drug interaction with which medication? Aspirin (Acetylsalicylic acid) Acetaminophen (Tylenol) Warfarin (Coumadin) Nitroglycerin (Nitrostat)

Nitroglycerin (Nitrostat) Sildenafil and other drugs for erectile dysfunction should not be taken with nitroglycerin because it may lead to a significant hypotension that could be life threatening.

During a postpartum patient assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based on this assessment data, the nurse prepares to administer which medication? Dinoprostone (Prostin E2) Terbutaline (Brethine) Clomiphene (Clomid) Oxytocin (Pitocin)

Oxytocin (Pitocin) Oxytocin is a uterine stimulant that causes uterine contractions, which would decrease the vaginal bleeding.

a patient has been taking finasteride (proscar) for almost one year now. the nurse knows that which is most important to evaluate at this time? CBC PSA lvels blood pressure fluid retention

PSA levels

To prevent the development of oral candidiasis when using corticosteroid inhalers, which instruction is MOST important for the nurse to teach the patient? Report any gingival irritation to the health care provider. Swish and swallow with Mycostatin after each use. Minimize use of an inhaler to every other day. Rinse the mouth after each use.

Rinse the mouth after each use. It is most important to teach patients to rinse their mouth with lukewarm water after each use of a steroid inhaler to prevent the occurrence of oral candidiasis, a fungal infection. Mycostatin is not routinely used to prevent this infection unless the patient is immunocompromised. Reporting irritation after it has occurred does not prevent the infection. Minimizing the use of the inhaler to every other day negates its therapeutic effect.

The nurse should teach a client about which antiemetic commonly used to prevent motion sickness? Prochlorperazine (Compazine) Droperidol (Inapsine) Metoclopramide (Reglan) Scopolamine (Transderm-Scōp)

Scopolamine (Transderm-Scōp) Scopolamine has potent effects on the vestibular nuclei, which are located in the area of the brain that controls balance. These effects make scopolamine one of the most commonly used drugs for the treatment and prevention of nausea and vomiting associated with motion sickness.

The nurse plans to administer 50 mg of diphenhydramine (Benadryl) intravenously. How will the nurse administer this medication? Undiluted over 2 minutes Diluted in 50 mL normal saline over 30 minutes Undiluted over 1 minute Diluted in 100 mL D5W over 20 minutes

Undiluted over 2 minutes Diphenhydramine should be administered undiluted at a rate of 25 mg/min.

A patient is experiencing severe diarrhea, flushing, and life-threatening hypotension associated with carcinoid crisis. The nurse will prepare to administer which drug? a. octreotide (Sandostatin) b. vasopressin (Pitressin) c. somatropin (Humatrope) d.cosyntropin (Cortrosyn)

a. octreotide (Sandostatin)

Which client statement demonstrates understanding of teaching by the nurse regarding the use of histamine2-receptor antagonists? "Because I am taking this medication, it is OK for me to eat spicy foods." "Smoking decreases the effects of this medication, so I should look into cessation programs." "I should take this medication 1 hour after each meal to maximally decrease gastric acidity." "I should increase bulk and fluids in my diet to prevent constipation."

"Smoking decreases the effects of this medication, so I should look into cessation programs." Clients taking histamine2-receptor-blocking drugs should avoid spicy foods, extremes in temperatures, alcohol, and smoking. Diarrhea, not constipation, is a GI adverse effect. Whereas cimetidine should be taken with meals, famotidine can be taken without regard to meals.

which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma? "exhale while pushing on the canister of the inhaler" "blow your nose after taking this medication" "rinse your mouth thoroughly after taking the medication" "do not eat immediately after taking this medication"

"rinse your mouth thoroughly after taking the medication"

The nurse provides care for a client receiving glipizide and prednisone. Which is the priority nursing assessment? 1.Monitor hemoglobin 2.Monitor platelets 3.Monitor photosensitivity 4.Monitor serum glucose

1) INCORRECT— Hemoglobin is the iron-containing pigment of red blood cells that carry oxygen. Glipizide may cause aplastic anemia, requiring periodic monitoring of the CBC. 2) INCORRECT— Because glipizide may cause aplastic anemia, the CBC is periodically monitored. 3) INCORRECT— Glipizide may cause photosensitivity, but this is not an urgent side effect. 4) CORRECT— Glipizide is an oral hypoglycemic that decreases blood glucose by stimulating insulin release from the beta cells of the pancreas. Prednisone is a corticosteroid that can cause hyperglycemia. Serum glucose level is the priority nursing assessment.

The pharmacy has called a patient to notify her that the current brand of thyroid replacement hormone is on back order. The patient calls the clinic to ask what to do. which is the best response by the nurse? "Go ahead and take the other brand at the pharmacy has available for now" "You could stop the medication until your current brand is available" "You can split the thyroid pills in half so that they will last longer" "Let me ask your prescriber what needs to be done; we will need to watch how you do if you switch brands"

" let me ask your prescriber what needs to be done; we will need to watch how you do if you switch brands"

The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse should provide which instruction to the patient for insulin administration? "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." "Inject the needle at a 30-degree angle." "Rotate sites at least once or twice a week." "Use a 23- to 25-gauge syringe with a 1-inch needle to increase insulin absorption."

"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." When insulins are mixed, withdraw the regular insulin (clear) first, followed by withdrawing the NPH insulin (cloudy).

Which client statement indicates the need for further teaching about antiemetic medications? "I may take Tylenol to treat the headache caused by ondansetron (Zofran)." "I will not drive while I am taking these medications because they may cause drowsiness." "I should take my prescribed antiemetic before receiving my chemotherapy dose." "I will apply the scopolamine patch to my right or left arm and rotate sites of application."

"I will apply the scopolamine patch to my right or left arm and rotate sites of application." Transdermal scopolamine patches should be applied to nonirritated areas behind the ear, not on the arms.

Which statement by the patient indicates an understanding of discharge teaching for the medication alendronate (Fosamax)? "I need to take this medication with food to prevent damage to my esophagus caused by reflux of stomach acid." "I need to decrease my intake of dairy products to prevent hypercalcemia." "This medication will help relieve the bone pain I have from my osteoporosis." "I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes."

"I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes." Alendronate can cause erosive esophagitis. To prevent this adverse effect, it is important for the patient to take the medication with an 8-oz glass of water in the morning on an empty stomach without any other medications and maintain an upright position for 30 minutes. These actions facilitate rapid absorption and prevent reflux into the esophagus.

Which statement by the patient indicates an understanding of discharge instructions given by the nurse about the newly prescribed medication levothyroxine (Synthroid)? "I can expect improvement of my symptoms within 1 week." "I will stop the medication immediately if I feel pain or weakness in my muscles." "I will take this medication in the morning so it does not affect my sleep at night." "I will take a double dose to make up for the missed one."

"I will take this medication in the morning so it does not affect my sleep at night." Levothyroxine increases basal metabolic rate and thus may cause insomnia. Patients should not double the dose or stop taking the medication abruptly. It may take up to 4 weeks for a therapeutic response to occur.

A patient receiving propylthiouracil (PTU) asks the nurse, "How does this medication relieve symptoms?" What is the nurse's best response? "PTU causes the pituitary gland to secrete thyroid-stimulating hormone, which blocks the production of hormones by the thyroid gland." "PTU helps your thyroid gland synthesize and use iodine, which produces hormones better." "PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal." "PTU removes thyroid hormones that are already circulating in your bloodstream, thus decreasing the adverse effects of this medication."

"PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal." PTU is an antithyroid medication used to treat hyperthyroidism. It works by inhibiting the synthesis of new thyroid hormone. It does not inactivate present hormone.

When providing education regarding the use of proton pump inhibitors, which statement will the nurse include? "Take the medication along with the first meal of the day." "Take the medication on an empty stomach, 30 to 60 minutes before eating." "Take the medication when you have symptoms of heartburn." "Take the medication at bedtime with a snack."

"Take the medication on an empty stomach, 30 to 60 minutes before eating."

When educating a patient about the use of oral contraceptives, the nurse provides what explanation for the pills having different colors each week? "They help you remember which week you are taking." "They are color coded for the weeks of the month." "The different color pills are because of different amounts of hormones in each week." "There isn't a reason for the color; it's just the choice of the drug company."

"The different color pills are because of different amounts of hormones in each week." Oral contraceptive pills can be monophasic, biphasic, or triphasic. If the pills are different colors, they have different amounts of hormones and are likely the triphasic type of contraceptive.

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy? "I will need to take this drug on a daily basis for at least 1 year." "I will isolate myself from my family for 1 week so there is no risk of radiation exposure." "This drug will help decrease my cold intolerance and weight gain." "This drug will be taken up by the thyroid gland and destroy thyroid tissue."

"This drug will be taken up by the thyroid gland and destroy thyroid tissue." Radioactive iodine is an antithyroid medication that is administered orally. It concentrates in the thyroid gland, where its radioactivity destroys thyroid tissue.

A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. Which information should the nurse include as education related to the oral contraceptives? "Your sexual partner should use a nonprescription test kit that will detect a urinary tract infection." "Use an alternative method of birth control for up to 1 month during and after antibiotic use." "Report any abdominal pain, blood in the urine, or changes in vision." "There is no drug interaction between oral contraceptives and antibiotics."

"Use an alternative method of birth control for up to 1 month during and after antibiotic use." When a patient takes oral contraceptives and is prescribed an antibiotic, the oral contraceptive effectiveness can be decreased, and an alternative method of birth control should be used for at least 1 month during and after taking certain antibiotics.

When teaching a patient about insulin glargine (Lantus), which statement by the nurse about this drug is correct? Incorrect "It is often combined with regular insulin to decrease the number of insulin injections per day." "You can mix this insulin with NPH insulin to enhance its effects on glucose metabolism." "You cannot mix this insulin with regular insulin and thus will have to take two injections." "The duration of action for this insulin is 8 to10 hours, so you will need to take it twice a day."

"You cannot mix this insulin with regular insulin and thus will have to take two injections." Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins. It is usually dosed once daily, but it may be dosed every 12 hours depending on the patient's glycemic response.

A client is prescribed levothyroxine sodium 0.75 mg daily. The nurse instructs the client about the medication. Which client statement indicates to the nurse that further teaching is required? 1."I will take my medication before I go to sleep." 2."If I have chest pain, I will call my health care provider" 3."If my hands shake, I will call my health care provider" 4."I will inform other health care providers about the medication"

1) CORRECT — Levothyroxine is a thyroid hormone used to treat hypothyroidism. Administration in the morning is preferred to prevent insomnia. 2) INCORRECT — Cardiovascular effects may include tachycardia, palpitations, dysrhythmias, and angina pectoris. The client should notify the health care provider if these symptoms occur. 3) INCORRECT — Central nervous system effects include nervousness and tremors. The client should notify the health care provider if the client has tremors, diarrhea, excessive sweating, heat intolerance, or weight loss greater than 2 lb (0.91 kg) per week. 4) INCORRECT — Levothyroxine may interact with other medications, including warfarin. The client should inform all health care providers about the medication.

The nurse provides care to a female client who is prescribed conjugated estrogen therapy for management of menopausal symptoms. Which client statement requires immediate follow up by the nurse? 1."I have trouble falling asleep at night" 2."I gained 5 pounds since I started taking this medication" 3."My left leg is sore behind the knee." 4."I am still having hot flashes several times each week."

1) INCORRECT - Insomnia is a common complaint during menopause. Hormone replacement therapy (HRT) may help decrease insomnia. However, the individual may still experience impaired sleep patterns. 2) INCORRECT - Weight gain is a common side effect of hormone replacement therapy (HRT). Although this side effect may be undesirable, it does not represent an indication that the client is experiencing a complication of HRT. 3) CORRECT— Complications associated with hormone replacement therapy (HRT) include abnormal clotting and deep vein thrombosis (DVT). Pain or soreness in the popliteal region may be a sign of DVT. The nurse should immediately follow up with the client regarding her statement, assess for additional manifestations of DVT, and notify the health care provider of abnormalities. 4) INCORRECT - Symptoms of menopause, including hot flashes, may persist with use of hormone replacement therapy (HRT). Other common symptoms associated with menopause include insomnia and emotional lability.

The nurse provides medication teaching to an adolescent diagnosed with type 1 diabetes mellitus. Which client statement indicates that teaching is effective? 1. "The peak action for isophane insulin (NPH) is 16 to 24 hours" 2. "The peak action for glargine insulin is 12 to 16 hours" 3. "The onset of action for regular insulin is 30 to 60 minutes" 4. "The onset of action for lispro is 60 minutes"

1) INCORRECT - NPH, an intermediate-acting insulin, has a peak action of 6 to 12 hours. 2) INCORRECT - Glargine, a very long-acting insulin, has continuous effect with no peak. 3) CORRECT — Regular insulin, a short-acting insulin, has an onset of action of 30 to 60 minutes. 4) INCORRECT - The onset of action for lispro insulin, a rapid-acting insulin, is 5 to 15 minutes.

The nurse completes a medication history with a client experiencing a bleeding duodenal ulcer. Which prescribed medication reported by the client causes the nurse concern? 1. Ranitidine hydrochloride 2. Metoclopramide hydrochloride 3. Sucralfate 4. Famotidine

1) INCORRECT - Ranitidine hydrochloride inhibits the action of histamine at the receptor sites of parietal cells to decrease gastric acid secretion. This medication is used for short-term treatment of duodenal and gastric ulcers. 2) CORRECT— Metoclopramide hydrochloride stimulates motility of the upper gastrointestinal tract and is contraindicated in a client with a possible hemorrhage of the gastrointestinal tract. This medication is used to treat nausea associated with chemotherapy. 3) INCORRECT - Sucralfate adheres to and protects the ulcer surface by forming a barrier. This medication is used for short-term treatment of a duodenal ulcer. 4) INCORRECT - Famotidine inhibits the action of histamine at the receptor site of parietal cells, decreasing gastric acid secretion. This medication is used for treatment of a duodenal ulcer.

An older adult client takes prednisone by mouth three times a day. Which client statement causes the nurse the most concern? 1. "I take my medication with meals" 2. "I have this little sore on my leg that won't go away" 3. "I should take a brisk walk several times a week" 4. I avoid public places during the flu season

1) INCORRECT - The medication should be taken with meals to decrease gastrointestinal irritation. 2) CORRECT— Steroids suppress the immune response. A nonhealing sore should be reported to the health care provider and further assessed. 3) INCORRECT - Older clients are more prone to developing osteoporosis. This is exacerbated by the use of oral steroids. Exercise should be encouraged. 4) INCORRECT - Since corticosteroids cause immunosuppression, avoiding public places during the flu season is recommended.

The nurse prepares an injection of glargine insulin at the client's bedside. Which client statement indicates a need for further teaching by the nurse? 1."I usually give myself this insulin in my belly" 2."I always take this insulin just before I take my sleeping pill when I am at home" 3."My health care provider said when my infection heals, we may be able to decrease the amount of insulin I take." 4."I will need a snack in about 30 minutes to prevent my blood glucose from going too low."

1) INCORRECT- The abdomen is an appropriate place to administer insulin. The statement indicates that teaching was effective. 2) INCORRECT- Taking the insulin before a sleeping pill at home is appropriate. Glargine should be given at the same time each day, usually at night. There are no known interactions between insulin and sedatives. 3) INCORRECT- Infection may temporarily increase the need for insulin. After an infection heals, the dose may need to be adjusted downward. 4) CORRECT - Glargine has no peak action. The onset of glargine is 3 to 4 hours, and it lasts 24 hours.

The nurse provides care for a client who is prescribed levothyroxine. Which client statements indicates need for further teaching? 1. "My blood TSH level will increase with this medication." 2. "I will feel more energetic when this medication works." 3. "I will take this medication on an empty stomach when I wake up." 4. "This medication replaces the hormone I don't produce."

1. CORRECT- Serum TSH levels will decrease with medication effectiveness. If the client has normal thyroid function as a result of the levothyroxine, the thyroid-stimulating hormone will decrease because it is not receiving negative feedback to cause it to increase. If the TSH level gets too low, this may indicate that the dose of levothyroxine may need to be decreased. 2. INCORRECT- Levothyroxine increases metabolism and cellular energy, which will likely cause the client to have more energy. This statement indicates a correct understanding of the medication therapy. 3. INCORRECT- Food in the stomach may affect absorption of this medication. This statement indicates a correct understanding of the medication therapy. 4. INCORRECT- Levothyroxine is a synthetic thyroid hormone that replaces the client's lack of endogenous hormone. This statement indicates a correct understanding of the medication therapy.

The nurse teaches a client who is prescribed prednisone for systemic lupus erythematosus (SLE). Which information related to prednisone would the nurse NOT include in the teaching plan? 1. Make sure to get a live influenza vaccine every year. 2. Report any symptoms of infection 3. Do not discontinue medication abruptly 4. Report unusual weight gain

1. CORRECT- Vaccinations are to be avoided when taking prednisone because of the decreased ability to mount an inflammatory response. This would not be included in teaching. 2. Incorrect- Prednisone causes immunosuppression, and symptoms of infection should be reported. This would be included in teaching. 3. Incorrect- Discontinuing prednisoone abruptly can cause adrenal crisis. This would be included in teaching. 4. Incorrect- Prednisone is associated with fluid retention and weight gain. This would be included in teaching.

A client diagnosed with peptic ulcer disease asks if an over-the-counter antacid can be taken instead of esomeprazole because of the cost. Which response by the nurse is inappropriate? 1. "Try the antacids for a few days. If you start to feel worse, call your health care provider." 2. "Esomeprazole helps reduce stomach acid, and you will need to take it for several weeks to achieve healing." 3. "I will call your pharmacy and find out the cost." 4. "Notify your health care provider if you have stools that are black and tarry."

1. Correct- Antacids are not the treatment of choice for peptic ulcer disease so this statement is inappropriate. 2. Incorrect- Esomeprazole acts to reduce stomach acid, which is the desired mechanism to help heal the ulcer so this statement is appropriate. 3. Incorrect- Volunteering to call the pharmacy demonstrates advocacy in order for the client to recieve appropriate treatment for the health problem. So this statement is approprite. 4. Incorrect- Black, tarry stools indicate gastrointestinal bleeding. The health care provider should be notified if this occurs. So this statement is appropriate.

The nurse prepares teaching material for a client prescribed levothyroxine. Which information would not be included when instructing the client? 1. "Call your health care provider if you feel your heart is racing." 2. "You should have more energy once the medication has reached a therapeutic level." 3. "Take the medication with food, just before going to bed." 4. "Ensure you have an adequate supply of medication when going on vacation."

1. Incorrect- Feeling like the heart is racing may indicate that the dose is too high. Heart racing is an adverse effect of the medication. 2. Incorrect- This medication is used to treat hypothyroidism, which causes a loss of energy and feelings of lethargy. Taking the medication as prescribed should decrease these feelings. 3. Correct- The medication should be taken in the morning on an empty stomach. 4. The medication needs to be taken every day, so an adequate supply needs to be available.

The nurse is providing education to a patient for the prescription glipizide (Glucotrol). The nurse explains this medication is more effective when administered at which time? 15 minutes postprandial At bedtime 30 minutes before a meal In the morning

30 minutes before a meal Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.

To avoid fecal impaction, psyllium (Metamucil) should be administered with at least how many ounces of fluid? 8 4 6 10

8 Bulk-forming laxatives such as psyllium must be given with at least 8 oz of liquid plus additional liquid each day to prevent esophageal obstruction and fecal impaction.

The nurse will question an order for misoprostol (Cytotec) in which patient? A 21-year-old man with Zollinger-Ellison syndrome A 32-year-old pregnant woman with a urinary tract infection A 45-year-old woman with GERD A 64-year-old man with hypertension

A 32-year-old pregnant woman with a urinary tract infection Misoprostol (Cytotec) is a prostaglandin E analogue and is believed to inhibit gastric acid secretion and protect the gastric mucosa from injury by enhancing the local production of mucus. However, it is also an abortifacient and therefore is contraindicated in pregnancy. The drug may be useful in treating patients with Zollinger-Ellison syndrome (a hypersecretory syndrome) and GERD. Hypertension is not a contraindication for its use.

A patient calls the clinic because she realized she missed one dose of an oral contraceptive. Which statement for the nurse is appropriate? (SATA) A. "Go ahead and take the missed dose now, along with today's dose." B. "Don't worry, you are still protected from pregnancy." C. "Please come to the clinic for a reevaluation of your therapy." D. "Wait 7 days, and then start a new pack of pills." E. "You will need to use a backup form of contraception concurrently for 7 days."

A. "Go ahead and take the missed dose now, along with today's dose." E. "You will need to use a backup form of contraception concurrently for 7 days."

When the nurse teaches a patient about taking bisacodyl tablets, which instruction is correct? A. "Take this medication on an empty stomach." B. "Chew the tablet for quicker onset." C. "Take this medication with juice or milk." D. "Take this medication with an antacid if it upsets your stomach."

A. "Take this medication on an empty stomach."

The nurse has provided patient education regarding therapy with the SERM raloxifene (Evista). Which statement from the patient reflects a good understanding of the instructions? A. "When I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel." B. "I can continue this drug even when traveling as long as I take it with a full glass of water each time." C. "After I take this drug, I must sit upright for at least 30 minutes." D. "One advantage of this drug is that it will reduce my hot flashes."

A. "When I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel."

A patient who is taking oral tetracycline complains of heartburn and requests an antacid. Which action by the nurse is correct? A. Give the tetracycline, but the delay the antacid for 1 to 2 hours. B. Give the antacid, but delay the tetracycline for at least 4 hours. C. Administer both medications together. D. Explained that the antacid cannot be given while the patient is taking the tetracycline.

A. Give the tetracycline, but the delay the antacid for 1 to 2 hours.

When the nurse is administering a proton pump inhibitor (PPI), which actions by the nurse are correct? (SATA) A. Giving the PPI on an empty stomach B. Giving the PPI with meals C. Making sure the patient does not crush or chew the capsules D. Instructing the patient to open the capsule and chew the contents for best absorption E. Administering the PPI only when the patient complains of heartburn

A. Giving the PPI on an empty stomach C. Making sure the patient does not crush or chew the capsules

The nurse is preparing to administer dronabinol (Marinol) to a patient. Which statements about dronabinol therapy are true? A. It is approved for nausea and vomiting related to cancer chemotherapy. B. It is approved for the use with hyperemesis gravidarum (nausea and vomiting associated with pregnancy). C. It is approved to help stimulate the appetite in patients with nutritional wasting due to cancer or AIDS. D. It may cause extrapyramidal symptoms. E. It may cause drowsiness or euphoria.

A. It is approved for nausea and vomiting related to cancer chemotherapy. C. It is approved to help stimulate the appetite in patients with nutritional wasting due to cancer or AIDS. E. It may cause drowsiness or euphoria.

Discharge teaching for a patient receiving glucocorticoids would include the use of which medication for pain management? Naprosyn (Naproxen) Aspirin (Acetylsalicylic acid) Ibuprofen Acetaminophen (Tylenol)

Acetaminophen (Tylenol) Acetaminophen does not cause GI distress as do aspirin, ibuprofen, naproxen, and glucocorticoids.

PPIs have the ability to almost totally inhibit gastric acid secretion. Because of this possibility, the use of the medication can lead to what condition? Gastric ulcer formation Gastroesophageal reflux disease (GERD) Achlorhydria Diverticulosis

Achlorhydria Because PPIs stop the final step of acid secretion, they can block up to 90% of acid secretion, leading to achlorhydria (without acid).

The nurse has a prescription for a patient to receive prednisone (Deltasone) to treat contact dermatitis. The nurse would question this prescription for this patient with what condition? Multiple sclerosis Chronic obstructive pulmonary disease Acquired immune deficiency syndrome (AIDS) Asthma

Acquired immune deficiency syndrome (AIDS) Because of their immunosuppressant properties, glucocorticoids are often avoided in the presence of any serious infection, including septicemia, systemic fungal infections, and varicella. These drugs would be contraindicated in patients with active AIDS infection because it could potentially decrease the immune system further. One exception is tuberculous meningitis, for which glucocorticoids may be used to prevent inflammatory central nervous system damage.

A 45-year-old women has been diagnosed with irritable bowel syndrome (IBS) and will be taking lubiprostone (Amitiza). The nurse assesses for conditions that may be contraindicated to this drug, such as A. Constipation B. Bowel obstruction C. Renal calculi D. Anemia

B. Bowel obstruction

A patient who has chronic renal failure wants to self-treat with an antacid for occasional heartburn. Which medication is the best choice for this patient? A magnesium-containing antacid A calcium-containing antacid An aluminum-containing antacid Because of renal problems, the patient should not take antacids for this problem.

An aluminum-containing antacid

Antidopaminergic drugs are useful to treat not only nausea and vomiting but also which other conditions? (Select all that apply.) Select all that apply. Anxiety Bone marrow suppression Seizures Intractable hiccups Schizophrenia

Anxiety Intractable hiccups Schizophrenia Antidopaminergic drugs are used to treat psychotic disorders (mania, schizophrenia, anxiety), intractable hiccups, nausea, and vomiting.

When administering sucralfate, which action by the nurse is most correct? A. Giving the drug with meals B. Giving the drug on an empty stomach C. Instructing the patient to restrict fluids D. Waiting 30 minutes before administering other drugs

B. Giving the drug on an empty stomach

A patient with a history of renal problems is asking for advice about which antacid he should use. The nurse will make which recommendation? A. "Patients with renal problems cannot use antacids." B. "Aluminum-based antacids are the best choice for you." C. "Calcium-based antacids are the best choice for you." D. "Magnesium-based antacids are the best choice for you."

B. "Aluminum-based antacids are the best choice for you."

The nurse is providing patient teaching regarding scopolamine transdermal patches (Transderm-Scop) to a patient who is planning an ocean cruise. Which instruction is most important? A. "Apply the patch the day before traveling." B. "Apply the patch at least 4 hours before traveling." C. "Apply the patch to the shoulder area." D. "Apply the patch to the temple just above the ear."

B. "Apply the patch at least 4 hours before traveling."

A patient has been receiving long-term antibiotic therapy as part of treatment for an infected leg wound. He tells the nurse that he has had "spells of diarrhea" for the last week. Which medication is most appropriate for him at this time? A. bismuth subsalicylate B. L. acidophilus C. diphenoxylate with atropine D. codeine

B. L. acidophilus

A 33-year-old patient is in the outpatient center for his first round of chemotherapy. The nurse knows that which schedule is the most appropriate timing for the IV antiemetic drug? A. Four hours before the chemotherapy begins B. Thirty minutes before the chemotherapy begins C. At the same time as the chemotherapy drugs D. At the first sign of nausea

B. Thirty minutes before the chemotherapy begins

Bismuth subsalicylate (Pepto-Bismol), as an adsorbent, has which mechanism of action? Binds to diarrhea-causing bacteria for excretion Increases peristalsis by irritating the bowel Decreases intestinal motility and secretion Promotes water absorption into the colon

Binds to diarrhea-causing bacteria for excretion Adsorbent antidiarrheal medications bind to diarrhea-causing bacteria to form a nonabsorbable complex, which is then excreted in the stool.

When diarrhea occurs in a pediatric client, the nurse will advise the parents to seek emergency medical treatment if which symptoms occur? (Select all that apply.) Select all that apply. Bloody diarrhea Firm or rigid abdomen Urination every 3 to 4 hours Severe abdominal pain Malaise or lethargic

Bloody diarrhea Firm or rigid abdomen Severe abdominal pain Malaise or lethargic If diarrhea is accompanied by fever, malaise, or abdominal pain, the parents should contact the health care provider immediately because of the possibility of excessive fluid and electrolyte loss. Dehydration and electrolyte loss occur very rapidly in pediatric clients because of the clients' size and sensitivity to loss of fluid volume and electrolytes through the stool. Immediately report to the health care provider any abdominal distention, firm abdomen, painful abdomen, or worsening of or lack of improvement in diarrhea 24 to 48 hours after medication administration. If symptoms persist or dehydration occurs (e.g., no tears and decreased urine output in the child), contact the health care provider. If the client is sluggish, lethargic, or confused or the diarrhea is bloody, contact the prescriber immediately or go to the closest emergency facility.

How does sucralfate (Carafate) achieve a therapeutic effect? By inhibiting the production of gastric acid secretion By enhancing gastric absorption By forming a protective barrier over the gastric mucosa By neutralizing gastric acid

By forming a protective barrier over the gastric mucosa Sucralfate has a local effect only on the gastric mucosa. It forms a protective barrier that can be thought of as a liquid bandage in the stomach. This liquid bandage adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.

The nurse is assessing a patient who is to receive dinoprostone (Prostin E2). Which condition would be a contraindication to the use of this drug? A. Pregnancy at 15wks gestation B. GI upset or ulcer disease C. Ectopic pregnancy D. Incomplete abortion

C. Ectopic pregnancy

The nurse is discussing therapy with clomiphene (Clomid) with a husband and wife who are considering trying this drug as part of treatment for infertility. It is important that they be informed of which possible effect of this drug? A. Increased menstrual flow B. Increased menstrual cramping C. Multiple pregnancy (twins or more) D. Sedation

C. Multiple pregnancy (twins or more)

When assessing for potential serious adverse effects to propylthiouracil (PTU), the nurse will monitor which laboratory test? Kidney function Brain natriuretic peptide Serum electrolytes Complete blood count (CBC)

Complete blood count (CBC) With antithyroid medications, the nurse should monitor for possible serious adverse reactions such as agranulocytosis, leukopenia, and thrombocytopenia. An abnormal CBC result would indicate bone marrow dysfunction.

The nurse will monitor a client taking an aluminum-containing antacid, such as aluminum hydroxide (Amphojel), for which adverse effect? Constipation Gastrointestinal (GI) upset Fluid retention Diarrhea

Constipation Aluminum- and calcium-containing antacids cause constipation, magnesium-containing antacids cause diarrhea, and sodium-containing antacids cause sodium and fluid retention.

Which conditions is aminoglutethimide (Cytadren) used to treat? (Select all that apply.) Select all that apply. Cushing's syndrome Metastatic breast cancer Testicular cancer Thyroid cancer Adrenal cancer

Cushing's syndrome Metastatic breast cancer Adrenal cancer Aminoglutethimide is an adrenal steroid inhibitor. Aminoglutethimide obstructs the normal actions of the adrenal cortex by inhibiting the conversion of cholesterol into adrenal corticosteroids. Aminoglutethimide is used in the treatment of Cushing's syndrome, metastatic breast cancer, and adrenal cancer.

A 30-year-old man is taking simethicone for excessive flatus associated with diverticulitis. During a patient teaching session, the nurse explains the mechanism of action of simethicone by saying: A. "It neutralizes gastric pH, thereby preventing gas." B. "It buffers the effects of pepsin on the gastric wall." C. "It decreases gastric acid secretion and thereby minimizes flatus." D. "It causes mucous-coated gas bubbles to break into smaller ones."

D. "It causes mucous-coated gas bubbles to break into smaller ones."

A patient who has been receiving chemotherapy tells the nurse that he has been searching the internet for antinausea remedies and that he found a reference to a product called Emetrol (phosphorated carbohydrate solution). He wants to know if this drug would help him. What is the nurse`s best answer? A. "This may be a good remedy for you. Let's talk to your physician." B. "This drug is used only after other drugs have not worked." C. "This drug is only used to treat severe nausea and vomiting caused by chemotherapy." D. "This drug may not help the more severe nausea symptoms associated with chemotherapy."

D. "This drug may not help the more severe nausea symptoms associated with chemotherapy."

The nurse is reviewing the use of obstetric drugs. Which situation is an indication for an oxytocin (Pitocin) infusion? A. Termination of a pregnancy at 12 weeks B. Hypertonic uterus C. Cervical stenosis in a patient who is in labor D. Induction of labor at full term

D. Induction of labor at full term

A parent calls to ask about giving a medication for diarrhea to his child, 12 years of age, who is recovering from the flu. The nurse expects the prescriber to recommend which medication? A. bismuth subsalicylate (Pepto-Bismol) B. Lactobacillus GG (culturelle) C. belladonna alkaloid/phenobarbital combination (Donnatal Elixir) D. loperamide (Imodium A-D)

D. loperamide (Imodium A-D)

The nurse is caring for a patient with diabetes insipidus (DI) who is receiving vasopressin (Pitressin). What therapeutic effect does the nurse expect from this drug? Decrease in urine output Increase in thirst Normal serum albumin level Improved skin turgor

Decrease in urine output Vasopressin increases the water reabsorption in the kidneys, thus decreasing urine output. It is used to treat DI, which presents with polydipsia, polyuria, and dehydration.

When monitoring for therapeutic response to prednisone, the nurse will look for which potential outcome? Increased lymphocyte levels Decreased inflammation Increased growth characteristics Decrease in Cushing's syndrome characteristics

Decreased inflammation

The nurse would question a prescription for estrogen replacement therapy in a patient with a history of which condition? Weight loss Vaginal bleeding Dysmenorrhea Deep vein thrombosis

Deep vein thrombosis Increased coagulation and risk of deep vein thrombosis are serious adverse effects of hormone replacement therapy.

An elderly female patient being treated for osteoporosis with a selective estrogen receptor modulator (SERM) should alert the nurse for an increased risk of which condition? Coronary heart disease Hypercalcemia Hypertension Deep vein thrombosis

Deep vein thrombosis The use of SERMs is contraindicated in postmenopausal women with venous thromboembolic disorders, such as deep vein thrombosis.

A patient has developed DI after a head injury. Which medication should the nurse anticipate to be prescribed for the management of DI? Corticotrophin (Acthar) Desmopressin (DDAVP) Somatropin (Genotropin) Octreotide (Sandostatin)

Desmopressin (DDAVP) Vasopressin (Pitressin) and desmopressin (DDAVP) are used to prevent or control polydipsia (excessive thirst), polyuria, and dehydration in patients with DI caused by a deficiency of endogenous antidiuretic hormone.

The nurse would question a prescription for steroids in a patient with which condition? Rheumatoid arthritis Diabetes mellitus Asthma Spinal cord injury

Diabetes mellitus A common adverse effect of steroid therapy is hyperglycemia; therefore, diabetes mellitus is a contraindication to steroid therapy.

The combined continuous administration of progestin and estrogen reduces the risk of which cancer? Breast Ovarian Endometrial Vaginal

Endometrial Estrogen, given alone, has been associated with an increased risk of endometrial hyperplasia, which can lead to endometrial cancer. Progestin reduces the incidence of endometrial hyperplasia.

When planning administration of antiemetic medications to a client, the nurse is aware that combination therapy is preferred because of which drug effect? It is easier to achieve the desired level of sedation. There are faster drug absorption and distribution. Different vomiting pathways are blocked. The risk of constipation is decreased.

Different vomiting pathways are blocked. Combining antiemetic drugs from various categories allows the blocking of the vomiting center and chemoreceptor trigger zone (CTZ) through different pathways, thus enhancing the antiemetic effect.

The patient is being discharged home with insulin aspart (NovoLog) and insulin isophane suspension (NPH). Which information does the nurse include when providing discharge teaching to the patient? Store the insulins in the refrigerator Shake the insulins for 1 full minute before use. Administer the injection at a 30-degree angle to your skin. Draw up the insulin aspart (NovoLog) first, then the insulin isophane suspension (NPH) into the same syringe.

Draw up the insulin aspart (NovoLog) first, then the insulin isophane suspension (NPH) into the same syringe. The rapid-acting (clear) then the intermediate-acting (cloudy) insulins should be mixed in the syringe after the appropriate amount of air has been injected. Insulin is stored at room temperature when it will be used within the month. The injection should be administered at a 90-degree angle for patients who have adequate body fat and at a 45-degree angle for patients who are very thin. Insulins should be rolled prior to administration and not shaken.

A client receiving an anticholinergic drug to treat nausea and vomiting should be taught to expect which adverse effect? Lacrimation Dry mouth Diarrhea Bradycardia

Dry mouth. Anticholinergic drugs block the parasympathetic nervous system, which causes the body to "rest and digest." Blocking of these effects leads to constipation, urinary retention, and decreased secretions (dry mouth).

What possible common adverse effect would the nurse include in the discharge teaching for a patient prescribed finasteride (Proscar)? Hair loss Muscle weakness Increased libido Ejaculatory dysfunction

Ejaculatory dysfunction Possible adverse effects of finasteride include ejaculatory dysfunction, loss of libido, loss of erection, hypersensitivity reactions, gynecomastia, and severe myopathy. It is also used to treat male pattern baldness and thus would cause hair growth, not hair loss.

The nurse is providing education to a patient and the patient's caregiver, who is pregnant, on the medication dutasteride (Avodart) for treatment of benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and the patient's caregiver about this medication? Notify your health care provider for an erection that lasts 2 hours. Emphasize it must not be touched or handled by pregnant women because of teratogenic effects. Instruct to put the drug into a container with other medications. Take the medication with dairy containing products such as milk or yogurt.

Emphasize it must not be touched or handled by pregnant women because of teratogenic effects. Finasteride (Proscar) and dutasteride (Avodart) are indicated for BPH. Both drugs are contraindicated in patients who have shown hypersensitivity and in pregnant women and children. It is considered potentially dangerous for a pregnant woman even to handle crushed or broken tablets. Both drugs are classified as pregnancy Category X.

Which is a priority nursing diagnosis for a patient receiving desmopressin (DDAVP)? Deficient knowledge regarding medication Excess fluid volume Acute pain Risk for injury

Excess fluid volume Desmopressin is a form of antidiuretic hormone, which increases sodium and water retention, leading to an alteration in fluid volume. Although the other nursing diagnoses may be appropriate, they are not a priority using Maslow's hierarchy of needs.

When assessing for potential adverse effects of fludrocortisone (Florinef), the nurse monitors for signs and symptoms of which condition? Hypovolemia Hyponatremia Hypercalcemia Hypokalemia

Fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention along with potassium excretion. Thus, a potential adverse effect is hypokalemia. Assessing for signs and symptoms of hypokalemia and close monitoring of electrolytes is needed.

The nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just after the injection, the dietary department calls to inform the patient care unit that breakfast trays will be 45 minutes late. What will the nurse do next? Inform the patient of the delay. Check the patient's blood glucose levels. Call the dietary department to send a tray immediately. Give the patient food, such as cereal and skim milk, and juice.

Give the patient food, such as cereal and skim milk, and juice. Lispro insulin's onset of action is 15 minutes. It is essential that a diabetic patient eat a meal after injection. Otherwise profound hypoglycemia may result.

Before administering the anticholinergic drug scopolamine (Transderm-Scōp), the nurse should carefully assess the client for a history of which condition? Hyperthyroidism Glaucoma Gastroenteritis Rheumatoid arthritis

Glaucoma

When caring for a pregnant patient with gestational diabetes, the nurse should question a prescription for which drug? Insulin glargine (Lantus) Insulin glulisine (Apidra) Glipizide (Glucotrol) NPH insulin

Glipizide (Glucotrol) Oral antidiabetic drugs are classified as pregnancy B or C drugs and are generally not recommended for pregnant patients.

Based on the nurse's knowledge of glucocorticoids, what instructions should be given for this drug? Advise that the drug does not have to be tapered before stopped. Inform the patient that the drug can be taken with coffee. Take the medication every evening. Advise to take drug with milk, other dairy products, or food.

Glucocorticoids can cause gastrointestinal (GI) distress and should be given with milk or food. They should not be administered with coffee, which contains caffeine and may increase gastric irritation. The best time to give exogenous glucocorticoids is early in the morning (6 AM to 9 AM) to minimize the amount of adrenal suppression. These medications should be tapered off slowly to prevent adrenal crisis and can be administered intravenously (IV).

After administering somatropin (Genotropin) to a patient, the nurse would assess for potential adverse effects of this medication by monitoring which laboratory test result? Glucose Magnesium Potassium Platelets

Glucose Hyperglycemia and hypoglycemia are potential adverse effects of somatropin therapy.

The nurse has provided teaching about oral corticosteroid therapy to a patient. Which statement by the patient shows a need for more teaching? "I will report any fever or sore throat symptoms" "I will stay away from anyone who has a cold or infection" "I can stop this medication if I have severe adverse effects" "I will take this drug with milk or food."

I can stop this medication if I have severe adverse effects

The nurse would question the prescription of bismuth subsalicylate (Pepto-Bismol) as an antidiarrheal medication for a client prescribed aspirin daily because of which potential adverse effect? Nausea Urinary retention Increased bleeding Constipation

Increased bleeding The adsorbent bismuth subsalicylate is a form of aspirin, or acetylsalicylic acid, and therefore it also has many of the same drug adverse effects as aspirin. Bismuth subsalicylate can lead to increased bleeding times and bruising when administered with warfarin as well as aspirin and other nonsteroidal antiinflammatory drugs.

For a client with chronic renal failure, the nurse MOST likely will question a prescription for which type of antacid? Aluminum-containing antacids Calcium-containing antacids Sodium-containing antacids Magnesium-containing antacids

Magnesium-containing antacids can cause hypermagnesemia in clients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in clients with chronic renal failure. Sodium- and aluminum-containing antacids are chemically more easily excreted in clients with renal compromise. Although calcium-containing antacids may accumulate in the bloodstream of clients with renal failure, they may also be appropriate because these patients may be hypocalcemic.

For a patient taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently, the nurse would closely monitor for which possible serious adverse effect? Acute confusion Cardiac dysrhythmias Orthostatic hypotension Increased bruising

Increased bruising Levothyroxine can compete with protein-binding sites of warfarin, allowing more warfarin to be unbound or free, thus increasing effects of warfarin and risk of bleeding. Bleeding commonly presents as bruising.

What is a pharmacodynamic effect of exogenous androgens? Increased protein synthesis Increased nitrogen excretion Decreased erythropoiesis Decreased sperm production

Increased protein synthesis Androgens retard the breakdown of amino acids, contributing to an increased synthesis of body proteins, which aids in the formation and maintenance of muscle tissue. Additionally, they stimulate the production of erythropoietin by the kidneys, resulting in enhanced erythropoiesis (red blood cell synthesis); increase the retention of nitrogen which is essential protein synthesis; and may suppress sperm production when given in large doses as a result of the feedback inhibition of pituitary follicle-stimulating hormone.

The physician orders lansoprazole (Prevacid) for a client with peptic ulcer disease. The nurse should teach the client that the main objective of this medication is to: Inhibit gastric acid secretion Increase histamine release Neutralize gastric acidity Increase gastric motility

Inhibit gastric acid secretion

When teaching a patient regarding proper application of a testosterone (Testoderm) transdermal patch, the nurse will provide which information about this medication? Remind to remove the patch every 72 hours. Explain to apply the patch on the back, abdomen, or upper arms. Instruct to place the patch on clean, dry, shaved scrotal skin. Advise to replace the patch every 36 hours.

Instruct to place the patch on clean, dry, shaved scrotal skin. Testoderm transdermal patches should be placed on clean, dry scrotal skin that has been shaved for optimal skin contact. A patch should be replaced every 24 hours.

Which is a rapid-acting insulin with an onset of action of less than 15 minutes? Regular insulin (Humulin R) Insulin glargine (Lantus) Insulin detemir (Levemir) Insulin aspart (NovoLog)

Insulin aspart (NovoLog) Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulins. Regular insulin is short acting.

The patient was taking metformin before this hospitalization. To facilitate better glucose control, the patient has been switched to insulin therapy while hospitalized. The patient asks the nurse why it is so important to time meals with the insulin injection and to give him an example of a long-acting insulin. Which drug will the nurse tell the patient is a long-acting insulin? Insulin glulisine (Apidra) Insulin isophane suspension (NPH) Insulin detemir (Levemir) Regular insulin (Humulin R)

Insulin detemir (Levemir) The nurse should inform the patient that timing of meals with insulin and oral antidiabetic therapy is important to prevent hypoglycemia and to obtain the most optimal results from the antidiabetic therapy. Insulin detemir (Levemir) is a long-acting insulin while insulin glulisine (Apidra) is a rapid-acting insulin. Insulin isophane suspension (NPH) is an intermediate-acting insulin, and regular insulin (Humulin R) is a short-acting insulin.

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? Insulin glulisine (Apidra) Insulin glargine (Lantus) Regular insulin (Humulin R) NPH insulin

Insulin glargine (Lantus) Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

The nurse would suspect a patient is taking too much levothyroxine (Synthroid) when the patient exhibits which adverse effect? Lethargy Irritability Weight gain Feeling cold

Irritability Irritability is a symptom of hyperthyroidism and may indicate toxicity of the medication. The other choices are signs of hypothyroidism.

What is the mechanism of action for Famotidine (Pepcid)? It forms a protective coating against gastric acid, pepsin, and bile salts. It competes with histamine for binding sites on the parietal cells. It irreversibly binds to the hydrogen-potassium-adenosine triphosphatase (ATPase) pump. It causes a decrease in stomach pH, reducing stomach acidity.

It competes with histamine for binding sites on the parietal cells. Histamine receptor-blocking drugs decrease gastric acid by competing with histamine for binding sites on the parietal cells.

What is the mechanism of action of diphenoxylate (Lomotil)? It decreases peristalsis in the intestinal wall. It inhibits intestinal excretion of water and sodium. It increases intestinal secretion and motility. It prevents the reabsorption of water in the bowel.

It decreases peristalsis in the intestinal wall. Diphenoxylate is an opiate antidiarrheal medication that acts on the smooth muscle of the intestinal tract to inhibit gastrointestinal (GI) motility and excessive propulsion of the GI tract (peristalsis).

The nurse recognizes that metoclopramide (Reglan) is useful in treating postoperative nausea and vomiting because of what action? It inhibits chemoreceptor stimulation. It promotes motility in the small intestine. It improves the body's response to analgesia. It decreases peristalsis in the intestinal wall.

It promotes motility in the small intestine. Metoclopramide works by increasing gastrointestinal (GI) motility in the small intestine, thus minimizing gastric distention and accompanying stimulation of the vomiting center.

The nurse is reviewing the adverse effects of antithyroid medications for a patient prescribed propylthiouracil (PTU). What potential serious adverse effects should the nurse discuss with the patient during discharge teaching? (Select all that apply.) Select all that apply. Kidney damage Increased urination Joint pain Bone marrow toxicity Liver toxicity

Joint pain Bone marrow toxicity Liver toxicity The most damaging or serious adverse effects of the antithyroid medications are liver and bone marrow toxicity. Myalgias and arthralgias (joint pain) may also occur with PTU.

Which laboratory test would the nurse expect the health care provider to prescribe to monitor a patient for adverse effects related to progestin medications? Complete blood count Serum creatinine level Liver function tests Cardiac enzymes

Liver function tests One of the most serious undesirable adverse effects of progestins is liver dysfunction, which would be assessed by monitoring liver enzymes.

The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct? Proton pump inhibitors can cause diarrhea These drugs can cause nausea and anorexia Proton pump inhibitors can cause drowsiness Long-term use of these drugs may contribute to osteoporosis.

Long-term use of these drugs may contribute to osteoporosis.

What condition will the nurse monitor for with a client using sodium bicarbonate to treat gastric hyperacidity? Hypercalcemia Hyperkalemia Metabolic acidosis Metabolic alkalosis

Metabolic alkalosis Solutions containing sodium bicarbonate (a base) can cause metabolic alkalosis. Serum potassium and serum calcium would decrease, not increase, with alkalosis.

The nurse is preparing a patient for a computed tomography scan using iodine contrast media. Which medication should the nurse question if prescribed one day before the scheduled procedure? Pioglitazone (Actos) Acarbose (Precose) Repaglinide (Prandin) Metformin (Glucophage)

Metformin (Glucophage) The concurrent use of metformin with iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore, metformin should be discontinued the day of the test and for at least 48 hours after the patient undergoes any radiologic study that requires the use of such contrast media.

A patient is receiving a continuous tube feeding via a PEG tube. Which drug would most likely be prescribed for this patient? metoclopramide (Reglan) meclizine (Antivert) aprepitant (Emend) phosphorated carbohydrate solution (Emetrol)

Metoclopramide is a prokinetic drug that promotes the movement of substances through the gastrointestinal tract and increases gastrointestinal motility. This action is helpful in preventing aspiration in those receiving tube feedings.

A patient is asking about the use of saw palmetto for prostate health. The nurse tells him that drugs that interact with saw palmetto include: acetaminophen nitrates NSAIDs antihypertensive drugs

NSAIDs

The nurse is preparing to administer scopolamine to a patient. It is most important for the nurse to determine if the patient has a history of which condition? Cataracts Narrow-angle glaucoma Presbyopia Detached retina

Narrow-angle glaucoma

When teaching a patient the adverse effects of desmopressin (DDAVP), the nurse will instruct the patient to monitor for which potential adverse effects? (Select all that apply.) Nasal Irritation Hyperglycemia Hypotension Headache Weight Gain

Nasal Irritation Headache Weight Gain Desmopressin works to decrease urine output; thus, the patient could retain fluid and gain weight. Other common adverse effects include increased blood pressure, fever, headache, abdominal cramps, and nausea. Desmopressin does not affect serum glucose levels. Because it is administered intranasally, it can be irritating; thus, nostrils should be rotated.

The nurse will teach clients that antacids are effective in the treatment of hyperacidity based on which mechanism of action? Neutralizes gastric acid Decreases gastric pH Decreases stomach motility Decreases duodenal pH

Neutralizes gastric acid Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affect gastric motility.

The nurse admitting a patient with acromegaly anticipates administering which medication? Octreotide (Sandostatin) Somatropin (Genotropin) Corticotropin (Acthar) Desmopressin (DDAVP)

Octreotide (Sandostatin) Octreotide suppresses growth hormone, the culprit of acromegaly.

What is the most common drug used for induction of labor in pregnant women and to promote ejection of milk during lactation? Mifepristone (Mifeprex) Misoprostol (Cytotec) Oxytocin (Pitocin) Clomiphene (Clomid)

Oxytocin (Pitocin) Oxytocin is a naturally occurring hormone that can be given in synthetic form for induction of labor.

Pramlintide (Symlin) is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information should the nurse include when teaching the patient about the action of this medication? Pramlintide stimulates glucose production. Pramlintide increases glucagon excretion. Pramlintide slows gastric emptying. Pramlintide corrects insulin receptor sensitivity.

Pramlintide slows gastric emptying. Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion and hepatic glucose production, and increasing satiety (sense of having eaten enough). It is only administered via subcutaneously injection.

Related to its mechanism of action, what is an additive effect of lactulose (Enulose)? Reducing ammonia levels Decreasing cerebral edema Correcting sodium imbalances Alleviating galactose intolerance

Reducing ammonia levels Lactulose draws water into the colon and produces a laxative effect. This drug-induced acidic environment also reduces blood ammonia levels by forcing ammonia from the blood into the colon. This effect is useful in treating clients with hepatic encephalopathy.

Which insulin can be administered by continuous intravenous (IV) infusion? Insulin aspart (Novolog) Insulin detemir (Levemir) Insulin glargine (Lantus) Regular insulin (Humulin R)

Regular insulin (Humulin R) Regular insulin is the only insulin used for IV therapy.

A client is prescribed the over-the-counter laxative of magnesium hydroxide (Milk of Magnesia). Which condition in the client's history would alert the nurse to discuss this medication with the client and the health care provider? Renal insufficiency Liver dysfunction Chronic constipation Hypertension

Renal insufficiency The magnesium saline laxatives are to be used with caution in clients with renal insufficiency, because they can be absorbed enough to cause hypermagnesemia. They are most commonly used for bowel preparation for diagnostic and surgical procedures.

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? Pioglitazone (Actos) Repaglinide (Prandin) Acarbose (Precose) Metformin (Glucophage)

Repaglinide (Prandin) Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.

Which information should the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) Select all that apply. Explain dietary changes are not necessary. Instruct that it is okay to skip breakfast 1 to 2 times per week. Report symptoms of anorexia and fatigue. Advise to avoid smoking and alcohol consumption. Take your medication only as needed.

Report symptoms of anorexia and fatigue Advise to avoid smoking and alcohol consumption. Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. Skipping meals can cause low blood glucose levels and should be avoided. Patients with type 2 diabetes mellitus are managed with lifestyle changes. All other options are correct.

Which nursing diagnosis is appropriate for a patient receiving famotidine (Pepcid)? Ineffective peripheral tissue perfusion related to hypertension Risk for infection related to immunosuppression Impaired urinary elimination related to retention Risk for injury related to thrombocytopenia

Risk for injury related to thrombocytopenia A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in platelet count and an increased risk of bleeding. The patient receiving famotidine may experience hypotension as an adverse effect, not hypertension. Famotidine does not cause immunosuppression or urinary retention.

The nurse enters the patient's room to complete the discharge process and finds the patient to be lying in bed unresponsive and breathing. The patient has a blood glucose reading of 48 mg/dL. What is the most appropriate response by the nurse? Place a packet of table sugar in the patient's mouth. Start CPR. Roll the patient to the side and administer the ordered glucagon. Have the patient drink orange juice.

Roll the patient to the side and administer the ordered glucagon. Glucagon, a natural hormone secreted by the pancreas, is available as a subcutaneous injection to be given when a quick response to severe hypoglycemia is needed. Because glucagon injection may induce vomiting, roll an unconscious patient onto his or her side before injection. Glucagon is useful in the unconscious hypoglycemic patient without established intravenous access. The patient is at risk for aspiration so nothing should be administered by mouth. CPR is not indicated.

The nurse is teaching a patient taking an antithyroid medication to avoid food items high in iodine. Which food item should the nurse instruct the patient to avoid? Chicken Seafood Milk Eggs

Seafood Seafood contains high amounts of iodine. The other choices do not.

A woman who has type II diabetes is now pregnant. She wants to know whether to take her oral antidiabetic medication. What instructions will she receive? She should continue the antidiabetic medication at the same dosage. The antidiabetic medication dosage will be increased gradually throughout her pregnancy. She will be switched to insulin therapy while she is pregnant. She will not receive any antidiabetic medication while pregnant and will need to monitor her dietary intake closely.

She will be switched to insulin therapy while she is pregnant. Oral antidiabetic medications are generally not recommended for pregnant patients because of a lack of firm safety data. Insulin therapy is the currently recommended drug therapy for pregnant women.

Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) Select all that apply. Increase hepatic glucose production Stimulate insulin secretion from beta cells Enhance action of insulin in various tissues Inhibit breakdown of insulin by liver

Stimulate insulin secretion from beta cells Enhance action of insulin in various tissues Inhibit breakdown of insulin by liver The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.

When planning to administer metoclopramide (Reglan), the nurse is aware that this drug must be given in regards to which fluid or food consideration? Give with a full glass of water in the morning. Take with 8 oz of orange or apple juice. Take 30 minutes before meals and at bedtime. Give with food to decrease GI upset.

Take 30 minutes before meals and at bedtime. Metoclopramide should be administered 30 minutes before meals and at bedtime. Administering the medication before meals allows time for onset to increase GI motility before food ingestion, thus decreasing stomach distention and resulting nausea and vomiting.

To help with the insomnia associated with thyroid hormone replacement therapy, the nurse will teach the patient to Take half the dose at lunchtime and the other half two hours later Use a sedative to assist with falling asleep Take the dose upon awakening in the morning Reduce the dosage as needed if sleep is impaired

Take the dose upon awakening in the morning

A patient with type 1 diabetes is admitted to the medical unit with an acute exacerbation of chronic obstructive pulmonary disease (COPD). He is placed on IVPB antibiotics, nebulizer treatments with albuterol, and an IV corticosteroid, and he is also taking a proton pump inhibitor for gastrointestinal esophageal reflux disease (GERD). He takes a dose of glargine insulin every evening. That evening the nurse notes that his blood glucose level is 170 mg/dL. The next morning, his fasting glucose level is 202 mg/dL. What is the most likely cause of his elevated glucose levels? The albuterol The antibiotics The proton pump inhibitor The corticosteroid

The corticosteroid Corticosteroids antagonize the hypoglycemic effects of insulin, resulting in elevated blood glucose levels.

A patient has been taking levothyroxine for 6 months. After this month's laboratory work, the nurse practitioner tells the nurse that the patient is "euthyroid." What does that term mean? The patient is experiencing hyperthyroidism. The patient is experiencing hypothyroidism. The patient's thyroid hormone levels are within normal limits. The patient's thyroid hormone levels are still fluctuating.

The patient's thyroid hormone levels are within normal limits.

How will the nurse describe the action of proton pump inhibitors (PPIs)? They form a protective barrier that can be thought of as a liquid bandage. They irreversibly bind to the hydrogen-potassium-ATPase pump. They compete with histamine for binding sites on the parietal cells. They help to neutralize acid secretions to promote gastric mucosal defensive mechanisms.

They irreversibly bind to the hydrogen-potassium-ATPase pump. PPIs work to block the final step in the acid-secreting mechanisms of the proton pump. They do this by irreversibly binding to the ATPase pump, H+/K+ ATPase, the enzyme for this step.

When discussing glucocorticoids to a patient, what statement by the nurse is accurate regarding the action of these medications? They are produced in lower amounts during times of stress. They decrease serum sodium and glucose levels. They regulate carbohydrate, fat, and protein metabolism. They stimulate defense mechanisms to produce immunity.

They regulate carbohydrate, fat, and protein metabolism. Glucocorticoids play a major role in carbohydrate, lipid, and protein metabolism within the body. They are produced in increasing amounts during stress, increase sodium and glucose levels, and suppress the immune system.

A client with benign prostatic hyperplasia is receiving finasteride. Which of the following is included in the plan of care? This medication should not be handled by pregnant women. Testicular pain is common and expected side effect associated with this medication. Irreversible gynecomastia is a common adverse effect of this medication. Taking this medication eliminates the need for prostate cancer screening.

This medication should not be handled by pregnant women.

A female patient arrives to the clinic for counseling on potential hormone replacement therapy. When taking the patient's history, which condition would the nurse consider as a contraindication to use of hormone replacement therapy for the patient? Hyperlipidemia Early onset of menarche Thromboembolic events Osteoporosis

Thromboembolic events A contraindication for estrogen administration is any history of thromboembolic disorder.

The nurse is assessing a 64-year-old patient will be starting thyroid replacement therapy. Which statement is true regarding the dosage of thyroid replacement hormones for the older adult? Thyroid hormone replacement requirements are approximately 25% lower for this age group Older adults require higher doses of thyroid replacement hormone for therapeutic effects There is no difference in the dosage of thyroid hormone replacement in older adults versus younger adults The dosage of thyroid hormone will depend upon the amount of iodine in the patient's diet

Thyroid hormone replacement requirements are approximately 25% lower for this age group

The nurse is educating a patient about medications used to treat erectile dysfunction. Which erectile dysfunction medications have the longest therapeutic effect when taken orally? (Select all that apply.) Select all that apply. Avanafil (Stendra) Alprostadil (Caverject) Vardenafil (Levitra) Tadalafil (Cialis) Sildenafil (Viagra)

Vardenafil (Levitra) Tadalafil (Cialis) Phosphodiesterase inhibitors (PDIs) are used in the treatment of erectile dysfunction. Sildenafil (Viagra) was the first oral drug approved for the treatment of erectile dysfunction. Two drugs that are similar but have a longer duration of action are vardenafil (Levitra) and tadalafil (Cialis). Collectively, these drugs are referred to as erectile dysfunction drugs. Avanafil (Stendra) is the newest PDI approved for erectile dysfunction. A second type of drug used to treat erectile dysfunction is the prostaglandin alprostadil (Caverject). This drug must be given by injecting it directly into the erectile tissue of the penis or pushing a suppository form of the drug into the urethra.

The nurse is teaching a patient who has a new prescription for the anti-thyroid drug prophylthiouracil (PTU). Which statement by the nurse is correct? "there are no food restrictions while on this drug" "you need to avoid foods high in iodine, such as iodized salt, seafood, and soy products." "This drug is given to raise the thyroid hormone levels in your blood" "Take this drug in the morning on an empty stomach"

You need to avoid foods high in iodine, such as iodized salt, seafood, and soy products

Glimepiride is prescribed for a client. The nurse instructs the client to avoid which of the following while taking this medication? Organ meats Potassium-rich foods Green, leafy vegetables Alcohol

alcohol When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can also potentiate the hypoglycemic effects of the medication. Clients need to be instructed to avoid alcohol consumption while taking this medication.

the nurse is reviewing the medication list for a patient and notes that finasteride 1mg daily is on the list. This drug is for which of these problems? BPH erectile dysfunction alopecia in male patients alopecia in male and female patients

alopecia in male patients

Which drugs have an action similar to that of the naturally occuring hormone ADH? (Select all that apply) a. cosyntropin (Cortrosyn) b. desmopressin (DDAVP) c. somatropin (Humatrope) d. vasopressin (Pitressin) e. octreotide (Sandostatin)

b. desmopressin (DDAVP) d. vasopressin (Pitressin)

The nurse is preparing to administer somatropin (humatrope) and will monitor the patient for which adverse effects? (Select all that apply). a. increased blood pressure b. headache c. flu-like syndrome d. nausea e. hyperglycemia f. fever

b. headache c. flu-like syndrome e. hyperglycemia

While looking at the lab values for pt. taking antithyroid drugs, the nurse knows to watch for? A. increase platelet counts B. increased white blood cell count C. increased blood urea nitrogen level D. increased blood glucose levels

c. increased BUN

A patient is about to be given octreotide is also taking a diuretic, IV heparin, ciprofloxacin (Cipro), and an opioid as needed for pain. The nurse will monitor for what possible interaction? a. hypokalemia due to an interaction with the diuretic b. decreased anticoagulation due to an interaction with the heparin c. prolongation of the QT interval due to an interaction with ciprofloxacin d. increased sedation if the opioid is given

c. prolongation of the QT interval due to an interaction with ciprofloxacin

When monitoring for the therapeutic effects of intranasal desmopressin (DDAVP) in a patient who has diabetes insipidus, which assessment finding will the nurse look for as an indication that the medication therapy is successful? a. increased insulin levels b. decreased diarrhea c. improved nasal patency d. decreased thirst

d. decreased thirst

The nurse is reviewing the medication list for a patient who will be starting therapy with somatropin. Which type of drug would raise a concern that needs to be addressed before the patient starts the somatropin? a. NSAID for arthritis b. antidepressent drug c. Penicillin d. glucocorticoid

d. glucocorticoid

A patient is suspected of having adrenocortical insufficiency. The nurse expects to administer which drug to aid in the diagnosis of this condition? a. octreotide (Sandostatin) b. vasopressin (Pitressin) c. somatropin (Humatrope) d.cosyntropin (Cortrosyn)

d.cosyntropin (Cortrosyn

During long term corticosteroid therapy, the nurse will monitor the patient's laboratory results for adverse effects, such as: (select all that apply) increased serum potassium levels decreased serum potassium levels increased sodium levels decreased sodium levels hyperglycemia hypoglycemia

decreased serum potassium levels increased sodium levels hyperglycemia

The antidiarrheal drug Lomotil contains both diphenoxylate, a synthetic opiate agonist, and atropine, an anticholinergic. The purpose of the atropine in this combination is to enhance the effects of the diphenoxylate. discourage recreational use of the opiate diphenoxylate. counteract the adverse effects of the diphenoxylate. act as an adsorbent for bacteria in the bowel.

discourage recreational use of the opiate diphenoxylate.

the nurse is performing an assessment of a patient who is asking for a prescription for sildenafil (Viargra). Which finding would be a contraindication to its use? 65 years of age history of thyroid disease medication list that includes nitrates medication list that includes saw palmetto

medication list that includes nitrates

A woman comes into the ED. She says that she is pregnant and having contractions but is not due yet. She is very upset. While assessing her vital signs and fetal heart tones, what is the most important question the nurse must ask the patient? what were you doing when the contractions started? are you preregistered at this hospital to give birth? how many weeks have you been pregnant? have you felt the baby move today?

how many weeks have you been pregnant?

when teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression? in the morning at lunchtime at dinnertime at bedtime

in the morning

A patient who is taking a thyroid replacement medication tells the nurse that she is starting to experience cold intolerance, depression, constipation, and dry skin. The nurse anticipates that these manifestations are caused by inadequate doses of the medication. possible overdose of the medication. worsening of the underlying disease. drug interactions with another medication.

inadequate doses of the medication.

During long term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by weight loss moon face hypotension thickened hair growth

moon face

Which would be the best menu choice for a patient who is taking an antithyroid medication? A seafood platter Sushi Tofu burger Pasta with marinara sauce

pasta with marinara sauce

A male patient who has a history of type 2 diabetes mellitus is admitted to the medical unit with a diagnosis of pneumonia. The patient has many questions regarding his care and asks the nurse why everyone keeps telling him about hemoglobin A1C. The nurse will inform the patient that hemoglobin A1C provides information regarding: which type of diabetes the patient has. if he has an infection. patient compliance with treatment regimen for several months previously. current fasting blood glucose level.

patient compliance with treatment regimen for several months previously. Hemoglobin A1C is a good indicator of the patient's compliance with the therapy regimen for several months previously.

During a counselling session for a group of teenage athletes, the use of androgenic steroids is discussed. The nurse will explain that which problem is a rare but devastating effect of androgenic steroid use? peliosis of the liver bradycardia kidneyfailure tachydysrhythmias

peliosis of the liver

When the testoderm form of testosterone is ordered to treat hypogonadism in a teenage boy, which instructions by the nurse are correct? Select all that apply. place the patch on clean, dry skin on the back, upper arms, abdomen, or thighs. place the patch on clean, dry scrotal skin that has been shaved place the patch on clean, dry scrotal skin, but do not shave the are first place the patch on any clean, nonhairy, dry area of the body remove the old patch before applying a new patch

place the patch on clean, dry scrotal skin that has been shaved remove the old patch before applying a new patch

The nurse is teaching a patient about the possible adverse effects of priapism, which may occur when taking ED drugs. The nurse emphasizes that, if this occurs, the most important action is to stay in bed until the erection ceases apply an icepack for 30 minutes turn toward his left side and rest seek medical attention immediately

seek medical attention immediately

A nurse is providing education to a group of athletes on the topic of anabolic steroids. What serious adverse effects would the nurse include in the discussion with the group of athletes? (Select all that apply.) Select all that apply. Impotence Sterility Cardiovascular disease Stroke Liver cancer

sterility cardiovascular disease liver cancer Anabolic steroids have a great potential for misuse by athletes, especially bodybuilders and weight lifters, because of their muscle-building properties. Improper use of these substances can have many serious consequences, such as sterility, cardiovascular diseases, and even liver cancer. For this reason, anabolic steroids are currently classified as Schedule III controlled substances by the U.S. Drug Enforcement Administration. This classification implies that misuse of these drugs can lead to psychological or physical dependence or both

A patient with terminal cancer has not had chemotherapy for a few weeks and has had no nausea or vomiting since then. However, he is taking dronabinol twice a day. The reason for the dronabinol order is to prevent recurrence of the chemotherapy-induced nausea and vomiting. prevent stress ulcers. improve his mood. stimulate his appetite.

stimulate his appetite.

A 60-year-old woman is taking a bisphosphonate. She calls the clinic and tells the nurse that her stomach has been bothering her and wants to know what she should do. The nurse will instruct her to: take this medication with milk. take this medication with breakfast. remain upright in a sitting position for at least 10 minutes after taking this medication. stop the medication and to come in for an evaluation.

stop the medication and to come in for an evaluation.

A patient is in pulseless cardiac arrest. Which medication does the nurse anticipate administering? vasopressin desmopressin cosyntropin somatropin

vasopressin Vasopressin is also a potent vasoconstrictor in larger doses and is therefore used in certain hypotensive emergencies, such as vasodilatory shock (septic shock). It is also used in the (ACLS) guidelines for treatment of pulseless cardiac arrest. Desmopressin is useful in treating certain blood disorders. Cosyntropin is used in the diagnosis of adrenocortical insufficiency. Somatropin and somatrem are effective in stimulating skeletal growth in patients with an inadequate secretion of normal endogenous GH.

A patient tells the nurse that he takes ginger almost every day for nausea. It is most important for the nurse to determine if the patient is taking which medication? furosemide (Lasix) acetaminophen (Tylenol) warfarin (Coumadin) calcium supplements

warfarin (Coumadin)