pharm nclex

Nifedipine (Procardia) has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further instructions?

"Nausea and drowsiness is expected, and if it occurs I don't really need to worry about it."

A client reports to the clinic for followup after a 1-month treatment with acebutolol (Sectral). The nurse determines that a therapeutic effect of the medication has occurred if which of the following is noted?

A blood pressure of 130/84 mm Hg

A nurse is ambulating a client with a known seizure disorder. The client says, "I'm seeing those flashing lights again," then loses consciousness and develops a clonic-tonic seizure. The nurse's initial action should be:

Assist the client to the floor

A client who is taking theophylline (Theo-24) reports to the health care clinic as scheduled to have a serum theophylline level drawn. The blood is drawn and the laboratory calls the nurse and reports the results as 10 mcg/mL. The client asks the nurse what this figure means. The nurse accurately responds by stating this level is:

At the low end of the therapeutic range

A nurse has given medication instructions to a client beginning therapy with carisoprodol (Soma). The nurse determines that the client understands the effects of the medication if the client states to:

Avoid alcohol while taking this medication.

A nurse in the preoperative holding unit administers a dose of scopolamine to a client. The nurse monitors the client for which common side effect of the medication?

Dry mouth

A client who was recently prescribed warfarin (Coumadin) is being instructed on diet changes necessary with this medication. The client reports she enjoys all of these food items. Which items should the nurse instruct the client to limit consuming? Select all that apply.

Spinach salad Mustard greens

A client is scheduled for an intravenous pyelogram and has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which of the following instructions will the nurse provide to the client?

"Take the medication on ice."

A client with tuberculosis (TB) will be treated with isoniazid (INH) and rifampin (Rifadin). The nurse is preparing instructions for the client regarding these medications. Which statement would the nurse plan to provide to the client?

"The entire year-long course of the medication needs to be completed."

Baclofen (Lioresal) is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effect, if identified by the client, indicates a need for further instruction?

Photosensitivity

A nurse notes that zidovudine (AZT) has recently been prescribed for a client. The client states, "I've been getting a little nauseated and I've had a couple of headaches since I started the AZT. Does this mean I can't take the medicine?" The nurse makes which response to the client?

"These symptoms may become more tolerable as you adjust to ongoing therapy."

A client with aldosteronism has been instructed on spironolactone (Aldactone) treatment. Which client statement indicates that the client needs further teaching about the medication?

"This medication will decrease my blood glucose."

A client began taking amantadine hydrochloride (Symmetrel) approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits decreased:

Rigidity and akinesia

A nursing student is assigned to care for a 30-week gestational woman who is admitted to the maternity unit in preterm labor. Betamethasone is prescribed to be administered to the mother. The nursing instructor asks the student about the purpose of the medication. Which statement by the student indicates an understanding of the purpose of this medication?

"This medication will promote fetal lung maturity."

A client informs the nurse that she has been taking acarbose (Precose) as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which of the following is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

A nurse is monitoring a client receiving furosemide (Lasix) 40 mg orally daily. Which of the following would indicate to the nurse that a therapeutic effect has occurred?

A blood pressure of 128/80 mm Hg

A client with rheumatoid arthritis has been taking aspirin (acetylsalicylic acid, ASA) more frequently than prescribed because the arthritis has been causing more discomfort than usual. The client complains of joint pain and has an elevated temperature. The nurse is concerned about the possibility of aspirin toxicity and asks the client which question that may confirm this suspicion?

"Do you have any ringing in your ears?"

Cyclophosphamide is prescribed for a client with a diagnosis of breast cancer. The nurse has provided instructions to the client regarding the medication to prevent hemorrhagic cystitis. Which statement by the client indicates an understanding of this chemotherapeutic regimen?

"I need to increase my fluid intake to 2000 to 3000 mL daily."

A nurse is providing instructions to a client who will be taking phenytoin (Dilantin) for seizure control. Which statement will the nurse make to the client regarding the administration of this medication?

"If you develop a sore throat, it is necessary to notify the health care provider."

Sucralfate (Carafate) 1 g four times daily has been prescribed for a client with a diagnosis of gastric ulcer, and the nurse provides instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 1 hour before my meals and at bedtime."

Metoclopramide (Reglan) four times daily has been prescribed for a client with reflux esophagitis, and the nurse provides instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 30 minutes before meals and at bedtime."

A nurse has reinforced discharge instructions to a mother of a child who is taking tetracycline (Sumycin) to treat Rocky Mountain spotted fever (RMSF). Which statement by the mother indicates an understanding regarding the administration of the medication?

"I need to use a straw when I give the medication."

A nurse has reinforced discharge instructions to a client with multiple sclerosis who is receiving baclofen (Lioresal). Which statement by the client indicates an understanding of the medication?

"I need to watch for urinary retention."

Moxifloxacin (Avelox) is prescribed for a client with a diagnosis of community-acquired pneumonia. The client needs to take the medication for 10 days, and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the medication instructions?

"I need to wear sunscreen and protective clothing when outdoors."

A client is being discharged following treatment for left-sided heart failure. The nurse is teaching the client the purpose, actions, adverse effects, and use of digoxin (Lanoxin) and hydrochlorothiazide (HydroDIURIL) prescribed for daily use. Which statement by the client indicates that further discharge teaching is needed?

"I should decrease my intake of foods high in potassium, such as bananas."

Psyllium (Metamucil) is prescribed for a client with a cardiac disorder to facilitate defecation and prevent straining with bowel movements. A nurse provides instructions to a client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I should mix the medication with a full glass of water."

A client is being discharged to home following recovery from an anterior myocardial infarction with recurrent angina. The client will be taking diltiazem (Cardizem) two times daily, isosorbide dinitrate (Isordil) four times daily, and nitroglycerin (Nitrostat) sublingually as needed, and the nurse reinforces information to the client about the medications. Which statement by the client indicates that further teaching is needed about the medications?

"I should notify my doctor immediately if I experience headaches with any of these medications."

A nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving aspirin (acetylsalicylic acid, ASA) 5 g orally daily. Which of the following, if stated by the client, would indicate an understanding of the instructions?

"I should notify the health care provider if I get any ringing in my ears."

A nurse has provided instructions to a client with Parkinson's disease who is taking carbidopa/levodopa (Sinemet). Which statement by a client indicates the need for further instruction?

"I will eat lots of foods high in vitamin B6."

Fluoxetine hydrochloride (Prozac) is prescribed for a client being treated for depression, and the nurse provides instructions to the client regarding the medication. Which statement by the client would indicate that the client understands this medication therapy?

"It takes approximately 2 to 4 weeks before improvement is noted."

A nurse is providing instructions to a client with a diagnosis of scabies regarding the administration of crotamiton (Eurax). Which statement by the client indicates an understanding regarding the application of this medication?

"I will massage the medication into the skin from my chin downward and apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application."

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids?

"I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress."

A nurse is caring for a client diagnosed with tuberculosis (TB). Rifampin (Rifadin), 600 mg by mouth daily is prescribed for the client. The nurse provides instructions to the client regarding the administration of this medication. Which of the following statements by the client indicates an understanding of the instructions?

"I will need to take the medication for months."

Warfarin sodium (Coumadin) has been prescribed for a client, and a nurse teaches the client and family about the medication. Which statement by the client indicates that further teaching is necessary?

"I will not take any over-the-counter medications except aspirin."

A nurse provides instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium (Synthroid). Which statement by the client would indicate an understanding of the nurse's instructions?

"I will report any episodes of palpitations, chest pain, or dyspnea."

Albuterol (Proventil HFA) two puffs and fluticasone propionate (Flovent Diskus) two puffs by metered-dose inhaler have been prescribed for a client with chronic obstructive pulmonary disease. The nurse caring for the client provides instructions regarding administration of the medication. Which statement by the client indicates an understanding of how to take these medications?

"I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."

A client with heart failure is being discharged to home and will be taking furosemide (Lasix). The nurse determines that teaching has been effective if the client states which of the following?

"I will weigh myself every day."

A client receiving therapy with carbidopa/levodopa (Sinemet) is upset and tells the nurse that his urine has turned a darker color since beginning to take this medication. The client wants to discontinue its use. In formulating a response to the client's concerns, the nurse interprets that this change is:

A harmless side effect of the medication

A nurse is monitoring a client receiving spironolactone (Aldactone) by mouth daily. Which of the following would indicate to the nurse that the client is experiencing a side effect related to the medication?

A potassium level of 5.2 mEq/L

A nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which of the following laboratory results?

A white blood cell (WBC) count of 2000 cells/mm3

A client has been receiving nitrofurantoin sodium (Macrodantin). The nurse determines that the therapy is effective if which of the following is noted?

Absence of dysuria

A nurse employed in the emergency department receives a telephone call from the emergency alert system informing the department that a child who ingested a bottle of acetaminophen (Tylenol) is en route to the emergency department. The nurse prepares the room for the arrival of the child and checks the medication supply to determine whether which medication that is the antidote is available?

Acetylcysteine (Mucomyst)

A nurse is caring for a client with chronic congestive heart failure who is taking digoxin (Lanoxin) 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which of the following actions should the nurse take based on this laboratory result?

Administer the dose of the medication as scheduled

A nurse is caring for a hospitalized client with a mechanical heart valve who is receiving maintenance therapy of warfarin sodium (Coumadin). The client's international normalized ratio (INR) is 3. The nurse anticipates which of the following prescriptions?

Administering the next dose of warfarin sodium

Exemestane (Aromasin) 25 mg orally daily is prescribed for a client with advanced breast cancer. The nurse provides instructions to the client about the medication and tells the client to take the medication:

After a meal

In reviewing the admission assessment data and health care provider's prescriptions for a client with peptic ulcer disease, the nurse notes that the client has a history of renal disease. Based on this data, the nurse determines that the likely antacid to be prescribed for this client is:

Aluminum hydroxide (Amphojel)

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on the understanding that these symptoms:

Are severe during initial therapy and decrease or disappear with long-term use

A client is being treated for heart failure and is receiving digoxin (Lanoxin). The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse would expect which of the following changes in the client's vital signs?

Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

A nurse provides instructions to a client who has been prescribed betaxolol (Betoptic) eye drops for the treatment of glaucoma. The nurse instructs the client regarding the administration of the medication and about the importance of returning to the clinic for monitoring of the:

Blood pressure and apical pulse

A nurse is assisting in monitoring a client who received hydralazine hydrochloride (Apresoline) to treat autonomic dysreflexia. Which finding accurately indicates that the medication is effective?

Blood pressure declines.

A nurse is assigned to care for a client with herpes simplex virus (HSV) who is receiving acyclovir (Zovirax). The nurse is monitoring for adverse effects of the medication. Which of the following laboratory results would the nurse specifically monitor to identify an adverse effect associated with the use of this medication?

Blood urea nitrogen (BUN)

A hospitalized client with allergic asthma has been started on cromolyn sodium (Intal) inhaler. The nurse assists in preparing a plan of care and includes monitoring for undesirable side effects associated with the use of this medication. The nurse places the highest priority on monitoring for which of the following?

Bronchospasm

A client with heart failure who is taking furosemide (Lasix) and digoxin (Lanoxin) calls the nurse and complains of anorexia and nausea. The nurse should take which action?

Check the result of the potassium level drawn 3 hours ago

A nurse administers scopolamine as prescribed to a client in preparation for surgery. The nurse monitors the client for side effects related to the administration of this medication. Which of the following would the nurse determine is an expected side effect of this medication?

Client complaints of a dry mouth

A client is to receive medication via a client-controlled analgesia (PCA), and the nursing instructor asks the nursing student caring for the client to describe the use of the PCA. The instructor determines that the student needs instructions about the PCA if the student states that:

Clients using PCA initiate the infusion by programming a pump

Levalbuterol (Xopenex) via inhalation is prescribed for a client with a diagnosis of emphysema. The nurse provides instructions to the client regarding the medication and teaches the client about the dietary restrictions that must be implemented while taking this medication. The nurse determines that the client understands the dietary instructions if the client states to avoid:

Cocoa

A nurse is caring for a client with Paget's disease of the bone. The nurse understands that the client is receiving calcitonin (Cibacalcin) to:

Decrease bone reabsorption.

A client with acquired immunodeficiency syndrome (AIDS) has an opportunistic respiratory fungal infection and is receiving intravenous amphotericin B. The nurse assisting in caring for the client monitors for which sign that indicates an adverse effect of the medication?

Decreased urine output

A nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin (Glucophage) is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?

Diabetes mellitus

A client being seen in the clinic is taking phenytoin (Dilantin). The client's phenytoin blood level is within therapeutic range and the client's seizures are controlled. Which of the following if observed by the nurse on data collection would require health care provider notification and possible discontinuation of the medication?

Diffuse body rash

A nurse is scheduled to administer a dose of digoxin (Lanoxin) to a client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. The nurse interprets that the:

Dose should be administered as prescribed.

A nurse is assisting in preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate in an extended format by mouth. The nurse suggests including which priority nursing action in the plan of care for this client?

Encourage the client to cough and deep breathe

A client is being treated with atenolol (Tenormin) for hypertension. The client tells the nurse, "I am very tired and weak since I began taking the medication." Based on the client's statement, the nurse determines that the client is experiencing which problem?

Fatigue

A nurse is admitting a client to the nursing unit who is scheduled for several diagnostic tests. When obtaining a medication history, the nurse discovers that the client is taking tacrolimus (Prograf) daily. On further data collection, the nurse would expect to note that the client

Had an allogenic liver transplant

A nurse is collecting data from a client who is taking pantoprazole (Protonix). The nurse determines that the medication is effective if the client states relief of:

Heartburn

A nurse is providing instructions to the spouse of a client who is taking tacrine (Cognex) for the management of moderate dementia associated with Alzheimer's disease. The nurse should tell the spouse which of the following?

If a change in the color of the stools occurs, notify the health care provider

Indinavir (Crixivan) is prescribed for a client with a diagnosis of human immunodeficiency virus (HIV). The nurse provides medication instructions and tells the client to:

Increase fluid intake to at least 1.5 L/day.

A nurse is providing instructions to a client who is taking codeine sulfate for severe back pain. The nurse tells the client to:

Increase fluid intake.

A nurse employed in a neighborhood health care clinic notes that the health care provider has prescribed oseltamivir (Tamiflu). The nurse teaches the client specific home care measures, knowing that this medication was prescribed to treat:

Influenza virus

A nurse is assisting in preparing a plan of care for a client with acquired immunodeficiency syndrome (AIDS) who will be receiving ganciclovir (Cytovene). Which priority intervention will be included in the plan of care?

Instruct the client to use an electric razor for shaving

A nurse is caring for a client who has been taking acetazolamide (Diamox) for glaucoma. The nurse reviews the assessment data documented in the client's medical record and determines that an adverse effect of the medication may be occurring if which of the following is noted?

Jaundice

A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse whether there is a risk of addiction. The nurse's response is based on the understanding that clorazepate:

Leads to physical and psychological dependence with prolonged high dose therapy

A client with a spinal cord injury has been experiencing discomfort because of spasticity, and dantrolene (Dantrium) is prescribed for the client. Before initiating therapy, the nurse anticipates that which of the following will be prescribed?

Liver function studies

A nurse is collecting data on a client admitted to the hospital with a diagnosis of a respiratory infection unresponsive to oral antibiotics. The nurse discovers that the client has a history of bronchial asthma and has been taking zafirlukast (Accolate). The nurse assists to develop a plan of care for the client and suggests that a priority includes monitoring:

Liver function tests

A client with carcinoma is admitted to the hospital for a chemotherapy treatment with intravenous bleomycin sulfate. The plan of care mentions observing for interstitial pneumonitis as the priority of care. Which assessment finding most closely correlates to symptoms of interstitial pneumonitis, requiring reporting?

Lung wheezing and shortness of breath

A nurse is preparing to administer ribavirin (Virazole) to a child with respiratory syncytial virus (RSV). The pharmacy dispenses the medication as a powder. The nurse helps prepare to administer the medication by:

Mixing the medication as prescribed and administering by inhalation

A nurse is assisting in caring for a client who is receiving amphotericin B intravenously (IV) to treat disseminated candidiasis. The nurse reviews the plan of care and implements which of the following during the administration of the medication?

Monitors urinary output

A postpartum nurse is caring for a client following a cesarean birth who received epidural analgesia. The client is lethargic and is exhibiting signs of respiratory depression. The nurse suspects that the respiratory depression is caused by the epidural analgesia. The nurse notifies the registered nurse immediately and prepares the client for the administration of:

Naloxone (Narcan)

A client with a diagnosis of gastric ulcer has a prescription for oral sucralfate (Carafate) four times daily. The nurse plans to administer the medication:

One hour before meals and at bedtime

A client arrives at the emergency department with an acetaminophen (Tylenol) overdose. Acetylcysteine (Mucomyst) is prescribed to be administered to the client immediately. The nurse prepares to administer the medication by which of the following routes?

Orally

A nurse is providing instructions to a mother regarding the administration of ear drops for her infant. The nurse observes the mother administer the drops and determines that the mother is performing the procedure correctly if the mother:

Pulls down and back on the earlobe and directs the solution toward the wall of the canal

Theophylline is being administered to a client with acute bronchitis. The nurse planning care for the client understands that the primary action of this medication is to:

Relax smooth muscles of the bronchial airway

Morphine sulfate is being administered to a client with cancer. The nurse is monitoring the client for signs of overdose related to this medication therapy. Which of the following findings, if noted in the client, would require the need to notify the registered nurse?

Respirations of 10 breaths per minute

A nurse is assisting in preparing a teaching plan for a client who has just been given a prescription for pioglitazone (Actos). The nurse plans to provide instructions to the client about which of the following related to this medication?

Signs of hypoglycemia

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol (Tenormin) for dysrhythmia suppression. The nurse determines that the client needs instruction about this medication if the client states to:

Stop taking the prescribed digoxin (Lanoxin) after starting this new medication.

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" The nurse interprets that the client can best be assisted to successfully adapt to this therapy by

Switching to a morning administration of the medication

A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which of the following would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

Tarry stools

A client taking metronidazole for the treatment of trichomonas vaginalis calls the nurse employed in the health care provider's office and is concerned because the color of the urine is very dark. Which of the following information would the nurse provide to the client?

That the darkening of the urine is a harmless side effect

A nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine (Tegretol) 400 mg orally daily. The client's white blood cell (WBC) count is 3000 cells/mm3, blood urea nitrogen (BUN) is 15 mg/dL, sodium is 140 mEq/L, and uric acid is 5 ng/dL. The nurse would notify the health care provider that:

The WBC is low, indicating a blood dyscrasia

A nurse is employed in a newborn nursery. The nurse is aware that medication toxicity is more likely to occur in the neonate than in an adult because:

The liver is immature.

A client with a history of seizures is taking phenytoin (Dilantin) for seizure control. The client arrives at the health care clinic, and a serum phenytoin drug level is drawn. The laboratory calls the nurse and reports a result of 10 mcg/mL. The nurse interprets that this value indicates:

The low end of therapeutic range

A newborn infant receives naloxone hydrochloride (Narcan) to reverse opiate-induced respiratory depression that occurred following labor and delivery. The nurse continues to monitor the respiratory status of a newborn infant following the administration of this medication because:

The newborn infant may demonstrate a reappearance of respiratory depression.

A client has a prescription for niacin (Slo-Niacin). The nurse determines that the client understands the importance of this therapy if the client verbalizes the importance of periodic monitoring of:

The serum cholesterol level

Lamivudine (Epivir) is prescribed for a client with human immunodeficiency virus (HIV) who is presently taking zidovudine (Retrovir). The nurse provides medication instructions to the client and tells the client:

To report vomiting or abdominal pain to the health care provider

A client has been prescribed cyclobenzaprine (Flexeril) in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse would withhold the medication and question the prescription if the client had concurrent prescriptions to take:

Tranylcypromine (Parnate)

A nurse is assisting in preparing a plan of care for a client with renal colic who is receiving meperidine hydrochloride (Demerol) for pain. The nurse includes in the plan of care to monitor for which side effect of this medication?

Urinary retention

Entacapone (Comtan) is prescribed for a client with a diagnosis of Parkinson's disease. The nurse provides medication instructions to the client and tells the client that a frequent side effect is:

Urine discoloration to dark yellow or orange

A nurse is assisting in caring for a client with a respiratory tract infection who is receiving intravenous tobramycin sulfate (Tobrex). The nurse is instructed to monitor for adverse effects of the medication. The nurse understands that which of the following findings is indicative of an adverse effect of this medication?

Vertigo

A nurse is providing instructions to a client taking ethambutol (Myambutol) about the medication. The nurse instructs the client to contact the health care provider immediately if which of the following occurs?

Visual disturbances

A nurse employed in the emergency department is preparing to administer syrup of ipecac to a 7-month-old child. The nurse prepares 5 mL of the syrup and administers one half glass of water following administration of the ipecac syrup. Which response would the nurse expect?

Vomiting