Pharmakon Solstice

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The nurse is caring for a client diagnosed with Parkinson disease receiving the following medications: levodopa and cardopa, pyridoxine, bromocriptine, and entacapone. The nurse should perform which assessment(s)? Select all that apply.

1: Alanine aminotransterase level (ALT) 2: Serum glutamic pyruvic transaminase (SPGT) level 3: Sclera and skin for yellowing 4: Presence of hallucinations

After teaching a group of students about tetracyclines, the instructor determines that the teaching was successful when the students choose which factor as a true statement? Select all that apply.

1: Are broad-spectrum antibiotics 2: May cause permanent discoloration of the teeth in children 3: Can be used when penicillins are contraindicated 4: Are used to treat Rocky Mountain spotted fever

A client with asthma is preparing to go home after being hospitalized with an acute attack with a new prescription for fluticasone/salmeterol inhalant. Which points should the nurse prioritize in the discharge teaching? Select all that apply.

1: Continue to carry a rescue inhaler 2: Check peak flow daily 3: Rinse mouth after each use

A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which actions would be appropriate for the nurse to include in the client's plan of care? Select all that apply.

1: Encouraging ambulation as tolerated 2: Promoting rest periods throughout the day as necessary

A nurse is teaching a client about the prescribed sulfasalazine. The nurse determines the teaching session is successful when the client correctly chooses which adverse reactions to be aware of when taking this medication? Select all that apply.

1: Headache 2: Reduced sperm count

A client with hyperlipidemia is prescribed cholestyramine. Which possible adverse reactions will the nurse point out when teaching the client about this drug? Select all that apply.

1: Malabsorption of vitamin K 2: Aggravation of hemorrhoids 3: Flatulence

A nursing instructor is conducting a class on heart failure and the events that occur. The instructor should point out that the increase in neurohormonal activity will result in which changes? Select all that apply.

1: Remodeling of the cardiac muscle cells 2: Hypertrophy of the heart 3: Increased need for oxygen 4: Cardiac necrosis

The nurse is completing an ongoing assessment of a client receiving erythromycin. The nurse would notify the primary health care provider immediately if assessment reveals which finding? Select all that apply.

1: Significant drop in blood pressure 2: Increase in heart rate 3: Increase in respiratory rate 4: Sudden increase in temperature

A nurse is reviewing the laboratory test results of a client who is receiving diuretic therapy. The nurse determines that the client is at risk for electrolyte imbalance based on which results? Select all that apply.

1: Sodium 124 mEq/L 2: Potassium 2.9 mEq/L Sodium levels below 132 mEq/L, such as 124 mEq/L, or above 145 mEq/L would indicate an imbalance. Potassium imbalances would occur with levels below 3 mEq/L, such as 2.9 mEq/L, or above 5 mEq/L. A magnesium level of 2 mEq/L is within the normal range of 1.5 to 2.5 mEq/L.

A nurse is assessing the serum digoxin level of a client who is receiving treatment for atrial fibrillation. Which result should the nurse prioritize and report to the primary health care provider?

2.2 ng/mL A serum digoxin level of more than 2 ng/mL would require the nurse to report to the primary health care provider; therefore, serum digitalis levels of 2.2 ng/mL indicate digoxin toxicity. The therapeutic levels range from 0.5 to 2 ng/mL.

A nursing instructor is teaching a class illustrating the various reactions to antivenins. The instructor determines the class is successful when the students correctly point out clients may react within which time period if they are sensitive to an antivenin?

30 minutes

The nurse is evaluating the medical records of several clients and note some are receiving both fluoroquinolone and corticosteroid therapy. The nurse concludes which client is at the greatest risk for tendonitis?

79-year-old-male

The nurse notes a client who is receiving naloxone suddenly goes from sleepy and calm to grimacing, moaning and drawing their legs up to the abdomen. The nurse determines which nursing diagnosis is most appropriate?

Acute Pain

The nurse is completing a preadministration assessment on a client with tuberculosis who is to start pyrazinamide. The nurse should question giving this drug after discovering which factor in the client's medical record?

Acute gout

The client is reporting GI disturbances after receiving the first dose of carbidopa/levodopa for Parkinson disease. Which action should the nurse prioritize for this client?

Administer the next drug dose with meals

Which factors should be included in the nurse's preadministration assessment prior to administering a penicillin to a client? Select all that apply.

Allergy history Medical history Medication history Current symptoms

While obtaining a medication history on a 48-year-old client who is to receive penicillin for an ear infection, the nurse learns the client takes a beta-adrenergic blocker for hypertension. The nurse develops appropriate nursing goals as this client is at increased risk for which adverse reaction if penicillin is administered?

Anaphylactic shock

A nurse is preparing to administer methotrexate to a client. The nurse determines close monitoring is warranted if the client is also administered which drug? Select all that apply.

Aspirin Diclofenac Ibuprophen Sulfamethoxazole/trimethoprim

The nurse is assessing the records of a client in preparation to administer an antiepileptic and notes the new order for periodic complete blood counts. Which new medication does the nurse prepare to administer? Select all that apply.

Carbamazepine Felbamate

A nurse is caring for several pediatric clients. The nurse would question an order for aspirin for a client with which disorder?

Chickenpox

A nurse is caring for a client with iron deficiency anemia who is receiving iron supplements. What information should the nurse point out in the teaching plan for this client?

Color of stools will become darker

A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment?

Complete blood count

A client is receiving an opioid analgesic following abdominal surgery. On assessment the nurse notes the client has been in a chair, ambulating with assistance, fluids and food intake is good with active bowel sounds with minimal bowel movement. Which nursing diagnosis would be most appropriate?

Constipation

A nurse is preparing to teach a client about the prescribed verapamil. The nurse would alert the client to the possibility of which adverse reactions as most common? Select all that apply.

Constipation Headache

A client is admitted to the emergency department with a severe headache, nausea, shortness of breath, and blood pressure of 200/120 mm Hg. Which response should the nurse prioritize?

Continuously monitor the client's status

A client has been receiving a diuretic as prescribed. Which findings on the ongoing assessment should the nurse prioritize? Select all that apply.

Dry mouth Muscle cramps Tachycardia

The nurse is assessing a client with thrombotic stroke after administering ticlopidine. Which finding should the nurse prioritize?

Dyspepsia

When assessing the medical records of several clients who are prescribed sulfonamide therapy, the nurse would expect laboratory findings related to which bacteria? Select all that apply.

Escherichia coli Klebsiella pneumoniae Staphylococcus aureus

A client presents to the clinic with a cough that is getting worse. The client reports having used over-the-counter dextromethorphan. Which findings on assessment should the nurse prioritize after noting the client is prescribed phenelzine? Select all that apply.

Fever Coma

After administering diphenoxylate to a client, the nurse would assess the client closely for increased CNS depression if the client was also prescribed which medication? Select all that apply.

Fexofenadine Zolpidem Temazepam

A client with congestive heart failure and currently administered digoxin is now prescribed indapamide for edema. Which intervention should the nurse prioritize?

Frequently monitor the client's pulse rate and rhythm

A nurse is preparing to administer NSAID therapy to a client. The nurse would be alert to a decrease in the effectiveness of which drug if given together? Select all that apply.

Furosemide Lisinopril

A nursing instructor is preparing to teach about clindamycin. Which disorders should the instructor point out as a potential contraindication and requires cautious use? Select all that apply.

GI disorders Myasthenia gravis Hepatic impairment

A nurse is preparing to administer bicarbonate to a client who is also prescribed fluoroquinolones. Which potential situation will the nurse carefully monitor the client for after administering these two drugs?

Increased risk of crystalluria

A nurse is explaining the actions of NSAIDs to a client. Which factor would the nurse integrate into the description as a mechanism by which NSAIDs elicit their effects? Select all that apply.

Inhibition of prostaglandins Inhibition of cycloooxygenase-1 Synthesis of cyclooxygenase-2

A nurse is preparing to administer insulin to the client. Which interventions should the nurse perform before administering each insulin dose?

Inspect the previous injection site for inflammation

The nurse is preparing a client for the initial treatment phase for tuberculosis. Which antitubercular drugs will the nurse anticipate teaching the client? Select all that apply.

Isoniazid Rifampin Pyrazinamide Ethambutol

A client is receiving allopurinol. Which instruction would be most important for the nurse to include in the client's plan of care?

Liberal fluid intake

A nurse is assessing a client's pain. When reporting the assessment findings to the primary health care provider which details would be most important for the nurse to report? Select all that apply.

Location Intensity

A client with allergies reports increased sedation after the initiation of chlorpheniramine. Which medications should the nurse point out as alterative medications for this client? Select all that apply.

Loratadine Cetirizine

A client has arrived to the clinic and is requesting an update on immunizations. The nurse will point out the client may not be able to have any vaccines due to which current prescribed medication? Select all that apply.

Methylprednisolone Prednisolone Paclitaxel Vinchristine

A family member brings a client to the urgent care center for assessment of the flu, stating various OTC drugs are not working. After an assessment, the nurse suspects acute acetaminophen toxicity based on which findings? Select all that apply.

Nausea Jaundice Cardiac Arrhythmias Confusion

The nurse is providing care to a client who is receiving an aminoglycoside and cephalosporin. Which assessment is a priority of care?

Nephrotoxicity

The health care provider has prescribed pravastatin for a client. The nurse should question this order, if the client is currently prescribed with additional medication? Select all that apply.

Niacin Clarithromycin Verapamil

A nurse is assessing a client's serum theophylline level and notes it is 7 mcg/L. After assessing the client's medical record, which drugs should the nurse question? Select all that apply.

Nicotine Phenytoin Ketoconazole

A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which ongoing assessments should the nurse prioritize when caring for this client?

Observe the client for hypoglycemic episodes

A client with seizures is prescribed phenytoin. Which assessment should the nurse prioritize?

Obtain serum plasma drug levels regularly

A client is prescribed probenecid. When assessing the client's medical record, the nurse will question administering this drug if the client is currently taking which additional drug? Select all that apply.

Phenobarbital Diazepam Diclofenac Acyclovir

A nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines that the class has been successful when the class correctly chooses which point as true?

Physical activity raises HDL cholesterol levels

A client receiving antiarrhythmic therapy develops a new arrhythmia potentially due to the administration of the drug. The nurse predicts this is related to which reaction?

Proarrhythmic effect

A client suffers from motion sickness. Which drug would the nurse anticipate the primary health care provider to prescribe? Select all that apply.

Promethazine Diphenhydramine

A nurse is assessing a client with angina who has received diltiazem. Which finding should the nurse prioritize and notify the health care provider for further instructions?

Pulse rate is 45 beats per minute The nurse should withhold the drug and notify the health care provider when the client's pulse rate is 45 beats per minute. When calcium channel blockers are administered, there may be a fall in the pulse rate. When the pulse rate falls below 50 beats per minute, the nurse should notify the health care provider. When the systolic pressure falls below 90 mm Hg, the nurse should notify the primary health care provider. Weight gain, and not weight loss, occurs with the use of calcium channel blockers. The nurse should report weight gain. Lightheadedness is a common central nervous system adverse reaction occurring after taking the drug, and the nurse should instruct the client to lie down until the symptoms pass.

A client receiving aminophylline reports heartburn on assessment to the nurse. What is the best response by the nurse?

Raise the head of the bed

A nurse is preparing to administer oprelvekin to a client. The nurse would administer the drug cautiously to the client if which disorder is noted on the preadministration assessment? Select all that apply.

Renal failure Heart failure Atrial fibrillation

A client with chronic pain has been prescribed an epidural analgesia. Which possible reaction should the nurse prioritize for treatment?

Respiratory depression

An opioid-naïve client experiences acute pain after surgery and is prescribed opioid therapy. The nurse would be especially alert for the development of which reactions?

Respiratory depression

An older adult client experiencing seizures is prescribed diazepam. Which assessment should the nurse prioritize?

Respiratory rate and depth

A nurse is caring for a client who is prescribed omeprazole and a benzodiazepine. Which assessment finding should the nurse prioritize?

Risk for toxic level of benzodiazepines

A nurse is teaching a client about the use of a PCA infusion pump. The nurse determines the teaching is successful when the client correctly indicates which factor about the system?

The control button activates administration of the drug

The nurse is explaining to a client the proper way to take extended release fluoroquinolone. Which instruction would be most important to include in the client's teaching plan?

To swallow the medication whole

The nurse is providing care to a client with diabetes who is receiving sulfonamides. The nurse counsels the client about the increased risk of hypoglycemia, especially if the client is taking which medications? Select all that apply.

Tolbutamide Chlorpropamide

The nurse administers rifampin to a 45-year-old client with tuberculosis. The nurse would monitor the client for which potential adverse reaction?

Vertigo

A nurse is caring for a client during antineoplastic drug therapy and determines a nursing diagnosis of Impaired Tissue Integrity is appropriate. Which action would be appropriate for the nurse to suggest during the teaching session?

Wear loose protective clothing

A nurse is monitoring a client prescribed dextran IV. Which finding on the ongoing assessment will the nurse prioritize?

Wheezing

The nurse is preparing to administer the next dose of methsuximide to a client experiencing partial seizures. The client remarks about hoping their stomach will do better this time. Which suggestion from the nurse will best assist this client when administering this next dose?

With some food or milk


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