PREPU CH3
An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?
Drugs cause unexpected or unacceptable reactions despite screening and testing.
A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?
Inspect the client's mucous membranes. Monitor the client's blood cell counts. Monitor the client's potassium levels.
A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion? The client's fasting blood glucose level The client's body mass index and hydration status The client's albumin, bilirubin, AST and ALT levels The client's blood urea nitrogen level and creatinine clearance rate
The client's blood urea nitrogen level and creatinine clearance rate
An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?
This may be coincidental, and the memory loss may be attributed to changes with aging.
An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?
toxicity
A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?
"I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."
The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?
20-year-old female client who has been diagnosed with a chlamydial infection
The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?
Ask the client, "What happens when you take a dose of tetracycline?"
What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?
Be sure to drink plenty of fluids to prevent dehydration.
A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?
Discontinue the drug immediately as ordered.
A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?
Elevated aspartate aminotransferase (AST) level
A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?
It is necessary to ensure that the client's drug levels are therapeutic but not toxic.
A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?
Monitor laboratory blood values.
A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?
Parkinsonian symptoms
A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan? The need for follow-up blood tests The importance of a low-stimulation environment Safety measures Educating about the signs and symptoms of stroke
Safety measures
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? The man may be experiencing nephrotoxic effects of aspirin The man may be experiencing liver toxicity from the aspirin The man may be experiencing a paradoxical effect of aspirin The man may be allergic to aspirin
The man may be experiencing nephrotoxic effects of aspirin
The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?
a decrease in urine output
Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?
anaphylactic
The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?
anaphylactic shock
For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?
cardiac monitoring
A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:
damage the immature nervous system of the fetus.
What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?
decreased glomerular filtration rate.
A client began a new medication 4 days ago and has been reporting increasing malaise for the past 72 hours. The nurse is reviewing the client's most recent laboratory findings. What findings should suggest the possibility of a cytotoxic reaction? (Select all that apply.) decreased hematocrit decreased leukocytes increased liver enzymes decreased potassium
decreased hematocrit decreased leukocytes increased liver enzymes
When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:
hyperglycemia.
What would the nurse expect to assess if a client develops neuroleptic malignant syndrome?
hypertension
A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?
ototoxicity from the ibuprofen
The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:
potassium levels.
The nurse is preparing to administer antineoplastic medication to a client with cancer who has been receiving these medications for several days. When monitoring for potential adverse effects of this medication, the nurse should perform what assessments? (Select all that apply.)
renal injury
When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of: hypersensitivity. primary actions. drug allergy. secondary actions.
secondary actions.
A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention? regular changes to the administration route frequent administration of scheduled "drug holidays" serum drug level monitoring half-life analysis
serum drug level monitoring
Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.
skeletal and limb abnormalities central nervous system alterations heart defects
When assessing a client who has developed an anaphylactic reaction, what would the nurse expect to find?
Difficulty breathing
Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? Select all that apply.
a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating
A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:
grapefruit
A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse? "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately." "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression." "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication." "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately."
"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."
A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?
"Allergic reactions happen after your body has been sensitized to a drug in the past."
The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?
"Do you remember what happened the last time you received penicillin?"
A client develops a cytotoxic reaction to a drug. What would the nurse expect to do?
Discontinue the drug immediately as ordered.
A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize? Administer subcutaneous epinephrine as prescribed. Administer naloxone as prescribed. Initiate emergency resuscitation measures. Provide supportive care to manage fever and inflammation.
Provide supportive care to manage fever and inflammation.
A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client? The importance of sitting upright while eating and for 30 minutes afterwards The rationale for taking probiotics for the duration of treatment The rationale for prophylactic antibiotics Techniques for providing safe and effective mouth care
Techniques for providing safe and effective mouth care
A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?
The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.
Preoperative atropine belongs to what classification of drugs?
anticholinergic
The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize? asking the client what the client's response is to taking NSAIDs assessing the client's pain tolerance and expectations for pain control asking if the client has tolerated narcotics and acetaminophen in the past assessing the client for signs and symptoms of inflammation
asking the client what the client's response is to taking NSAIDs
The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize?
aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels
The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:
poisoning.