Pharmacology Final Exam 1240

The physician orders potassium chloride (KCI) intravenous (IV) for the patient. The nurse administers this drug IV push. What will be the most likely outcome for this patient?

The patient will most likely experience cardiac arrest

The physician orders Metoprolol (Toprol-XL) for several patients. The nurse will hold the medication and contact the physicians for which patient?

The patient with chronic bronchitis

The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?

The patients cardiac status

A patient whose spouse recently died is having difficulty falling asleep and does not want to take any prescriptions to induce sleep. How should the nurse respond ?

There are alternative methods to treat insomnia, such as yoga, meditation, and massage therapy. Avoid caffeinated beverages. nicotine, and alcohol immediately prior to bedtime.

Integrase inhibitors and Fusion inhibitors are usually not the first drugs used for the therapy of HIV. They usually have less severe side effects, so what is the drawback to these drugs?

These drugs are very expensive

What are some of the protective mechanisms of viruses (virions) that make them so difficult to treat?

They are enclosed within a capsid They are resistant to exogenous antibiotics Their viral RNA is housed in an "envelope"

The patient in the emergency department is experiencing an acute myocardial infarction (MI). The nurse is administering reteplase (Retavase) intravenously. The patient asks the nurse what is being done. What is the best response by the nurse?

This medication is dissolving the clot that is causing your heart attack.

A patient is getting a new prescription of orlistat (Alli). The nurse is providing education about the medication and should include all the following EXCEPT?

This medication should be taken at least 2 hours before or after a meal.

The client with AIDS asks the nurse why he must take so many medications. What is the best response by the nurse?

To decrease the possibility of the virus developing resistance to the medications.

Following a myocardial infarction, elevations in which of the following cardiac markers would be seen first, and are cardiac tissue—specific?

Troponin I

The client receives methotrexate (Rheumatrex). The nurse assesses for side effects of this drug. Which side effects are a primary concern for the nurse?

Ulcerative stomatitis and diarrhea

The client has been diagnosed with Cushing's syndrome. What will the nurse's assessment likely reveal?

Upper body obesity

Amiodarone, a potassium channel blocker used for dysrhythmias, hs some serious side adverse effects. The nurse instructs the patient to report what symptoms immediately?

Urinary hesitancy

The nurse is managing the care of a group of patients with schizophrenia. The patients are receiving 1st generation antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

Urinary retention

The nurse is teaching an anemic patient about the possible side effects from Ferrous sulfate (Iron) supplements and interventions to reduce the severity. These include all the following:

Use a straw if taking the liquid form Increase your fiber and fluids in your diet Do not chew or crush tablets

Which of the following adverse effects would most likely be associated with the use of phenytoin (Dilantin)?

Ventricular dysrhythmias Gingival hypertrophy anemia

A patient is complaining of numbness and tingling, weakness, and pain in the feet and hands. The patient is on several chemotherapeutic agents. Which medication is the most likely cause?

vincristine (Oncovin)

A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient's spouse calls the clinic and reports the patient is increasingly moody and seems "disconnected with life." What is the best response by the nurse?

"Bring him to the clinic for assessment today."

The parent of a child being treated for ADHD says a neighbor child with the same diagnosis is on a "Drug Holiday." How should the nurse explain this treatment option?

"Drug holidays may be used to reduce tolerance of medications or to assess symptoms."

The client receives interferon alfa-2b (Intron-A) for treatment of Kaposi's sarcoma. Which question by the client would alert the nurse that additional assessment is necessary?

"I feel really sad; do I need to see a psychiatrist"

The nurse teaches the patient about digoxin (Lanoxin) toxicity and determines that learning has occurred when the patient makes which statements?

"If I have nausea and vision changes, I must call my care provider" "I will eat a banana or drink orange juice every morning to get my potassium" "I must check my pulse and not take the medication if it is less than 60"

The patient has generalized anxiety disorder. He asks the nurse, "Will I need medication for this? My neighbor is very nervous and he takes medication." What is the best response by the nurse?

"Managing anxiety without medications is preferred, but medication may be necessary when anxiety may cause harmful physical effects."

A parent says to the nurse, "The doctor prescribed ethosuximide (Zarontin) for my child, who has absence seizures. What does this mean? What is the best response by the nurse?

"Your daughter's seizures manifest as a staring into space for a few seconds. Ethosuximide (Zarontin) is a good medication for this type of seizure.

The nursing instructor teaches the student nurses about the endocrine system. The nursing instructor evaluates that learning has occurred when the student nurses make which statements?

*The pituitary gland secretes TSH *The endocrine system is the major controller of homeostasis *They hypothalamus is considered the master gland

You are teaching a client who has been diagnosed with epilepsy and starting on valproic acid (Depakene). In detail, what should you teach the client regarding this medication:

*This is a GI irritant, can cause sores in the mouth and gingival hyperplasia, and cause esophageal ulcers. Make sure to use good oral hygiene, avoid alcohol, coffee, and spicy foods. *It causes Bone marrow suppression so it is important to have blood labs drawn for RBC's, WBC's, and Platelets. Also, a CMP will be done to check for hepatic disfunction. *Pt. may have CNS depression so watch for dizziness, H/A, lethargy, fatigue, ataxia, sleep pattern disturbances, attention difficulties, and hiccups. **DO NOT use if pt. has severe liver or kidney disease.

The nurse plans to teach a client with HIV about zidovudine (Retrovir). What will the best plan by the nurse be?

*Zidovudine therapy frequently results in the development of anemia. *Zidovudine will slow the disease, but not cure it. *Zidovudine will need to be stopped if bone marrow suppression occurs.

The nurse is reviewing the tonicity of the different intravenous fluids on the medical surgical unit in preparation for an educational presentation. All of the following IV fluids are considered isotonic EXCEPT"

0.45% sodium chloride

An 80 y/o gentleman is brought to the emergency department who had collapsed while mowing his lawn. He is confused, lethargic, dry mucous membranes, an no urine output with a BP of 80/52. When labs are drawn, his sodium is 145 mg/dL. What initial treatment should the nurse expect?

0.9% normal saline at 150 cc/hr

The nurse is reviewing the steps of the negative feedback regulation of thyroid hormone. The nurse would place these steps in which sequence starting with #1.

1) Blood levels of thyroid hormone are low 2) Hypothalamus secretes TRH 3) The anterior pituitary secretes TSH 4) T3 and T4 are secreted by the thyroid 5) Secretion of TSH and TRH are suppressed. (1,2,5,4,3) on the exam...

When administering blood products, the nurse follows protocols and monitors for complications. Please list 3 nursing interventions required during blood administration.

1) Pt. is monitored often, take vital signs before and during administration 2) Start infusion slowly 3) watch for s/s: increased temp., lower back pain, SOB, rash. 4) Stop infusion if suspicion of allergic reaction, this includes removal of tubing as well and start NS.

The nurse begins a liter of D5W at 2200 to infuse over 8 hours. What rate of infusion per hour (mL/h), what is the completion time?

125 mL/h and 0600

Hyponatremia is marked by a serum sodium level less than:

135 mEq/mL

The nurse receives an order to administer Ampicillin Sodium 500 mg in 300 mL 0.9% NS to infuse over 40 min. Drip factor: 20 What is the drip rate in gtt/min?

300x20/40 = 150 gtt/min

A nurse is preparing to administer imipramine 200 mg PO daily divided equally every 12 hours. The amount available is imipramine 25 mg tablets. How many tablets should the nurse administer with each dose?

4

The IV order is as follows: 1000 mL D5W to run over 12 hours. How many mL/hr will the nurse set on the IV pump?

83 mL/hr

AIDS

A chronic, potentially life-threatening

Viral Load

A numerical expression of the quantity of virus in a given volume.

The nurse is caring for a group of patients on a medical surgical unit. For which patients would the nurse anticipate the need for intravenous fluid therapy to correct fluid depletion?

A patient with a severe burn A patient with uncontrolled diabetic ketoacidosis A patient exhibiting nausea and vomiting following s surgical procedure

The client receives cisplatin (Platinol), an alkylating agent, as therapy for cancer. Which assessment finding would prompt the nurse to contact the client's physician immediately?

A temperature greater than 101* F

Integrase

A viral enzyme that catalyzes the insertion of a viral DNA chromosome into the host chromosome and its subsequent excision.

HIV

A virus that attacks cells that

A patient is taking procainamide for dysrhythmias. After 3 months of therapy, the patient is seen for a follow-up on the medication. The nurse will expect the provider to discontinue the medication with what assessment finding?

A white blood cell count < 5,000 mm/dL

AZT used to be the drug of choice used during pregnancy. There is a new, better drug that can be started during the first trimester. What drug is this?

Dalutegravir (Tivacay)

The nurse is assessing a female patient who is about to start taking Chlorpromazine for schizophrenia. The nurse should include which screening test before starting the medication and continue throughout therapy?

Abnormal Involuntary Movement Scale (AIMS)

A client who has been taking a glucocorticoid for years for chronic obstructive pulmonary disease. When hospitalized for a hip fracture, the medication is accidentally omitted from continuing medications and he does not receive it for several days. What condition could this client develop due to the error?

Addison's Crisis

A nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder. Which of the following interventions should the nurse anticipate?

Administration of Thiamine

A nurse is assessing a client who has acute cocaine toxicity. Which of the following findings should the nurse expect?

Agitation Tachycardia Increased temperature

Biologic Response Modifiers such as interferon alfa-2b, can cause many adverse effects. These include all EXCEPT:

Alopecia

Lopinavir/Ritonavir (Kaletra), is one of the preferred drugs for initial treatment of HIV. It is usually well-tolerated compared to the other drugs. Two additional serum lab tests may be required to monitor for adverse effects of this drug.

Amylase or Lypase and Glucose

A client is diagnosed with bone cancer, and is placed on methotrexate (Mexate). What is the correct classification for this medication?

An antimetabolite

The nurse is teaching a client about the adverse effects of antineoplastic drugs. Which topics should the nurse include in the teaching session?

Anemia Fatigue Alopecia

In order to prevent complications such as an infection from Total Parental Feedings for a patient, the nurse knows that basic ? is of utmost importance:

Asepsis

A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform?

Assess blood glucose level Monitor for signs of infection Weigh the client daily

The client has hypothyroidism and is treated with levothyroxine (Synthroid), The nurse plans to do medication education. What will the best plan by the nurse include?

Assess blood levels in 6 weeks

The physician has ordered intravenous diazepam (Valium) for the patient in status epilepticus. During administration, which assessment by the nurse is most important?

Assessing respirations

A nurse is teaching a client who has a new prescription for lorazepam (Ativan). Which of the following information should the nurse include in the teaching?

Ativan can cause drowsiness and sedation. Do not drive until you know how it affects you.

Which drugs reduce heart's demand for oxygen by lowering heart rate?

Beta-adrenergic blockers and calcium channel blockers

The nurse will monitor the ? and Viral Load while a patient is diagnosed with HIV. Once the patient is diagnosed with AIDS and on antiretroviral drugs, the primary lab to monitor for effectiveness is the?

CD4 PTT

The nurse is preparing care for a patient diagnosed with substance abuse of a Schedule I drug. Which drugs could be implicated?

Cannabinoids LSD Heroin

The nurse is caring for a client who is receiving doxorubicin (Adriamycin). Which serious adverse effect will the nurse monitor this client for during the assessment?

Cardiac arrhythmia's

While talking with a patient about starting a new prescription to treat heart failure and hypertension, which should you include to help her manage the drug's adverse effects?

Change positions slowly

A client has been taking procainamide, a sodium channel blocker. The nurse knows the priority intervention before administering the medication is to:

Check the BP, HR and rhythm

Which food items should the nurse advise a patient taking a monoamine oxidase inhibitor (MOAI) to avoid?

Chocolate, Wine, and Sour Cream

In addition to pharmacologic treatment of mood disorders, insomnia, and anxiety, what other treatment must be included for optimal outcomes?

Cognitive and behavioral therapy

The patient is receiving quetiapine (Seroquel), an atypical antipsychotic. During morning assessment, the nurse notes that the patient has a temperature of 101 degree F and lead pipe rigidity. What is the priority nursing intervention?

Contact the physician, as this could be a symptom of neuroleptic malignant syndrome.

An important factor to consider when patients are not responding to prescribed pharmacologic therapy, or experiencing more frequent exacerbations of a chronic disorder is medication non-compliance. List 4 factors that could be the cause of non-compliance.

Cost of medication Frequency of taking the medication Lack of insurance or coverage Unwanted side effects Education Level

The nurse is preparing to administer nitroglycerine via the intravenous route. What must the nurse plan to do prior to administering this medication?

Cover the IV bottle to decrease light exposure

The nurse is teaching the client about the general goals of chemotherapy. What items should the nurse include in the teaching session?

Cure Control Palliation

A patient has severe hypomagnesemia and has been prescribed Magnesium Sulfate to be given intravenously. The nurse is aware that this medication requires careful observation to prevent toxicity. What assessment finding will prompt the nurse to stop the infusion and call the care provider?

Decreased DTR and Bradypnea

A nurse is caring for a client who has a prescription for risperidone (Risperidal). The nurse should monitor the client for which of the following manifestations as a therapeutic response to this medication?

Decreased auditory hallucinations and paranoia

A nurse is caring for a client who has just started therapy with alprazolam (Xanax), a benzodiazepine, to treat anxiety. The nurse should monitor the client for which of the following common side effects of this medication?

Dependence

The patient is started on efavirenz (Sustiva) for treatment of HIV. Besides resistance and lymphadenopathy, what other adverse effects will the nurse teach the patient about?

Dizziness, nightmares, and delusions

The nurse is administering phenobarbital (Luminal) to a patient who has had multiple seizures. Before administration, the nurse reviews nursing implications which includes all the following EXCEPT?

Do not give if respirations are above 14/min

Match the following terms with the correct definition:

Dystonia: lip smacking, wormlike movements Akathisia: inability to rest and relax; pacing Pseudoparkinsonism: tremor, muscle rigidity, stooped posture Tardive dyskinesia: muscle spasms of face, tongue sticking out

A client is to receive enteral nutrition through a nasogastric feeding tube. Which information should the nurse provide to the client and family?

Enteral feedings are chosen when you cannot swallow enough to maintain nutrition. Ensure that the tube does not dislodge

The client asks the nurse why cancer is difficult to cure. Which statement by the nurse is most important?

Every cancer cell must be removed or destroyed to cure cancer.

A client is undergoing antineoplastic therapy. The nurse, in an effort to minimize the toxic effects of therapy, administers which growth factor?

Filgrastim (Neupogen)

The patient comes to the emergency department after an overdose of lorazepam (Ativan). The nurse will plan to administer which medication?

Flumazenil (Romazicon)

Methotrexate (Rheumatrex) works by mimicking the nutrient :

Folic Acid

Regimen to follow if accidentally stuck with a contaminated needle and you found that the patient it was from was HIV positive:

Get checked at 6 wks., 12 wks., and 6 mos. Get checked again at 6 and 12 mos. to make sure you aren't carrying the HIV virus. You will need to be started on Truvada for 4 mos.

If a client is diagnosed with Primary Hyperthyroidism, what can the nurse determine as a probable cause?

Grave's Disease

The total parental nutrition (TPN) bag is empty and there is not another prepared bag to continue infusion. You call the pharmacy but it will not be ready for at least 15 minutes. What is the nurses best action?

Hang a bag of D10 until TPN is ready

A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Have another nurse witness the disposal of the extra medication.

A nurse is preparing to administer the monthly injection of chlorpromazine to a client who has schizophrenia. Which of the following actions should the nurse plan to take?

Have the client lie down for 30 min. after the medication is injected.

A male patient taking a monoamine oxidase inhibitor (MAOI) calls the nurse and reports severe headaches, tachycardia, and bounding pulse. Which instructions are appropriate from the nurse?

Have the patient call for emergency help.

The mother of an adolescent patient says to the nurse, "I think my teenage son is staying up to late studying. He seems listless, and I see him using eye drops all the time for his red eyes. Should I have his vision checked?" What is the best response by the nurse?

He could be smoking marijuana, would you like me to talk to him?

The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema. The nurse hangs a bag of hypotonic solution in error. What manifestations will the patient exhibit?

Headache, Irritability, and decreasing level of consciousness

Which of the following factors would need to be considered when administering IV fluids?

Heart Failure Electrolyte levels End stage renal disease Age

A 26 y/o female patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). What characteristics will the nurse expect to see with mania?

Hyperactivity and pressured speech

Match the correct electrolyte and acid-base imbalance with it's manifestation:

Hyperkalemia: Dysrhythmias, cardiac arrest Hypocalcemia: Tetany, positive Trousseau's Hypernatremia: Decreased level of consciousness Metabolic Acidosis: Hyperkalemia, Tachypnea Hypercalcemia: Decreased reflexes, kidney

A patient was admitted with Addison's disease. The nurse would expect all the following EXCEPT?

Hypertension

The client receives hydrocortisone (Solu-Cortef) therapy. The nurse will primarily assess for with electrolyte disturbance?

Hypokalemia and Hypocalcemia

The nurse has completed medication education for a patient prior to the patient receiving phenelzine (Nadal). The nurse evaluates the education is effective when the patient makes all the following statements EXCEPT?

I am really going to miss my morning coffee and sweet roll.

A patient has been prescribed corticosteroid therapy for the treatment of severe osteoarthritis. The nurse evaluates the teaching about this drug is understood if the patient makes which statements?

I will make sure I wash my hands frequently and avoid large crowds. I may get a little irritable with this medication.

The nurse is caring for a patient with a pH of 7.30 and in metabolic acidosis. Which medication would be appropriate to administer to a patient with this condition?

IV Sodium Bicarbonate

The nurse educator is teaching a patient about the difference between stable and unstable angina. The nurse knows the teaching is effective when the patient makes what statement?

If my chest pain is not relieved by rest or after 3 doses of Nitroglycerine, I must call 911

The nurse educates the client on possible side effects of chemotherapy. What should NOT be included in the teaching?

Increased RBC's

A nurse is caring for a client following a suicide attempt with opioids. The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurses priority?

Initiating suicide precautions

Zidovudine (AZT) is a nucleotide reverse transcriptase inhibitor (NTRI). The mechanism of action of these medications is:

It creates a "decoy" that blocks the reverse transcriptase from converting the viral RNA into DNA.

Before administering Nitroglycerine tablets, or paste to a patient, the nurse remembers some important nursing interventions learned in nursing school about this medication. These include the following EXCEPT?

It is important to hold the medication if the patient is hypertensive.

The patient has been receiving amitriptyline (Elavil), a tricyclic antidepressant, for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?

It is working, but it can take several weeks to notice effect.

A nurse notes that a clients laboratory findings reveal elevated liver enzymes. The client is taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should monitor the client for which of the following?

Jaundice and bleeding disorders

The physician has ordered intravenous phenytoin (Dilantin). The nurse does not read the drug label and administers this medication intramuscularly. What is the most likely response in the patient?

Local tissue damage following extravasation will most likely occur.

Your patient is being treated for acute Myocardial Infarction. In addition to reteplase, a thrombolytic, what other medications would you expect to be on the patient's medication administration record (MAR)?

Lorazepam or alprazolam

A patient is in the intensive care unit being treated for septic shock and receiving norepinephrine (Levophed) through a central line at 2 mcg/min. The nurse is monitoring the MAP for effectiveness and knows it is effective when:

MAP= Diastolic BP (2) + Systolic BP/3 A blood pressure of 94/58 (good perfussion)

A 5-y/o client who is immunosuppressed is getting his kindergarten immunizations. Which immunizations are contraindicated?

MMR, Varicella, and Rotavirus

The nurse is educating new nurses in the emergency department about treatment of hypovolemic shock, hemorrhage, and burns. After management of airway and breathing, what is the next priority action for these patients?

Maintain blood pressure with isotonic fluids

What formulas are disease-specific supplements that contain a single nutrient, protein, lipid, or carbohydrate?

Modular

When a patient is receiving IV therapy, no matter what the solution, what are the nurses responsibilities to avoid any complications?

Monitor BP, HR, LOC Check IV site for redness, tenderness, and patency Monitor for fluid overload Monitor for edema Monitor I&O's Monitor breath sounds

In addition to monitoring blood pressure and cardiac output when a patient is receiving norepinephrine (Levophed), what other nursing interventions are essential to prevent complications?

Monitor extremities for diminished pulses and color Monitor IV site for signs of extravasation Monitor telemetry continuously

The nurse is preparing to administer IV phenytoin (Dilantin) to a patient with tonic seizures. The nurse knows that important interventions are required to prevent complications from the drug.

Monitor telemetry Monitor for rash Monitor CBC for dyscrasias

Staticus Epilepticus

Most dangerous of seizures because it is a continuous seizure, doesn't give your body a chance to recover. For tx. give them O2, diazepam, and glucose to prevent hypoglycemia. We can also give them phenytoin to prevent further seizures. Loosen their clothing and watch their airway. Put them in the rescue side-lying position to protect them from aspirating.

Match the following categories of antipsychotic drugs with it's correct definition:

Most effective for positive symptoms: Typical Antipsychotics Treats both positive and negative symptoms: Atypical Antipsychotics

A client recently diagnosed with ovarian cancer is concerned about alopecia while taking cyclophosphamide (Cytoxan). Which response by the client reflects understanding of the teaching of cyclophosphamide (Cytoxan)?

My hair will probably grow back

A nurse is preparing to administer morphine IV to a client. Which of the following medications should the nurse plan to have available?

Naloxone

A patient with chronic stable angina is given two prescriptions, one to treat acute angina attacks only taken as needed and the other to prevent the occurrence of attacks taken daily. Which two medications would you expect to see prescribed?

Nitroglycerine tablets and Diltiazem (Cardizem)

Vinca Alkaloid, vincristine (Oncovin) is a natural product derived from the:

Periwinkle plant

The patient is receiving phenobarbital (Luminal) for seizure control. The patient asks the nurse how this little pill can stop his seizures. What is the best response by the nurse?

Phenobarbital stops your seizures by increasing a chemical called GABA that calms down the excitability in your brain.

The client receives cyclophosphamide (Cytoxan). The nurse evaluates the client's laboratory work. Which laboratory finding would support canceling the client's next treatment with this drug?

Platelet count of 8000/mm3

The patient is receiving Phenytoin (Dilantin) for control of seizures. The patient tells the nurse she plans to become pregnant. What is the best response of the nurse?

Please talk to your doctor; this drug is contraindicated in pregnancy.

What formulas are the most common type of enteral preparation containing various mixtures of proteins, carbohydrates, and lipids?

Polymeric

There are four different classifications of Antidysrhythmics with mechanisms of action that affect the conduction system of the heart. Match the following classifications with it's correct mechanism of action.

Procainamide (Class I): Slows conduction and repolarizes Amiodarone (Class III): Slows conduction and prolongs Propranolol (Class II): Blocks beta cells and slows conduction Verapamil (Class IV): Blocks calcium channels in

Besides bone marrow suppression, alkylating agents may also cause:

Pulmonary Toxicity and Sterility

A patient with the history of suicidal behavior with schizophrenia stopped taking an atypical antipsychotic medication after 4 weeks therapy. Reasons the nurse may suspect as to why the patient is non-compliant are all the following EXCEPT?

Relief of auditory hallucinations

The nurse is providing education to the family of a patient diagnosed with absence seizures and prescribed ethosuximide (Zarontin). What education is appropriate for this medication?

Report immediately any suicidal ideation or psychosis

A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching?

Report sudden weight gain or increased thirst.

The patient has heart failure and receives digoxin (Lanoxin). Prior to discharge, what will the best teaching plan by the nurse include?

Report visual changes to your care provider immediately Report a weight gain of 2 or more pounds per day Hold the medication if your pulse is 56

An older patient is taking phenobarbital (Luminal) for seizure control. What is most important for the nurse to assess in the patient?

Respiratory function

Which drug type is often used as a first-line treatment for depression due to it's side effect profile?

Selective serotonin reuptake inhibitors (SSRIs)

In addition to treating all shock initially with isotonic fluids to raise blood pressure, match the other expected treatment for each type of shock.

Septic Shock: Antibiotics Anaphylactic Shock: Epinephrine Neurogenic Shock: Spinal stabilization Cardiogenic Shock: Cardiac glycosides

A nurse is assessing a client who has a peripheral IV with a continuous infusion. Which of the following findings would NOT indicate a need to stop the infusion?

Site is non-tender

During the shift report, the charge nurse tells the oncoming nurse that she just hung a new 1000 mL IV bag of 0.9% normal saline for one of her patients about 30 min. ago. When the oncoming nurse checks the patient, she notes that the IV bag only has 400 mL left to infuse and rate is set for 1000 mL/hr when the ordered rate was 100 mL/hr. What action should the nurse take FIRST?

Slow or stop the infusion and listen to the patients lungs.

A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements?

Sodium and Water

The patient is receiving sodium bicarbonate intravenously for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse's priority action?

Stop the infusion and notify the physician; the patient is in alkalosis.

The client asks the nurse what the possible treatments for cancer are. Which responses by the nurse are appropriate?

Surgery, Chemotherapy, and Radiation

The nurse is caring for a client who experiences nausea and vomiting with each treatment of chemotherapy. What should the nurse advise the client to do to decrease nausea and vomiting?

Take antiemetic medications prior to treatment

The patient is dehydrated but has a normal BP. The new medical intern orders 3% NS intravenously for this patient. What is the best evaluation by the nurse regarding this order?

The intern should have ordered 0.45% sodium

The client has been prescribed levothyroxine. The nurse will provide all the following medication information EXCEPT?

Take this medication at whatever time you eat your evening meal.

A client with breast cancer is started on chemotherapy. Her daughter is started on the same drug prophylactically. The daughter is considered high risk for developing breast cancer. Which medication does the nurse anticipate hs been prescribed to both the client and her daughter?

Tamoxifen (Nolvadex)

The client receives Tamoxifen (Nolvadex) for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?

Tamoxifen works by blocking estrogen receptors on breast tissue.

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with haloperidol (Haldol). He notes the client is experiencing some involuntary movements of the tongue and face. the nurse should suspect the client has developed which of the following adverse effects?

Tardive dyskinesia

The client receives cyclophosphamide (Cytoxan) as treatment for cancer and is experiencing oral irritation as an adverse effect. What does the best plan by the nurse include as it relates to providing oral comfort?

Teach the client to avoid extreme temperatures of food selections.

Dextran 40 (Gentran 40) has been prescribed for non-emergency infusion. The nurse should plan to take all the following actions EXCEPT?

Teach the patient to avoid use of any over-the-counter herbal products.

A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram (Antabuse). The client reports having discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the client's distress?

The client consumed alcohol while taking the medication.

A nurse is assessing a client who has been taking sertraline (Zoloft) for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?

The client reports increase in mood.

The nurse assesses several clients for their potential risk for developing cancer. Which client does the nurse assess to be at highest risk for developing cancer?

The client who drinks alcohol daily and eats red meat at most meals.

The patient receives dextran 40 (Gentran 40). The patient starts coughing and blood pressure elevates. What is the best evaluation by the nurse?

The drug/fluid was infused too rapidly

The nurse explains to the client why combination therapy and special dosing schedules are used to treat cancer. Which client response indicates the need for further teaching?

The medications need to be given in higher doses when used in combination

The nurse teaches clients with acquired immune deficiency syndrome (AIDS) about the importance of taking their medications as prescribed. What does the nurse recognize as the primary factor for medication noncompliance in the AIDS population?

The necessity of having to take multiple medications throughout the day.

The patient has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the patient has also been prescribed a triptan (Imitrex) for migraines by another physician. The patient comes in to the office with symptoms of fever, tremors, and dilated pupils. Which statement best describes the result of the nurse's assessment?

The patient is experiencing symptoms of serotonin syndrome.

A nurse is assessing a client who has schizophrenia and is taking risperidone (Risperidal). Which of the following findings should the nurse expect?

Weight gain

Which common side effects of selective serotonin reuptake inhibitors (SSRIs), that may cause the patient to be noncompliant, would be included in the instructions for a patient just starting the medication?

Weight gain and sexual dysfunction

The nurse is providing teaching to a group of student nurses about the administration alerts for acyclovir (Zovirax). What would be correctly included in this presentation?

You may need to wake your patients up to take their dose Check the IV site often when administering IV

A client has been taking thyroid hormone replacement for several years. On today's clinic visit, the nurse remarks that the client has lost 20 lbs. The client states, "I was getting so fat, so I started taking an extra thyroid pill every day or so." How should the nurse respond?

You should follow the dosage instructions for your thyroid medication exactly as written, that could be dangerous for your health.

A nurse is providing administration instruction to the wife of a client going home on intermittent enteral nutrition. Which information should the nurse include?

You will need to flush the tubing prior to and after each feeding. You will need to check his blood sugar more frequently You will need to check residual before each feeding.

A patient who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep. What would be the most appropriate responses?

Zolpidem (Ambien)

Virulent

a pathogen's or microbe's ability...

A patient is experiencing an extrapyramidal adverse effect, is not able to relax. How would the nurse record this information in the medical record?

akathesia

Match the following immune-modulating drugs with their correct description.

aldesleukin (may cause cardiac effects...) interferon alfa-2b (Intron-A): May cause suicidal ideation

Tamoxifen works by:

blocking estrogen which is essential for tumor growth

The function of the thyroid gland is to:

control basal metabolism

Protease

enzyme that breaks down proteins

If extravasation of the antitumor antibody, bleomycin (Blenoxane) occurs, the nurse knows to quickly apply:

ice packs and cooling

The most important nursing consideration for clients receiving alkylating agents is:

monitoring CBC with differential