Pharmacology adaptive quiz

A nurse is caring for a client who has a new diagnosis of BPH. which of the following medications should the nurse expect to be prescribed? A.Fluoxymesterone B. Methlytestosterone C. Finasteride D. Sildenafil

C. Finasteride -For BPH the nurse should expect Finasteride, which will decrease the size of the prostate in 3-6 months. Fluoxymesterone is prescribed for hypogonadism. Methyltestosterone is used for postpubertal cryptorchidism. Sildenafil is used for erectile dysfunction.

A nurse is collecting data from a client taking levothyroxine, which of the following is an indication of levothyroxine overdose? A. Bradycardia B. Cold intolerance C. Tremor D. Hypothermia

C. Tremors- overmedication can result in manifestations of hyperthyroidism (anxiety, tremors, tachycardia, heat intolerence, altered appetite, abdominal cramping, fever, diaphoresis, weight loss, and menstrual irregularities)

A nurse administered an antibiotic 10 minutes ago. The client is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse take first? A. Give oral corticosteroids B. Administer dopamine C. Give diphenhydramine IV D. Administer Epinephrine Subcut.

D. Administer epinephrine subcut.

A nurse is caring for a client who has a dry nonproductive cough. Which of the following medications should the nurse recommend? A. Expectorant B. Mucolytic C. Bronchodilator D. Antitussive

D. Antitussive. -antitussive suppress the cough reflex.

A client who is taking warfarin to treat atrial fibrillation has early manifestations of alzheimer's disease. should this client take ginkgo biloba to help treat his alzheimer's?

NO! -Gingkgo biloba could increase the client's risk for bleeding while on warfarin

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications? A. Celecoxib B. Prednisone C. Adalimumab D. Abatacept

A. Celecoxib - This medication or another NSAID should be prescribed to a patient who has rheumatoid arthritis. Prednisone a glucocorticoid is indicated for severe rheumatoid arthritis and should only be used short term due to its adverse effects. Adalimumab and abatacept are only prescribed for rheumatoid arthritis when other medication have been ineffective.

A nurse is collecting data from a client who is taking varenicline for smoking cessation. Which of the following findings is the nurses priority? A.Erratic behavior B. Nausea C. Altered sense of taste D. Skin rash

A. Erratic behavior -Erratic behavior is more serious than the other options. Nausea, altered sense of taste, and skin rash are adverse effects of varenicline.

A nurse is caring for a client who has schizophrenia and a new prescription for Chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia

A. Orthostatic Hypotension -Orthostatic hypotension is an adverse effect of Chlorpromazine, other adverse effects include palpitations, tachycardia, constipation,urinary retention, sedation, and photosensitivity.

A nurse should monitor a client taking rifampin for treatment of TB for which of the following adverse effects? A. REd tinged urine B. Tinnitus C. Blurred vision D. Dry mouth

A. Red tinged urine -The nurse should identify that red-tinged urine, saliva, and tears are adverse effects of taking rifampin. Tinnitus, blurred vision, and dry mouth are all adverse effects of lithium.

A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following findings of an adverse effect of selegiline and notify the provider? A. Brusing B. Drowsiness C. Coughing D. Constipation

B. Drowsiness. -Drowsiness can be an adverse effect of selegiline, which can also be a manifestation of serotonin syndrome. The nurse should notify the provider of the finding immediately. Diarrhea is an adverse effect of selegiline, but drowsiness is more important to report and watch for! Bruising is an adverse effect of NSAIDs. A cough is an adverse effect of ACE inhibitors.

A nurse is caring for a client who is taking streptomycin. Which of the following medications should the nurse identify as increasing risk for ototoxicity when taken with streptomycin? A. Cefoxitin B. Furosemide C. Naproxen D. Amphotericin B

B. Furosemide. -furosemide a loop diuretic increases risk of ototoxicity when taken with streptomycin an aminoglycoside. Naproxen and amphotericin B increase risk of nephrotoxicity when taken with streptomycin.

A nurse is reinforcing teaching for a client who just started taking hydrochlorothiazide to treat hypertension. the nurse tells the client to include plenty of potassium in their diet. Which of the following client responses indicates understanding of the teaching. A. This medication will not work unless i have enough potassium B. This medication causes loss of potassium C. Potassium will lower my BP D. Potassium will increase the therapeutic effect of this medication

B. This medication can cause loss of potassium. -hydrochlorothiazide can result in hypokalemia due to excretion of potassium by the kidneys. The client should supplement their diet with potassium rich foods. Potassium rich foods include bananas, raisins, pumpkin, milk, and baked potatoes.

A nurse is reinforcing teaching with a client who has a new diagnosis of peptic ulcer disease PUD and a prescription for bismuth subsalicylate. The client asks the nurse how will this medication help my ulcers? Which of the following statements should the nurse make? A. This medication will decrease prostaglandins B. The amount of bicarbonate is your body will increase C. This medication can decrease bacteria in your GI tract D. This medication acts by increasing blood flow to the stomach

C. This medication can decrease bacteria in you GI tract -The nurse should include in the teaching that bismuth subsalicylate can assist by eliminating the bacteria helicobacter pylori which causes PUD. A decrease in prostaglandins could contribute to the progression of PUD. Bismuth subsalicylate does not increase bicarbonate, although an increase in bicarbonate could stop progression of PUD. This medication does not increase blood flow to the stomach.

The nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse tell the client to monitor for? A. Diarrhea B. Anxiety C. Nausea and vomiting D. Dry mouth

D. Dry mouth -Hydroxyzine has anticholinergic properties, dry mouth is a common adverse effect of this medication. The nurse should encourage the client to take small sips of water and suck on hard candies. Diarrhea, Anxiety, nausea, and vomiting are not adverse effects of hydroxyzine.

A nurse is administering a dose of nifedipine to a pregnant client. which of the following pieces of information related to nifedpine should the nurse monitor and document? A. hypoglycemia B. Uterine ripening C. Increased blood pressure D. Number of uterine contractions

D. Number of uterine contractions -A client who is going into to preterm labor can have a prescription for nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into the myometrial cells, which can delay labor. An adverse effect of nifedipine is hyperglycemia not hypoglycemia. Nifedipine stops preterm labor for at least 48 hours it does not cause uterine ripening. Nifedipine can be used to decrease BP not inclease blood pressure.

A nurse is caring for a client who is taking orlistat for weight loss. The nurse should inform the client that this medication can intensify the effects of which of the following supplement or medications? A. Psyllium B. Multivitamin C. Metoprolol D. Warfarin

D. Warfarin -Orlistat can increase the effects of warfarin which increases the client's risk of bleeding. The client should undergo close anticoagulant monitoring if the medications are taken together. Psyllium a bulk forming agent can decrease the GI effects of orlistat, the medications are often given in combination. orlistat can decrease absorption of fat soluble vitamins A,D,E and K therefore the patient should take a multivitamin while taking orlistat. There are no documented reactions between orlistat and metoprolol.

A client has osteoporosis and is taking risedronate which of the following client statements indicates understanding of the teaching? A.I will take this medication with a full cup of water B. I will lie down after i take this medication C. I will take this medication with food D. I will take this medication at bed time

A. I will take this medication with a full cup of water -Risedronate should be taken with at least 180-240 mL water. The client should remain upright for 30 minutes after taking this medication, no lay down. The client should take the medication on an empty stomach, food decrease absorption. The client should take risedronate in the morning at least minutes before breakfast.

A nurse is assessing a client who was recently admitted and has a history of alcohol abuse. The client displays ataxia, an altered level of consciousness, and nystagmus. Which of the following medications should the nurse anticipate administering to the client? A. Parenteral thiamine B. niacin extended release tablets C. Parenteral pyridoxine D. Riboflavin tablets

A. Parenteral thiamine -The nurse should recongnize these signs as manisfestations of Wernicke-Korsakoff syndrome due to thiamine deficiency.

A client is requesting a prescription for sildenafil citrate. which of the following findings in the client's record should the nurse identify as a contraindication for the use of this medication? A. Diabetes mellitus B. Current use of nitroglycerine to treat heart failure C. Eye glasses for presbyopia D. Osteoarthritis

B. Current use of nitroglycerine to treat heart failure -Taking any nitrates such as nitroglycerine is a contraindication for taking sildenafil, a medication used to treat erectile dysfunction. Taking it concurrently with nitroglycerine can cause life threatening hypotension.

A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs? A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache

C. Tinnitus -Loop diuretics should as furosemide can cause ototoxicity. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs. Furosemide does not cause movement disorders such as tremors. Nasal congestion and headaches are not adverse effects of furosemide.

A nurse is going to administer Epoetin Alfa to a client who has chronic kidney failure. Which of the following should the nurse plan to review prior to administering this medication? A. Blood pressure B. Temperature C. Blood glucose levels D. Total protein level

A. Blood pressure -Epoetin Alfa causes hypertension, which can lead to a stroke or cardiovascular complications. The nurse should monitor clients BP and notify the provider if it increases. Epoetin Alfa does not affect temp, BG, or protein levels.

A nurse is reinforcing discharge instructions with a client who has major depressive disorder and a new prescription for Phenelzine. Which of the following food should the nurse include in the plan as okay for the client to consume? A. Broiled beef steak B. Pizza with pepperoni C. Smoked salmon D. Macaroni and cheese

A. Broiled beef steak -Beef steaks and other meats that are fresh do not interact with phenelzine and are safe to consume. Most cheeses except for cottage cheese and cream cheese interact with MAOs. Pepperoni, salomi, and other dried meats interact with MAOs. Fish that have been cured or dried interact with MAOIs.

A nurse is reinforcing teaching with a client who has a seizure disorder and has began taking Carbamazepine. Which of the following statements should the nurse include in her teaching? A. This medication will decrease the effectiveness of oral contraceptives. B. Once you are seizure free for a month you will be able to stop taking this medication. C. You can cut the dose in half if GI upset occurs D. This medication might initially increase the frequency of your seizures.

A. This medication will decrease the effectiveness of oral contraceptives. -The nurse should inform the client that traditional antiepileptic medications (AEDs) can decrease the effectiveness of oral contraceptives. The client will remain on the medication even if seizures subside. The client should not cut the dose in half. The medication should decrease frequency of seizures.

A nurse in a community health client is collecting data a new client who is taking both isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. Tuberculosis B. Hypertension C. Diabetes D. Cirrhosis

A. Tuberculosis. - A nurse should recognize that isoniazid and rifampin are first-line antitubercular medications used to treat active tuberculosis in combination therapy.

What would you use ginkgo biloba for? A. decreased platelet aggregation B. Prevention of migraine headaches C. Increased risk of DVT D. Lowered cholesterol and triglyceride levels

A. decreased platelet aggregation -Ginkgo Biloba can decrease platelet aggregation by inhibiting the ability of platelets to clump together. Ginkgo biloba can increase a client's risk of bleeding rather than clotting. Feverfew is used to prevent migraine headaches. Garlic can lower cholesterol and triglyceride levels.

A client is receiving simvastatin. which of the following food choices should a nurse remove from the clients tray? A. Grapefruit juice B. oatmeal C. coffee D. Hard Boiled eggs

A. grapefruit juice -Grapefruit juice is contraindicated for a client taking simvastatin because it raises blood levels of the medication significantly by inactivating the liver enzyme responsible for metabolism. Oatmeal would be recommended for a client who has hypercholesterolemia because it is rich in soluble fiber which lowers LDL cholesterol. Coffee and hard boiled eggs are not contraindicated.

A nurse is reviewing the medical record for a client taking sumatriptan for migraine headaches. Which of the following indicates a contraindication to the administration of this medication? A. History of uncontrolled hypertension B. Currently taking metformin for type 2 diabetes mellitus C. Currently taking an oral contraceptive D. History of recurrent urinary tract infections

A. history of uncontrolled hypertension - Sumatriptan can cause coronary vasospasms therefore it is contraindicated for an individual with a history of uncontrolled hypertension.

Abrupt withdrawal of phenytoin can cause which of the following adverse effects? A. status epilepticus B. bleeding gums C. disorientation D. severe nausea

A. status epilepticus -The nurse should reinforce with the client that abruptly stopping phenytoin can lead to status epilepticus. Abruptly stopping phenytoin will not cause bleeding gums, however an adverse effect of phenytoin is gingival hyperplasia. Abruptly stopping phenytoin will not cause disorientation, however an adverse effect of phenytoin is altered cognitive functions. Abruptly stopping phenytoin will not cause severe nausea, however an adverse effect of phenytoin is nausea and vomiting.

A nurse is caring for a client who has peptic ulcer disease and reports a headache. which of the following medications should the nurse plan to administer? A. Naproxen B. Acetaminophen C. Ibuprofen D. Aspirin

B. Acetaminophen -Acetaminophen can be administered to a client with peptic ulcer disease because it does not affect coagulation and does not increase the risk of GI bleeding. Naproxen, Ibuprofen, and aspirin are all NSAIDs, NSAIDs can decrease platelet aggregation and increase risk of GI irritation and hemorrhage.

A nurse is caring for a client who had a positive tuberculin skin test and has started taking isoniazid. Which of the following labs should the nurse monitor? A. Thyroid stimulating hormone level TSH B. Aspartate Aminotransferase AST C. Potassium d. Sodium

B. Aspartate Aminotransferase AST. -Isoniazid can be toxic to the liver, therefore it is important to monitor liver enzymes such as AST. In addition the nurse should educate the client to report any indication of jaundice, nausea, dark-colored urine, or other finding indicating hepatitis.

A nurse is monitoring a client who is receiving phenytoin IV for treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Hypertension B. Cardiac arrhythmias C. Gastric discomfort D. Tachycardia

B. Cardiac arrhythmias -The nurse should identify that cardiac arrhythmias is an adverse effect of phenytoin IV. As a result of this potential complication cardiac monitoring is required. Hypertension is not an adverse effect of phenytoin IV, although hypotension may occur if the medication is administered to fast. Gastric discomfort is an adverse effect of oral phenytoin not IV. Tachycardia is not an adverse effect of IV phenytoin, due to risk of bradycardia IV administration should not exceed 50 mg/min.

A nurse is caring for a client who has suspected adrenal insufficiency. which of the following medications should the nurse anticipate the provider using to determine adrenal insufficiency? A. Prednisone B. Cosyntropin C. Dexamethasone D. Ketoconazole

B. Cosyntropin - The client is monitored after injection with cosyntropin to determine if cortisol levels rise above 20 mcg/dl. If the adrenal response cause the cortisol levels to elevate, the response is considered to be within the expected reference range. If the cortisol level does not elevate the provider should determine that the client has adrenal insufficiency. Prednisone is a glucocorticoid used for life-long replacement therapy for adrenal insufficiency. Dexamethasone is used to determine if a client has cushing's syndrome. Ketoconazole is used to suppress the synthesis of adrenal steroids in client's who has Cushing's syndrome.

A nurse is caring for a client who is taking memantine for alzheimer's disease. Which of the following laboratory results should the nurse recognize as increasing the client's risk of decreased clearance of the medication? A. AST 30 units/ liter B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

B. Creatinine clearance of 35 mL/min. -Creatinine clearance is an estimate of glomerular filtration rate and the kidneys ability to filter wastes. A creatinine clearance of 35 mL/min indicate moderate renal impairment. AST is a liver enzyme, severe liver disease requires caution when prescribing memantine however these AST levels are within normal range.

A nurse is assisting with the care of a client who has atrial fibrillation and a HR of 155/min. The nurse should expect a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin

B. Diltiazem -Diltiazem is an antiarrhythmic medication that reduces the ventricular rate in atrial fibrillation. Atropine is used to accelerate the HR in patients with sinus bradycardia and heart block. Epinephrine is used to treat cardiac arrest and anaphylaxis. Vasopressin is administered to treat cardiac arrest and asystole.

A nurse is caring for a client who is taking cefotetan 1 mg intermittent IV bolus every 12 hours to treat a postoperative infection. Which of the following manifestations should the nurse recognize as an adverse reaction to the medication? A. Disorientation B. Epistaxis C. Constipation D. Jaundice

B. Epistaxis. - Cefotetan is an antibiotic which can affect vitamin K levels. The nurse should monitor the client for bleeding and notify the provider if the manifestations occurs so the medication can be discontinued. Cefotetan does not cause jaundice or disorientation. The nurse should monitor for diarrhea not constipation.

A nurse is teaching a client who has a new diagnosis of angina and a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicate understanding of the teaching? A. I can take my second dose no later than 9 pm B. I should change positions slowly when getting out of bed C. If i miss a does i should double the next dose D. I should notify the provider if i experience a headache while taking this medication

B. I should change positions slowly when getting out of bed. -Isosorbide mononitrate is a vasodilator therefore it may cause orthostatic hypertension. The client should take their last does no later than 7 pm to prevent intolerance. If a dose is missed the client should take the dose as soon as they remember, the client should never double a dose! A headache is an expected finding when taking nitrates. The client can take acetominphen or aspirin to relieve the headache.

A nurse is reviewing the medical record for a client who is taking a combination oral contraceptive. The nurse should identify that which of the following is a contraindication for receiving this medication? A. High cholesterol B. Liver disease C. Family hisotry of ovarian cancer D. Client report of hypermennorrhea

B. Liver disease -The nurse should identify that liver disease or abnormal liver functions is a contraindication to receiving a combination oral contraceptive. Other contraindications include thrombophlebitis and breast cancer.

A nurse is caring for a client who has unstable angina. The nurse should anticipate a prescription from the provider for which of the following medications? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine

B. Nitroglycerin. - Nitroglycerin is an organic nitrate and vasodilator that acts by relaxing and preventing spasms in the coronary arteries, thereby decreasing the oxygen demand of the heart along with ventricular filling. Epinephrine is used to control superficial bleeding, delay local anesthetic absorption, and treat cardiac arrest and anaphylaxis. Lidocaine is a medication used to treat ventricular arrhythmias. Atropine is used to treat bradycardia by increasing the heart rate.

Which of the following durations should the nurse identify for regular insulin? A. Intermediate duration B. Short duration, slow acting C. Long duration D. Short duration, fast acting

B. Short duration, slow acting. -The nurse should identify that regular insulin has a should duration with a slow acting time. The nurse should plan to administer regular insulin 30 minutes before meals. NPH is an intermediate duration insulin. Glargine and detemir insulin are long duration and should be administered once or twice daily. Lispro, aspart, and glulisine insulin are short duration with a rapid acting time. The nurse should administer these 5-15 minutes before or after a meal.

A nurse is reinforcing teaching with a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. Johns wort to treat depression. which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together B. Stop taking the herbal supplement while taking this medication C. Take the herbal supplement and medication at least 2 hours apart D. Take and antacid with both the medication and herbal supplement

B. Stop taking the herbal supplement while taking this medication. -Taking the herbal supplement and medication together increase the clients risk of developing serotonin syndrome.

A nurse is reviewing a prescription for fexofenadine for a 7 year old with seasonal allergies. Which of the following findings should the nurse clarify with the provider? A. The prescription says to avoid taking the medication with orange juice B. The prescription says to take standard tablets C. The prescription says to take 30 mg twice daily D. The prescription says to administer the medication orally.

B. The prescription says to take standard tablets. -The nurse should identify that standard tablets are designed for individuals 12 years or older. Therefore the nurse should clarify the prescription as a 7 year old should be receiving the oral disintegrated suspension. The therapeutic effect of fexofenadine is decreased when taken with orange juice so the nurse should not question this. 30 mg twice daily is an appropriate dose for a 7 year old. fexofenadine is taken orally.

A nurse is collecting data from a client who has AIDs and is taking zidovudine. Which of the following findings is priority for the nurse to report to the provider? A. Nausea and vomiting B. Decreased hemoglobin C. Decreased appetite D. Anxiety

B. decreased hemoglobin. -When using ABC decreased hemoglobin would be priority. Zidovudine can cause severe anemia and neutropenia from bone marrow suppression, resulting in hematologic toxicity. All other findings are adverse effects of zidovudine but decreased hemoglobin has more prioirity.

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following manifestations of an adverse reaction? A. Weight loss B. Peptic ulcer C. Hyperkalemia D. Diplopia

B. peptic ulcer -The nurse should monitor a client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should check the clients stool periodically for occult blood and instruct the client to notify the provider is black tarry stool occur. The nurse should monitor for weight gain not weight loss. The nurse should monitor for hypokalemia not hyperkalemia. Diplopia is not an adverse effect of glucocorticoids.

A nurse in a provider's office is reinforcing teaching with a client who has osteoporosis and a new prescription for Alendronate sodium. Which of the following pieces of information should the nurse provide? A. Alendronate can be administered by IV once a year B. Take Alendronate sodium with a full glass of water on an empty stomach C. Side effects of alendronate sodium include leukopenia D. Alendronate sodium should be taken with calcium rich foods to increase absorption

B. take alendronate sodium with a full glass of water on an empty stomach -Alendronate sodium should be taken with at least 8 oz. of water 30 minutes before ingesting food. Maintaining an upright position after administration is recommended to decrease risk of esophagitis. Alendronate is given PO not through an IV.

A nurse is collecting data on a client who has type 2 diabetes mellitus and is taking metformin. Which of the following findings should indicate to the nurse the medication is having its therapeutic effect? A. Tachycardia B. Fasting BG level of 118 mg/dl C. Glycosylated Hemoglobin (hbA1c) of 6.8% D. Increased appetite

C. Glycosylated Hemoglobin of 6.8% -The nurse should identify that a hbA1c level of 6.8% is within the expected reference range of less than 7% indicating the medication is having a therapeutic effect. The nurse should identify that tachycardia is a manifestation of hypoglycemia therefore the medication is not having a therapeutic effect. The nurse should identify that a fast blood glucose of 118 is above the expected reference range of 70-110 therefore the medication is not having a therapeutic effect. The nurse should identify that hunger is a manifestation of hypoglycemia therefore the medication is not having a therapeutic effect.

A nurse is reinforcing discharge teaching about lithium toxicity with a client who has a new prescription for this medication. Which of the following statements by the client indicates an understanding of the teaching? A. I should take naproxen if i have a headache because aspirin can cause lithium toxicity B. I can develop lithium toxicity if i eat foods with lots of sodium C. I can develop lithium toxicity if i experience vomiting and diarrhea D. I might need to take a daily diuretic with lithium to prevent lithium toxicity.

C. I can develop lithium toxicity if i experience vomiting and diarrhea. -Vomiting and diarrhea can cause electrolyte imbalances. If serum sodium decreases more lithium will be retained by the kidneys, which increases risk of lithium toxicity. NSAIDs such as naproxen increase lithium levels. Eating a foods with lots of sodium would promote lithium excretion by the kidneys. Taking a diuretic would decrease the kidneys excretion of lithium therefore increasing risk of lithium toxicity.

A nurse is monitoring a client who is taking diphenoxylate-atropine. Which of the following statements by the client should indicate to the nurse that the medication has been effective? A. I feel a little drowsy with this medication B. I am now drinking much more water C. I have not had a bowel movement today D. I know longer feel chest-tightness

C. I have not had a bowel movement today. - The nurse should identify that diphenoxylate-atropine is an opiod used to treat diarrhea. The therapeutic response of this medication is to decrease frequency of watery stools due to reduced motility of the intestinal lining. Drowsiness and dry mouth are adverse effects of the medication. Diphenoxylate-atropine has no bronchodilation effects.

A nurse is reinforcing teaching with a client who has osteoporosis and is taking nasal calcitonin-salmon. Which of the following statements by the client indicates understanding of the teaching? A.I will administer a spray into each nostril daily B. I should expect bleeding for the first week C. I will need to depress the side arms initially to activate the pump D. I should expect to take this medication for a short-term treatment

C. I will need to depress the side arms initially to activate the pump. -The nurse should advise the client to hold the white side arms toward the bottle six times to activate the pump. Calcitonin-salmon should be taken daily alternating nostrils not weekly. Nasal bleeding is an indication to stop treatment and notify provider. Calcitonin-salmon is a long-term treatment for postmenopausal osteoporosis.

A nurse is teaching a client about the use of dinoprostone vaginal insert pouch to stimulate labor. Which of the following statements should the nurse include in her teaching? A. It is inserted using a catheter B. One pouch is given every 4 hours until labor occurs C. Lie on your back for at least 2 hours without getting up D. If labor doesn't occur within 6 hours a second dose can be administered.

C. Lie on your back for at least hours until labor occurs. - The client should remain supine for at least hours after dinoprostone vaginal pouch is inserted to allow slow release of the medication from the pouch to stimulate labor. Dinoprostone gel not the insert is administered through a catheter. To prevent leakage when using the gel the client should remain supine for at least 30 minutes. The dinoprostone pouch releases the medication slowly until active labor occurs or is removed after 12 hours. Dinoprostone gel not the pouch often requires 2-3 doses in the twelve hour period.

A nurse is caring for a client who is 39 weeks gestation who has gestational hypertension. The client has a new prescription for misoprostol to ripen the cervix and induce labor. Which of the following findings in the client's medical history should the nurse identify as increasing the client's risk of complications due to the use of this medication? A. Positive bacterial vaginosis culture B. History of failure to progress C. Previous cesarean delivery D. Positive serum Rh sensiniztaion

C. Previous cesarean delivery. - An adverse effect of misoprostol is uterine tachysystole( excessively frequent contractions). Therefore this medication should be used with extreme caution in patients who have had a previous cesarean delivery. Bacterial vaginosis can increase the clients risk of preterm labor, This finding alone does not increase the risk of premature delivery when taking misoprostol.

A nurse is preparing to administer the first injection of diphtheria, pertussis, tetanus Dtap vaccine to an infant. Which of the following pieces of information should the nurse tell the parent proir to administration? A. Your child may experience diarrhea and vomiting within 24 hours of recieiving this vaccination. B. I can either give your child all of the vaccinations in this series at once or seperately. C. The vaccine will be injected into the infants thigh D. This injection contain a live virus

C. The vaccine will be injected into the infants thigh. -Dtap is administer IM into the deltoid or mediolateral thigh because these are larger muscles that can better diffuse inflammation. Diarrhea and vomiting are not adverse effects of Dtap, adverse effects of Dtap are; localized reactions, fever, fretfulness, drowsiness, and anorexia. Dtap consists of 5 vaccinations given at 2 ,4,6 15-18 months, and 4-6 years of age. Dtap does not contain live viruses, but MMR, MMRV, Varicella, Varicella Zoster all do!

A nurse is reinforcing teaching with a client who has diabetes mellitus about a new prescription of pioglitazone. Which of the following statements should the nurse include in her teaching? A. Monitor hypoglycemia for 6 hours after taking this medication B. This medication can not be taken if you have a sulfa allergy. C. This medication can be taken while using insulin. D. This medication is effective for people with type one diabetes

C. This medication can be taken while using insulin. -Pioglitazone increases the cellular response to insulin, and insulin is needed in order for the medication to be effective. The client should monitor for hypoglycemia for 2-4 hours after taking the medication. Pioglitazone is used to treat type 2 diabetes not type 1. This is because insulin is needed for the medication to be effective.

A nurse is reviewing the medical record of a client taking hydrochlorothiazide. The nurse should expect to find improvement in which of the following conditions? A. Gouty arthritis B. dehydration C. diabetes insipidus D. Hypokalemia

C. diabetes insipidus. -Thiazide diuretics are administered to treat diabetes insipidus. Diabetes insipidus is a condition in which there is an over production of urine. Thiazides decrease urine production from 30-50%. Gouty arthritis is an adverse effect of hydrochlorothiazide due to retention or uric acid. Dehydration is an adverse effect of thiazide diuretic due to the loss of water, sodium, and chlorite. The nurse should weigh the client on a regular basis to monitor for dehydration. Hypokalemia is an adverse effect of thiazide diuretics.

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take? A. Place the client leaning forward in a chair B. Hold the medication dropper 2.5 cm (1 in) from the clients ear canal. C. Pull the pinna of the client's ear upward and outward D. Have the client remain still for 30 seconds after administration

C. pull the pinna of the client's ear upward and outward. -The nurse should place the client side-lying not leaning forward in a chair. The nurse should hold the dropper 1.3 cm (0.5 in) from the ear not 2.5 cm (1 in). The nurse should instruct the client to remain side-lying for 2-3 minutes not 30 seconds.

A nurse is contributing to the plan of care for a client taking phenytoin for seizures. Which of the following recommendations should the nurse include to counteract the adverse effects of this medication? A. Administer an antidiarrheal agent to the client as needed B. Encourage the client to increase dietary intake of food high in potassium. C. Reinforce teaching with the client about how to perform gum massages. D. Offer hard candy for the client to suck on.

C. reinforce teaching to the client about how to perform gum massage. -Phenytoin can cause gingival hyperplasia (Gum overgrowth). The nurse should instruct the client about proper flossing and brushing techniques as well as gum massage to decrease risk of damage and discomfort. Phenytoin can cause constipation not diarrhea. Phenytoin does not adversely affect potassium levels. Phenytoin does not cause dry mouth.

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and is taking prednisone. The nurse should instruct the client to monitor for which of the following adverse effects? A. Gingival Ulcerations B. Orthostatic hypotension C. Stress fractures D. Weight loss

C. stress fractures -Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures. Clients who take prednisone are not at risk for gingival ulcerations. Clients how take prednisone are at risk for hypertension due to sodium and fluid retention. Weight gain can occur due to prednisone usage not weight loss.

A nurse was administering medication to a client. Which of the following circumstance should the nurse identify as a medication error due to performance deficit by the nurse? A. A medication safety coordinator was not present B. A verbal prescription was transcribed incorrectly C. A medication with a similar name was dispensed rather than the correct medication D. An IM injection was given rather than a Subcut.

D. An IM injection was given rather than a Subcut. -Performance deficits include using the incorrect route of administration. If the nurse is not following the rights of medication administration then the nurse has a performance deficit.

A client is taking hydroxychloroquine for rheumatoid arthritis. which of the following should the nurse identify as an adverse effect of this medication? A. I have developed sores in my mouth B. I often feel like the room is spinning C. I have noticed the whites of my eyes look yellow D. i have had a change in vision recently

D. I have had a change in my vision recently. -Hydroxychloroquine is an antimalarial medication used to treat rheumatoid arthritis. In high doses there is risk for developing retinopathy, which can be irreversible and lead to blindness. Methotrexate is a DMARD which can cause GI tract ulceration.

A nurse is reinforcing teaching about the adverse effects of baclofen with a client who has multiple sclerosis with spasms. Which of the following statements should the nurse identify as the client understanding teaching? A.Adverse effects include urinary frequency B. I should increase my fiber intake to counteract the adverse effect of diarrhea. C. This medication can cause addiction D. I should not abruptly stop taking this medication

D. I should not abruptly stop taking this medication. -There are adverse effects associated with the abrupt withdrawal of this medication, those adverse effects are visual hallucinations, paranoid ideations, and seizures. Baclofen is a muscle relaxer that can cause urinary retention not frequency. Baclofen is more likely to cause constipation than diarrhea. Baclofen is not associated with physical dependence.