Safety Test
which of the following interventions should be included in the medical management of Crohn's Disease
using long-term steroid therapy
Which of the following medications is available in "sprinkles" (making it easier to administer to children)
valproic acid
A nurse is caring for a client in liver failure with ascites who is receiving spironolactone (Aldactone). Which of the following outcomes should the nurse expect from the client's medication therapy?
Increased sodium secretion
The administering furosemide to your patient who has CHF, the nurse would assess?
electrolyte levels, blood pressure, and LS
A client with CHF is being discharged on digoxin, furosemide, spironolactone, and a low sodium diet. Which statement indicates the need for further teaching? "I should...
weigh myself daily and go on a diet if I gain more than a couple of pounds
Why is it necessary for clients to avoid alcohol intake when taking barbiturates?
Additive effect - CNS depression
A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin, Pantoprazole, and Clarithromycin. Which statement made by the nurse correctly explains the purpose of these medications?
The medicines will stop the acid production and kill the bacteria
Which of the following medications is considered a thrombolytic?
alteplase
which classification of medications play a pivotal role in the management of heart failure due to systolic dysfunction
angiotensin converting enzyme inhibitors
A client with a history of TIA has an order for aspirin 160 mg daily. When administering the medications, the client says, "I don't need the aspirin today. I don't have aches or pain." The nurse...
explains that the aspirin is ordered to decrease stroke risk
What are predictors of poor HIV medication adherence
financial, compliance, life-long therapy (commitment), side effects
Which adverse reaction si the nurse concerned with when administering Vancomycin?
flushing of the face, neck, and chest
Sucralfate (Carafate) achieves therapeutic effect by:
forming a protective barrier around gastric mucosa
Which of the following medications is used for partial seizures, restless leg syndrome, and neuralgia?
gabapentin
Digoxin toxicity is most likely to develop in clients receiving digoxin in combination with:
potassium wasting diuretics
Which medication should the nurse anticipate administering first to a child in status epileptics?
Administer rectal diazepam
You are working in the ED caring for a client who has just been admitted with left anterior chest pain, possible ACS. Which action will you take first?
Administer sublingual nitroglycerin
A nurse is caring for a client who is receiving the muscle relaxant vecuronium for ARDS. Which of the following medications should the nurse anticipate administering with the medication (select all that apply)
Fentanyl (sublimaze), Midazolam (Versed)
The nurse is preparing to administer warfarin (Coumadin), an oral anticoagulant, to a patient with mechanical valve replacement. The patient's INR is 2.7. Which action should the nurse take?
Administer the medication as ordered.
a nurse is caring for a client who is receiving esomeprazole. Which of the following best indicates the desired therapeutic effect?
"I don't have pain in my stomach"
Teaching has been effective on the use of atenolol (Temormin) for angina by which statement?
"It is important not to suddenly stop taking the atenolol"
The nurse needs to know that the therapeutic range for phenytoin is?
10-20mcg/mL
What effect do NSAIDs have in treating kidney stones?
Anti-inflammatory response
List various anti platelet aggregators. What do they do?
Aspirin, Plavix. Prevent clots. H/H, Platelets
A nurse is teaching a client who takes furosemide (LASIX) and has a serum potassium level of 3.2 mEq/mL. Which of the following foods should the nurse tell the patient to include in his/her diet?
Bananas
A client is prescribed valproic acid for seizure control. The nurse must check other meds the client is taking because which adverse effect can occur?
Bleeding (anticoagulants)
Following surgery for closure of ASD (atrial septal defect), the nurse expects which of the following medications to prevent clots from forming on the repaired area?
Clovidogrel
high dose prednisone is given to a child with juvenile idiopathic arthritis. The nurse will monitor for the development of?
Diabetes
side effects of loperamide (Imodium) include all of the following except?
Diarrhea
A client with BPH taking 5-alpha-reductase inhibitors may experience what severe psychosocial side effects?
ED and gynecomastia
While caring fora client with acute respiratory distress syndrome (ARDS), the nurse will: (select all that apply)
Elevate the head of bed 45-90 degrees, cluster client's ADL's together, assess lung sounds.
The patient with a VSD (ventricular septal defect) may be prescribed which medication to alleviate pulmonary edema?
Furosemide
A nurse is teaching medication safety to a group of healthy older adults at a community center. The nurse explains that due to the high frequency of food-drug interactions, the clients should avoid taking their medications with which of the following?
Grapefruit Juice
When taking Carbamazepine, what fluid places the client at risk for drug toxicity?
Grapefruit Juice
Which of the following baseline laboratory data should be established before a client is started on tissue plasminogen activator or alteplase recombinant
Hbg, Hct, and Platelet count
As a home health nurse obtaining an admission history on a client who has deep vein thrombosis and is taking warfarin 2 mg daily, which statement indicates more education is needed?
I have started to eat more healthy foods like green salads and fruits
What is the only route of administration Mannitol can be given?
IV
Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD) - select all that apply
Lansoprazole (Prevacid), Rabeprazole (AcipHex), Esomeprazole (Nexium)
Patient diagnosed with hypo plastic left heart syndrome would be prescribed alprostadil for which reason?
Maintain patency of DA
A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen?
One oral anticonvulsant medication to observe effectiveness and minimize side effects
To prevent shock and syncope in a client diagnose with kidney stones, the nurse would administer what medication?
Opioids
For a client receiving a continuous heparin infusion for a DVT, the infusion rate will be adjusted according to the:
PTT
A client who has had a Transient Ischemic Attack (TIA) has been placed on aspirin therapy every day. The nurse relates the expected outcome is prevention of...
Platelet aggregation
Whenever the nurse is caring for clients who are receiving heparin, which of the following medications should the nurse have on hand in the event of an overdose?
Protamine Sulfate
A nurse is caring for a client who is recovering from surgical placement of an artificial heart valve and is to be started on warfarin (Coumadin) prior to discharge. Which of the following diagnostic tests should the nurse use to monitor the effect of this therapy?
Prothrombin Time (PT)
A nurse is caring for a client who is recovering from surgical placement of artificial heart valve and is to be started on warfarin (Coumadin) prior to discharge. Which of the following diagnostic tests should the nurse use to monitor the effect of this therapy?
Prothrombin Time (PT)
A client realizes they forgot to take their anticonvulsant medication. What should they do?
Take it asap!
A nurse is caring for a client who is hospitalized with deep vein thrombosis and has been on IV heparin for 5 days. The provider prescribes oral warfarin (Coumadin) without discontinuing heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate nursing response?
The Coumadin takes several days to work, so the IV heparin will be used until the Coumadin reaches a therapeutic level
The nurse understands the purpose of administering dexamethasone to a patient w/ ARDS is?
The medication is given to decrease inflammation
Your patient with RA is taking prednisone and naproxen. What is most important to report to HCP?
The patient has stools that are very dark.
The nurse completes an assessment and health history for an HIV-positive patient considering starting highly active retroviral therapy (HAART). Which patient information is of most concern?
The patient states they are not consistent about taking medications
A patient is receiving enoxaparing (Lovenox) and warfarin (Coumadin) therapy for VTE. Which lab value indicated that anticoagulation is adequate and enoxaparin (Lovenox) can be discontinued?
The patient's international normalized ratio (INR) is 2.5.
Digoxin (Lanoxin) improves cardiac output by increasing intracellular calcium in the heart, which improves the contractility of the ventricles. (T/F)
True
During a home visit to an 88 year old client who is taking digoxin (lanoxin) 0.25 mg daily to treat heart failure and atrial fibrillation, you obtain this assessment information. Which finding is most important to communicate to your healthcare provider.
Vision that is becoming "Fuzzy"
A child is recently prescribed levetiracetam. The nurse understands which of the following medications would be prescribed to minimize the side effects of this drugs.
Vitamin B6
Which of the following drugs is the antidote to Coumadin (warfarin)
Vitamin K
A nurse is providing information about probiotic supplements to a client with inflammatory bowel disease. Which of the following information should the nurse include? Probiotics... (select all)
are microorganisms that are normally found in the GI tract, are used in patients with C-diff, can cause bloating and increased flatulence
A client who has been started on the beta-1 agonist dobutamine needs to be monitored for which adverse reaction?
arrhythmias
The nurse should assess the patient taking non-selective BB for which side effect
bronchospasm
A nurse is teaching a client who is taking sucralfate for PUD has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?
allow a 2-hour interval between these medications
The nurse teaching the client using transdermal nitroglycerin patches to:
best be placed at the same time each day
Histamine2-receptor antagonists:
compete with histamine for binding sites on the parietal cells
the nurse knows an expected outcome of beta adrenergic blocking agents is:
decreased myocardial oxygen consumption
The nurse knows the therapeutic effect of metoprolol (Lopressor) for a patient with MI is?
decreased resting heart rate
Nifedipine (Procardia) is prescribed for a client with newly diagnosed Prinzmetal's (variant) angina. When teaching, the nurse includes information that Nifedipine will:
decrease spasm of the coronary arteries
In evaluating the effectiveness of Nadolol (Corgard), which is prescribed for a patient with Coronary Artery disease, the nurse would expect:
decreased heart rate, decreased blood pressure, and relief of chest pain
A client has a history of CHF and takes digoxin (Lanoxin) and furosemide (Lasix). The nurse evaluates a digoxin (Lanoxin) level of 3.96 ng/mL and potassium level of 3.0 and...
holds the medications and contact the primary health care provider
The nurse is collecting a client's medication history who has GERD. Which medication below is not typical used to treat GERD?
hydroxyzine
What would a client with BPH taking Alpha-adrenergic receptor agents expect to experience and why?
increase urine flow and decrease of symptoms
What major complications associated with immunosuppression therapy should a nurse monitor a patient for?
infections, bone marrow suppression, cancer, hepatic toxicity, renal failure, pulmonary edema
During anticoagulant therapy, the nurse monitor the client for which common undesirable effect?
internal and superficial bleeding
The nurse recognizes the drug classifications used in the treatment of angina are: (select all)
nitrates, calcium channel blockers, beta blockers
You have given morphine sulfate 4mg IV to a client who has an acute MI. When you evaluate the client's response 5 minutes after giving the medication, which findings indicate a need for immediate action?
persisting pain at a level of 2 (on a scale of 1-10)
HIV medication enfuviritide, a fusion inhibitor, has what mechanism of action?
prevents virus from attaching to cell membrane
It is important to teach the patient what assessment prior to taking their digoxin
radial pulse and hold for HR <60
medical management of cardiac failure, whether is it right-sided or left-sided, demonstrates similar methodology. Measure such as dietary modifications, lifestyle changes, medications to reduce dyspnea, and relieve anxiety, etc. are all used with one primary infection. What is the primary goal in the medication management of heart failure?
reducing cardiac workload
disease-modifying antirheumatic drugs (DMARDs) suppress the immune system's response to RA that causes pain and inflammation. Methotrexate is a first line choice of drug for long-term use. List 2 serious adverse effects:
renal toxicity, birth defects, anaphylactic shock
After successful digitalization, a client is to being oral maintenance of digoxin (Lanoxin) and furosemide (Lasix) for control of CHF. To prevent digitalis toxicity, the nurse understands that it is most important to monitor the client's...
serum potassium
which laboratory value would alert the nurse caring for a client taking spironolactone to take further action?
serum potassium level of 5.2 mEq/L
NSAIDS used initially for RA can cause GI disturbances. Nursing education regarding NSAID should include:
take with food, monitor for bleeding, N/V/D, constipation
A patient is admitted to the medical surgical unit with a census thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin (Coumadin). The patient asked the nurse why two medications are needed. Which response by the nurse is accurate?
the Lovenox will work immediately, but the Coumadin takes several days to reach its full effect
