Pharmacology Exam 2

By which action does atorvastatin (Lipitor) decrease lipid levels? A. Inhibiting absorption of dietary cholesterol in the small intestine B. Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces C. Stimulating the biliary system to increase excretion of dietary cholesterol D. Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

D. Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver Atorvastatin (Lipitor) is an HMG-CoA reductase inhibitor, decreasing the synthesis of cholesterol in the liver.

A client is prescribed enoxaparin 0.5 mg/kg subcut. The client weighs 50 kg and the enoxaparin comes in a prefilled syringe containing 40 mg/mL. The nurse should prepare a dose of how many mL? Round to two decimal places.

0.63 mL

A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? "It's best to wait to see if the fever gets worse." "You can use the aspirin, but watch for worsening symptoms." "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." "You can use aspirin, but be sure to follow the instructions on the bottle."

"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet." "I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."

"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet." "I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."

"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication." Response Feedback: Colestipol is available as a powder that must be well diluted in fluids before administration to avoid esophageal irritation or obstruction and intestinal obstruction. The powder should not be stirred because it may clump—it should be left to dissolve slowly for at least 1 minute.

The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that FURTHER teaching is needed? "I will flush the eyes after instilling the ointment." "I will clean the newborn's eyes before instilling ointment." "I need to administer the eye ointment within 1 hour after delivery." "I will instill the eye ointment into each of the newborn's conjunctival sacs."

"I will flush the eyes after instilling the ointment."

A nurse instructor is about to administer a vitamin K injection to a newborn. The student nurse asks the instructor regarding the purpose of the injection. The appropriate response would be: "The vitamin K provides active immunity " 'The vitamin K will prevent the occurrence of hyperbilirubinemia." "The vitamin K will protect the newborn from bleeding." "The vitamin K will serve as protection against jaundice and anemia "

"The vitamin K will protect the newborn from bleeding."

What teaching would the nurse provide to a patient receiving tetanus toxoid? "Increase fluid and fiber in your diet to prevent constipation." "Soreness at the injection site is a common reaction." "You will have lifetime immunity from this injection." "This medication must be repeated weekly for four weeks."

"Soreness at the injection site is a common reaction."

What instructions are given to a patient who is prescribed oral iron tablets? "Take the iron tablet in a powdered form." "Take an iron tablet just before going to bed." "Take the iron tablet after dissolving it in water using a straw." "Take the iron tablet with plenty of fluids

"Take the iron tablet with plenty of fluids."

the client taking an estrogen-progestin combination oral contraceptive calls the clinic reporting that she has forgotten her pills for the last 2 days. What medication directions should the nurse provide? 1. "take two pills today and two pills tomorrow, then one pill today for the rest of the pill pack" 2. "take two pills today and then one each day until the pill pack is finished" 3. "notify your healthcare provider of the missed dose" 4. "stop taking the pills and have your partner use condoms until the next months, then restart a new pill pack"

1. "take two pills today and two pills tomorrow, then one pill today for the rest of the pill pack"

The client with preterm labor is receiving magnesium sulfate IV. to detect an early side effect, the nurse should perform which assessments? 1. check deep tendon reflexes 2. auscultate lung sounds every 15 minutes 3. ask the client to report sudden flank pain 4. percuss the suprapubic area every hour

1. check deep tendon reflexes

the perinatal nurse is assigned to several clients. the nurse anticipates that which client is most likely to be a candidate for drug therapy with terbutaline? 1. client at 27 weeks gestation who has a regular uterine contractions 2. clients at 41 weeks gestation with irregular uterine contractions 3. client with postpartum hemorrhage following delivery 4. client at 38 weeks gestation with hypertension and seizures

1. client at 27 weeks gestation who has a regular uterine contractions

The healthcare provider at an outpatient clinic is considering prescribing sildenafil for a 61-year-old client. The nurse would make it a priority to discuss which item in the client's health history with the prescriber? 1. coronary artery disease (CAD) with nitroglycerin use 2. renal impairment with elevated creatinine level 3. blurred vision of unknown etiology 4. gout managed with allopurinol

1. coronary artery disease (CAD) with nitroglycerin use

after a female client taking estrogen-progestin combination reports by phone a sudden onset of blurred vision, the nurse at the outpatient clinic should ask what more appropriate question? 1. is there someone there with you? 2. when was the last time you had your eyeglasses prescription changed? 3. when is your next appointment with your gynecologist? 4. do you have problems with migraine headaches?

1. is there someone there with you?

the nurse determines a client with endometriosis understands the purpose of the newly prescribed danazol when the client makes which statement? 1. it suppresses pituitary output of FSH 2. I'll need to take this medication for the rest of my life 3. I have to administer injections weekly 4. this medication will relieve hot flashes

1. it suppresses pituitary output of FSH

because the client is being prepared for labor induction with oxytocin, the nurse instructs the LPN to report which client data? SATA 1. sudden rise in BP 2. changes in discomfort level immediately after the drug is initiated 3. gain of more than 2.27kg or 5 lb during the last month 4. sensation of nausea without vomiting 5. changes in level of consciousness

1. sudden rise in BP 5. changes in level of consciousness

to better help a client understand the action of clomiphene, the nurse should include which information in the teaching plan for a female client who will begin taking the drug? 1. teach normal processes of conception 2. explain uterine involution process 3. teach the client to keep a record of daily temperatures 4. explain function of female hormones

1. teach normal processes of conception

the nurse should conclude that a female client has understood medication instruction when she makes which statement about clomiphene? 1. this medication will help make me ovulate 2. i'll take this medication orally for 1 month 3. the medication prepares the wall of the uterus for fertilization 4. my husband is going to ask if he can take the medication as well

1. this medication will help make me ovulate

The nurse is reviewing the health history of a client who is to begin therapy with a combined oral conceptive drug. Which findings in the client's history should the nurse address with the client? Select all that apply. 1. use of st. john's wort for depression 2. smoking cessation over 10 years ago 3. frequent migraine headaches 4. follows a vegan diet 5. cholecystectomy 3 months ago

1. use of st. john's wort for depression 3. frequent migraine headaches

The current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range? Under 6 years of age 11-12 years of age and older Any age range In the first two years of life

11-12 years of age and older

the nurse determines teaching regarding the levonorgestrel-releasing intrauterine delivery system has been effective when the client makes which statement? 1. these devices are 100% effective 2. I can keep this device in place for up to 5 years 3. I will need to use a barrier method of birth control in addition to this device 4. I will have the device removed every 2 years and replaced

2. I can keep this device in place for up to 5 years

the nurse should consult with the healthcare provider after noticing that testosterone enanthate has been prescribed for which client? 1. a 16 year old with moderate acne 2. a 32 year old with an increased prostatic antigen level (PSA) 3. a 66 year old with melanoma 4. a 65 year old male with high HDL level of 88

2. a 32 year old with an increased prostatic antigen level (PSA)

A pregnant client is being prepared for labor induced with oxytocin. The nurse concludes that the client has adequate understanding when the client verbalizes the medication will have which action? Select all that apply. 1. cause an increase in blood pressure to provide adequate oxygen for the baby 2. cause the uterus to contract harder and more often 3. start contractions that will be almost continuous until the baby is born 4. be given through the intravenous line in small continuous amounts that can be adjusted as needed 5. cause the client to be in real labor

2. cause the uterus to contract harder and more often 4. be given through the intravenous line in small continuous amounts that can be adjusted as needed 5. cause the client to be in real labor

several clients in an outpatient clinic have requested prescriptions for sildenafil. the nurse anticipates having to inform which client that the request has been denied by the prescriber? 1. client diagnosed with DB type 2 2. client taking medication therapy for angina pectoris 3. client with BPH who is being managed medically 4. client who has chronic sinusitis with flare-ups in the spring

2. client taking medication therapy for angina pectoris

after dinoprostone is administered to a client, a nurse plans to monitor for which of the following? 1. fetal heart tone on a client who has difficultly conceiving 2. initiation of contractions for a client desiring an elective abortion 3. initiation of lactation fora client interested in breastfeeding 4. early signs and symptoms of pregnancy

2. initiation of contractions for a client desiring an elective abortion

A client beginning oral contraceptives therapy with desogestrel and ethinyl estradiol asks the nurse why two different drugs are needed in the pill. Which explanation by the nurse is the best? 1. this medication is a weak estrogen and progestin combination that requires additional estrogen to work 2. together the hormones prevent pregnancy through the cervical mucus 3. estrogen alone would prevent pregnancy, but progestin are added so that spotting doesn't occur 4. taking each hormones separately would prevent most pregnancies, but the combination together is more effective

2. together the hormones prevent pregnancy through the cervical mucus

because of hypertensive client is experiencing postpartum hemorrhage, the nurse anticipates that the healthcare provider will most likely prescribe which drug to treat the hemorrhage? 1. ergonovine 2. methylergonovine 3. oxytocin 4. carboprost tromethamine

3. oxytocin

the nurse should conclude that which client is most likely to have testosterone transdermal prescribed for his condition? 1. a 45 year old with status-post bilateral vasectomy 2. a 17 year old with status-post right cryptorchidism repair 3. a 23 year old with status-post varicocele repair 4. a 32 year old with status-post bilateral orchidectomy

4. a 32 year old with status-post bilateral orchidectomy

the client in preterm labor who has a history of asthma received 2.5mg of terbutaline sulfate subcutaneously. after the client expresses concern about the use of this drug, which reply by the nurse would be best? 1. the healthcare provider wanted to make sure you did not have asthma problems and early labor 2. i am sure the healthcare provider has a very good reason for ordering this medication 3. what do you normally take to control your asthmatic attacks? 4. terbutaline sulfate causes the respiratory tract to relax as well as the uterine wall

4. terbutaline sulfate causes the respiratory tract to relax as well as the uterine wall

after testosterone cypionate is prescribed for a 16 year old client diagnosed with hypogonadism, the client asks "Why do I need these hormones, anyway?" The nurse should provide which description for the relationship between this condition and the drug? 1. testosterone is necessary to prevent your muscles from atrophying 2. this medication is a form of testosterone, your doctor can explain it to you 3. testosterone prevents your body from becoming female-looking 4. this medications will increase your testosterone to a normal level

4. this medications will increase your testosterone to a normal level

What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient? "This medication will take over for other interventions you have been trying to decrease your cholesterol." "It is important for you to double your dose if you miss one in order to maintain therapeutic blood levels." "Stop taking the medication if it causes nausea and vomiting." "Continue your exercise program, and maintain a diet high in omega-3 fatty acids."

: "Continue your exercise program, and maintain a diet high in omega-3 fatty acids."

The nurse recognizes that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.) Selected Answers: A Garlic B Ginkgo C Dong quai D Glucosamine E St. John's wort

A Garlic B Ginkgo C Dong quai E St. John's wort Garlic, ginkgo, dong quai, and St. John's wort alter blood coagulation and may increase the risk of bleeding when given concurrently with oral anticoagulants. Glucosamine does not affect coagulation.

Nursing care for a patient receiving alteplase (Activase) would include which action? (Select all that apply.) A Record vital signs and report changes. B Observe for signs and symptoms of bleeding. C Monitor liver enzymes. D Assess for cardiac dysrhythmias. E Administer injections intramuscularly to prevent bleeding.

A Record vital signs and report changes. B Observe for signs and symptoms of bleeding. D Assess for cardiac dysrhythmias. Alteplase can cause bleeding as well as cardiac dysrhythmias. Vital sign changes can alert the nurse to these complications. Alteplase does not directly affect liver enzymes. Injections should not be administered intramuscularly because of the increased risk of bleeding.

Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group? A. Low-molecular-weight heparin B. Oral anticoagulant C. Glycoprotein IIb/IIIa inhibitor D. Thrombolytic drug

A. Low-molecular-weight heparin Enoxaparin is a low-molecular-weight heparin.

Discharge teaching for a patient receiving simvastatin (Zocor) would include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medication? A. Muscle pain B. Headache C. Weight loss D. Fatigue

A. Muscle Pain Muscle pain must be reported because it could signify an uncommon but serious side effect of rhabdomyolysis associated with statin drugs.

A child who accidently ingested an enteric-coated iron supplement develops seizures and is immediately hospitalized. The serum iron concentration is found to be 350 mcg/dL. What intervention should the nurse expect the provider to prescribe to reduce the serum iron levels? Bowel irrigation An electrolyte infusion Administration of deferoxamine Abdominal radiographs

Administration of deferoxamine

A patient arrives at the clinic with a wound inflicted by a rusty nail. After checking the patient's history, the nurse finds that the patient last received the tetanus booster about 10 years earlier. What is the most appropriate nursing action in this situation? Administer Tdap. Administer DTaP. Administer immunoglobulin Administer polyvalent vaccine

Administer Tdap.

When alteplase is administered to a client diagnosed with a CVA in the ED, the nurse determines that the priority nursing interventions in this clients care should include which of the following. SATA After admin., assess VS ever 15 min during the first hour Report dysrhythmias noted on cardiac monitor Insert urinary catheter and maintain accurate hourly output measures Monitor client for hypothermia for first 8 hours of infusion Report increase in partial thromboplastin time (PTT)

After admin., assess VS ever 15 min during the first hour Report dysrhythmias noted on cardiac monitor Report increase in PTT

After the intramuscular administration of immune globulin, the nurse should provide which instructions to the client? SATA Apply ice pack to injection site if swelling occurs Postpone receiving live vaccine for at least 3 months use protective measures fo rthe next 2 months until immunity develops Notify nurse if chills and fever develop Urinary output is likely to decrease

Apply ice pack to injection site if swelling occurs Postpone receiving live vaccine for at least 3 months Notify nurse if chills and fever develop

A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better." What will the nurse suggest? Apply an ice pack to the injection site. Apply warm compresses to the injection site. Observe the site for further swelling and redness. Bring the infant in to the emergency department for an immediate examination.

Apply warm compresses to the injection site.

A patient with warfarin toxicity is prescribed vitamin K. Which nursing assessment ensures patient safety? Assess the site for intramuscular drug delivery. Assess the white blood cell count of the patient. Assess the amount of blood loss in the patient. Assess the prothrombin time of the patient.

Assess the prothrombin time of the patient.

The nurse interprets a patient's international normalized ratio (INR) value of 2.5. What is the meaning of this reported value? A The patient is not receiving enough warfarin for a therapeutic effect. B The patient's warfarin dose is therapeutic. C The patient is not receiving enough subcutaneous heparin for a therapeutic effect. D The patient is receiving a dangerously high amount of heparin.

B The patient's warfarin dose is therapeutic. INR determination is a routine test to evaluate coagulation while patients are taking warfarin, not heparin. A therapeutic INR is 2 to 3.

The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? A Complete blood count (CBC) B Activated partial thromboplastin time (aPTT) C Prothrombin time (PT) D Blood urea nitrogen (BUN)

B aPTT Heparin dosing is based on aPTT results. The PT is reflective of warfarin's anticoagulant effect.

The nurse plans which intervention to decrease the flushing reaction of niacin? ] A Administer niacin with an antacid. B Administer aspirin 30 minutes before nicotinic acid. C Administer diphenhydramine hydrochloride (Benadryl) with the niacin. D Apply cold compresses to the head and neck.

B. Administer aspirin 30 minutes before nicotinic acid Administration of an antiinflammatory drug such as aspirin has been shown to decrease the flushing reaction associated with niacin.

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time? A. When the stomach is empty B In the evening C With breakfast D With an antacid

B. In the evening The liver produces the majority of cholesterol during the night. Thus statin drugs, which work to decrease this synthesis, are generally administered during the evening so that blood levels are highest coinciding with this production.

Which vaccination is recommended in the prevention of a virus that is known to cause cervical cancer? Herpes zoster vaccine Human papillomavirus vaccine Pneumococcal vaccine Hepatitis B virus vaccine

Human papillomavirus vaccine

Which medication has antiplatelet properties? clopidogrel enoxaparin heparin alteplase

Clopidogrel Response Feedback: Clopidogrel (Plavix) is an antiplatelet drug indicated for thrombus prevention associated with strokes and myocardial infarction. Enoxaparin and heparin are anticoagulants. Alteplase is a thrombolytic drug.

A client with a seizure disorder is taking an antiepileptic medication medication along with cyclosporine. Which nursing intervention should the nurse include in the plan of care? SATA Consult with the prescriber regarding the need to increase the cyclosporine dosage Evaluate for symptoms of elevated blood pressure Consult with the prescriber regarding the need to lower the antiepileptic dosage Routinely monitor blood glucose levels for hyperglycemia Monitor the client for seizures

Consult with the prescriber regarding the need to increase the cyclosporine dosage Evaluate for symptoms of elevated blood pressure Consult with the prescriber regarding the need to lower the antiepileptic dosage Routinely monitor blood glucose levels for hyperglycemia

What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient? "This medication will take over for other interventions you have been trying to decrease your cholesterol." "It is important for you to double your dose if you miss one in order to maintain therapeutic blood levels." "Stop taking the medication if it causes nausea and vomiting." "Continue your exercise program, and maintain a diet high in omega-3 fatty acids."

Continue your exercise program and maintain a diet high in omega 3 fatty acids Response Feedback: Antilipemic medications are an addition to, not a replacement of, the therapeutic regimen used to decrease serum cholesterol.

What is the priority nursing assessment to monitor when administering vaccinations? Pain at the injection site Signs and symptoms of infection Anaphylaxis Myalgias

Correct Anaphylaxis

The nurse anticipates a prescription to administer which drug to a client with aplastic anemia? Dipyridamole Allopurinol Acetylsalicylic acid Cyclosporine

Cyclosporine

The nurse evaluates and determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) when the patient responds with which statement? A "I will double my dose if I forget to take it the day before." B "I should keep taking ibuprofen for my arthritis." C "I should decrease the dose if I start bruising easily." D "I should use a soft toothbrush for dental hygiene."

D "I should use a soft toothbrush for dental hygiene." The patient should reduce the risk of bleeding, such as using a soft toothbrush. The other choices are inaccurate.

An allergy to which substance is listed as a contraindication to the administration of an immunizing drug? Soy Corn Wheat Egg

Egg

A 69 yo client, who is taking desmopressin for von Willebrand disease, asks the nurse to provide information about the drug. An appropriate response by the nurse includes which statements? SATA Desmopressin helps restore and release deficient clotting factors that are reduced in von Willebrand disease. You can ask your healthcare provider about using an intranasal preparation you should monitor your fluid intake and output while taking this drug Take your bp every day while taking this drug you will receive cryoprecipitate transfusions while you are taking this drug

Desmopressin helps restore and release deficient clotting factors that are reduced in von Willebrand disease. You can ask your healthcare provider about using an intranasal preparation you should monitor your fluid intake and output while taking this drug Take your bp every day while taking this drug

A 61-year-old female client has severe rheumatoid arthritis that is being managed with leflunomide and inflixamab. After the client reported having an elevated temperature of 37.7C, the nurse should consider which possible etiology for this symptom? Development o finfection Joint inflammation Probable dehydration Drug interaction

Development of infection

A client being cared for at home is taking sargramostim. The nurse manager at the home health agency is most concerned when the UAP reports which finding? Early-morning oral temp of 37.2C Nausea and occasional diarrhea Dyspnea on exertion and dependent edema Mental depression and fatigue

Dyspnea on exertion and dependent edema

A nurse is assessing an athlete who has been admitted for cardiac arrest. The investigation reports reveal increased blood viscosity. Which drug did the patient likely receive? Folic acid Ferrous fumarate Epoetin alfa Cyanocobalamin (vitamin B12)

Epoetin alfa

A client has been taking iron therapy for treatment of anemia. To evaluate drug effectiveness, the nurse reviews which laboratory test results as the best verification of iron stores in the body? Ferritin level Transferrin level Hematocrit Platelet level

Ferritin level

The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters should the nurse assess as a result of this prescription? Select all that apply. Heart rate Hemoglobin Respirations Platelet Count Blood Pressure Activated partial thromboplastin time (aPTT)

Hemoglobin Platelet Count Activated partial thromboplastin time (aPTT)

The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters should the nurse assess as a result of this prescription? Select all that apply. Heart rate Hemoglobin Respirations Platelet Count Blood Pressure Activated partial thromboplastin time (aPTT)

Hemoglobin Platelet Count Activated partial thromboplastin time (aPTT)

The nurse would question an order for simvastatin (Zocor) in a patient with which condition? Leukemia Diabetes Hepatic disease Chronic obstructive pulmonary disease (COPD)

Hepatic disease Simvastatin (Zocor) can cause an increase in liver enzymes and thus should not be used in patients with preexisting liver disease.

Which statement will indicate to the nurse that the patient understands the discharge instructions regarding cholestyramine (Questran)? ] "I will take Questran 1 hour before my other medications." "I will increase fiber in my diet." "I will weigh myself weekly." "I will have my blood pressure checked weekly."

I will increase fiber in my diet Response Feedback: Cholestyramine can cause constipation; thus increasing fiber in diet is appropriate. All other drugs should be taken 1 hour before or 4 hours after cholestyramine to facilitate proper absorption.

Which statement when made by the patient indicates deficient knowledge regarding warfarin? "I will avoid contact sports." "I will take my medication in the early evening each day." "I will increase the dark green leafy vegetables in my diet." "I will contact my physician if I develop excessive bruising."

I will increase the dark green leafy vegetables in my diet Response Feedback: Dark green leafy vegetables are rich in vitamin K, which would antagonize the effects of warfarin. Therefore, it is important to maintain a consistent daily intake of vitamin K and avoid eating large amounts of these foods.

After taking an anti-platelet medication for several weeks, a client presents with a noticeable bruise on the right arm. What assessment data is most significant to managing the client;s health needs? Whether the bruise is the result of a specific injury Whether the client is taking the medication as prescribed If the client self-monitors for skin manifestations If the client's response to injury is different now

If the clients response to injury is different now

When managing the care of a client receiving IV anistreplase, the nurse should take which of the following actions. SATA Instruct client to avoid activities that could lead to bruising or bleeding handle client gently when turning and positioning in bed post sign at bedside that states "No IM injections" anticipate medicating the client with ibuprofen for join pain prn monitor lab results for 50% decrease in bleeding time

Instruct client to avoid activities that could lead to bruising or bleeding handle client gently when turning and positioning in bed post sign at bedside that states "No IM injections"

The nurse is monitoring a patient receiving alteplase for treatment of an arterial embolism in the left leg. Which finding indicates that the therapy is effective? 2+ pitting edema Faint posterior tibial pulse Left leg warm to touch Numbness in left leg

Left leg warm to touch

While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient completes which action? Does not aspirate prior to injecting the medication Massages the site after administration of the medication Administers the medication greater than 2 inches away from the umbilicus Injects the medication and then waits 10 seconds before withdrawing the needle

Massages the site after administration of the medication Response Feedback: It is not recommended to massage the area of injection of anticoagulants due to the increased risk of hematoma formation.

A client diagnosed with iron-deficiency anemia is taking iron supplements. Teh nurse should instruct the client to include which of the following foods to enhance the absorption of the medication? Green Leafy vegetables whole grain bread and cereals yogurt orange juice or lemonade

Orange juice or lemonade

A patient had a total gastrectomy 12 months ago. The nurse learns that the patient has been eating a well-balanced diet rich in vitamin B12, folic acid, iron, and other micronutrients. Despite this, the patient is diagnosed with anemia. What is the most likely cause of anemia in this patient? Fecal occult blood loss Bone Marrow Depression Deficiency of renal erythropoietin Poor absorption of vitamin B12

Poor absorption of vitamin B12

The nurse is monitoring the aPTT for a client receiving heparin therapy. WHen the latest aPTT is 2.0 times the normal aPTT, the nurse should perform which action based on this result? Assess for bleeding gums after toothbrushing is complete Perform a test for occult blood on stool Assess client for abnormal bruising Report the value during intershift report

Report the value during intershift report

The nurse assesses the patient's activated partial thromboplastin time (aPTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. How will the nurse interpret this value? The aPTT is inadequate to evaluate treatment. The aPTT is significantly decreased. The aPTT is significantly elevated. The aPTT is within normal limits.

The aPTT is significantly decreased.

A client is taking epoetin alfa for treatment of anemia related to chronic renal disease. The nurse uses which clinical finding as the best measure of the drugs therapeutic effectiveness? The client is not experiencing any related bone pain when teh med is being administered. The hemoglobin and hematocrit levels are rising rapidly based on latest two daily blood draws The clients hemoglobin increases to 12 grams /dL The client maintains an afebrile state

The clients hemoglobin increases to 12 grams /dL

A client is scheduled to receive a high-dose regimen of aldesleukin. What should the nurse include when teaching about the drug? SATA Flulike symptoms are rare and indicated a potentially serous complication This drug has potential interactions with most other drugs This drug should help your body fight cancer cells If severe fatigue occurs, the drug will need to be discontinued This drug can only be given by brief intravenous infusions

This drug has potential interactions with most other drugs This drug should help your body fight cancer cells If severe fatigue occurs, the drug will need to be discontinued This drug can only be given by brief intravenous infusions

The nurse is assessing a patient who has been taking warfarin and vitamin K1 for the past week. The lab reports reveal that the patient has developed venous thromboembolism. What vitamin ingestion may be the reason for this finding? Vitamin A Vitamin D Vitamin E Vitamin K

Vitamin K

The nurse should teach which item of information to a client being discharged on long term warfarin therapy following cardiac valve replacement surgery? Eat lettuce and tomatoes for lunch only a few times per week Limit dietary intake of yellow wax beans to twice weekly use aspirin for minor aches and pains wear shoes that completely enclose the feet

Wear shoes that completely enclose the feet

A client is scheduled to receive filgrastim 5mcg/kg/day. The nurse considers that the dose should be withheld and the prescriber notified if which assessment data is noted? Hematocrit 37%, Hemoglobin 12 grams/dL Mental depression Bone Pain\ White blood cells 11,000/mm^3

White blood cells 11,000/mm^3

A surgical client has suddenly begun to bleed excessively while in the operating room. The nurse should prepare which medication for possible injection? Alteplase AMinocaproic acid dipyridamole heparin

aminocaproic acid

The home health nurse is scheduling appointments for several clients who are taking folic acid for treatment of folic acid anemia. WHich client should have the first appointment? Client taking vitamin b12 100 mcg daily by subcut injection for pernicious anemia. client taking tetracycline 500 mg PO four times daily for gonorrhea client taking allopurinol 100 mg PO daily for hyperuricemia client taking an oral contraceptive daily

client taking an oral contraceptive daily

A client treated with heparin sodium exhibits signs and symptoms of a heparin overdose. the nurse should place priority on initiating what action? Administer standard dose of 50 mg of protamine sulfate over a 10 minute period draw clients activated partial thromboplastin time level during injection of protamine sulfate determine amount of heparin infused along with time frame associated with the infusion administer protamine sulfate concurrently with vitamin K to increase its therapeutic effect.

determine amount of heparin infused along with time frame associated with the infusion

What information should the nurse present in an educations seminar for clients who are taking nicotinic acid for elevated cholesterol level? SATA b/c niacin tx is individualized, dose adjustments are correlated with lab values facial flushing may occur immediately after ingesting dose eating a diet high in niacin will ensure that the medication works effectively for maximum effect, niacin can be taken concurrently with lovastatin

facial flushing may occur immediately after ingesting dose for max effect, niacin can be taken concurrently with lovastatin

Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors? Serum cholesterol levels Liver function tests Serum electrolytes Complete blood count

liver function tests Response Feedback: HMG-CoA reductase inhibitors can cause hepatic toxicity; thus it is necessary to monitor liver function tests every 3 months for the first year of treatment.

The home health nurse instructs the client to avoid taking ibuprofen after noting a decrease in which lab test result? Ferritin level Triglyceride level neutrophil count platelet count

platelet count

THe nurse is providing medication info about warfarin to a client who is being discharged following a mechanical heart valve replacement. Which items of info would provide the best protection to the client. SATA Follow up lab testing is required every 3 months use an electric razor and a soft bristle toothbrush take this med upon arising in the morning on an empty stomach if a dose is missed, take the missed dose with the next scheduled dose eat a diet contain consistent but not large amounts of vitamin K

use an electric razor and a soft bristle toothbrush eat a diet contain consistent but not large amounts of vitamin K

The nurse received a prescription to start iv heparin on a client admitted with a DVT. To implement this order appropriately, what action should the nurse take? Place vitamin K on bedside tell client about need for being NPO while the medication is infusing use an infusion pump to administer the drug weight the client twice weekly

use an infusion pump to administer the drug

The nurse checks the lab values of a client receiving chemo who is scheduled to receive epoetin alfa subcut. Upon finding the hemoglobin is 12.2 grams/dL, the nurse should take which actions. SATA administer the med as prescribed withhold the med dose check clients platelet count before administer epoetin alfa notify the primary care provider of the clients lab value assess the client for signs of internal bleeding

withhold the med dose notify the primary care provider of the clients lab value

When the client with pernicious anemia is asked why vitamin B12 injections are necessary, the nurse should provide which of the following responses? They contribute to teh increased production of RBCs after a significant blood loss Vitamin b12 is needed to prevent the RBC from sickling your stomach does not produce a substance needed for intestinal absorption of vitamin b12 Vitamin B12 is needed to prevent excessive production of RBC's

your stomach does not produce a substance needed for intestinal absorption of vitamin b12