Pharmacology ATI Practice

A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make?

"Aspirin will increase the risk of bleeding"; Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding.

A nurse is teaching the client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching?

"I should sit up for 30 minutes after taking this risedronate"; Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?

"I should tell my provider if I develop a sore throat" ; The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued.

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?

"Report yellowing of the skin"; Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?

"Rinse your mouth after inhaling the beclomethasone"; The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

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

- Avoid taking the medication with grapefruit juice; When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. -Expect therapy with this medication to be lifelong; If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months.

A nurse is caring for a client who received 0.9% sodium chloride 1L over 4hr instead over 8hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?

0.9% sodium chloride 1 L IV infused over 4hr. Vital signs stable, provider notified; The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status.

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report?

0830; The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching?

A transition in care requiring the nurse to conduct medication reconciliation; The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications?

Acetylcysteine; Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.

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

Administer the medication outside the 5-cm (2-in) radius of the umbilicus; The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus.

A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?

Atropine;A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?

Bibasilar crackles; Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

A nurse is caring for a client who is receiving heparin therapy vio continuous IV infusion to treat pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?

Blood in the urine; The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.

A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effect of morphine?

Constipation; Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.

A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?

Decreased respirations might occur; The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care?

Determine apical pulse prior to administering; Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate?

Digoxin; The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity.

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over the counter medication?

Ibuprofen; Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.

A nurse is assessing a client who is taking propylthiouracil for the treatment of Grave's disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?

Increase in the ability to focus; A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective.

A nurse is caring for a client who is receiving oprelvekin. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?

Increased platelet count; oprelvekin stimulates the bone marrow to produce platelets

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take?

Monitor the client for constipation; The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.

A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?

Obtain the client's blood pressure; When using the nursing process, the first action the nurse should take to prevent injury to the client is to assess the client for adverse effects of atenolol, such as hypotension.

A nurse is reviewing the ECG of a client who is receiving IV furosemide for the heart failure. The nurse should identify which of the following finding of hypokalemia?

Presence of U-waves; The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide.

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor?

Sedation; Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation.

A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?

Sexual dysfunction; Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant.

A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)?

Temperature of 39.7° C (103.5° F); The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension.