vATI Pharmacology

A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching? "Glucosamine can help relieve urinary frequency." "Glucosamine is used to treat viral infections." "Glucosamine can help relieve hot flashes." "Glucosamine can suppress joint inflammation."

"Glucosamine can suppress joint inflammation." The nurse should include in the teaching that glucosamine suppresses joint inflammation and cartilage degradation by stimulating the activity of chondrocytes.

A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? "I won't pass gas as often now that I am taking this medication." "I will take this medication each morning with my breakfast." "I have an increased risk of getting pneumonia while taking this medication." "I will need to take a daily stool softener while taking this medication."

"I have an increased risk of getting pneumonia while taking this medication." The client taking esomeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? "If I get a rash from this medication, I will take my usual antihistamine." "I need to increase my fluid intake while taking this medication." "I should take this medicine on an empty stomach." "If I get a fever while taking this medication, I will take some aspirin."

"I need to increase my fluid intake while taking this medication." Clients who have gout should increase their fluid intake to 2 to 3L per day to prevent toxicity of allopurinol and decrease uric acid levels.

A nurse is providing teaching to a client who has a new prescription for clopidogrel. Which of the following statements by the client indicates an understanding of the teaching? "I will stop taking this medication 2 days prior to a scheduled surgical procedure." "I will have my bleeding times checked daily for the first 5 days of taking this medication." "This medication might cause me to become constipated." "I should notify my provider if I notice any unexplained bruising."

"I should notify my provider if I notice any unexplained bruising." Clopidogrel can cause clients to bruise more easily. The client should report any unexplained bruising to the provider.

A nurse is providing teaching to a client who has been prescribed sucralfate. Which of the following client statements demonstrates an understanding of the administration of the medication? "I will take my antacid with my sucralfate." "I will take my sucralfate with milk." "I will take my sucralfate before meals." "I will take my sucralfate with my digoxin."

"I will take my sucralfate before meals." Sucralfate should be administered on an empty stomach 1 hr before meals and at bedtime.

A nurse is providing teaching to a client who has a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching? "I should avoid eating food that is high in potassium." "I will take this medicine before I go to bed." "I will take this medication with food." "I should take ibuprofen if I experience muscle aches."

"I will take this medication with food." The client should take furosemide with food to minimize gastric upset.

A nurse is evaluating teaching on a client who has a new prescription for Montelukast to treat asthma. which of the following statements by the client indicates an understanding of the teaching? "I'll rinse my mouth after taking this medication." "I'll take this medication when I get an asthma attack." "I'll take this medication once a day in the evening." "I'll use a spacer device when I inhale this medication."

"I'll take this medication once a day in the evening." Montelukast, a leukotriene modifier, is used to prevent asthma exacerbations. The client should take it on a daily basis once a day in the evening.

A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin (Nitrostat) to treat angina pectoris. Which of the following instructions should the nurse include? "Place the tablet under your tongue, and then take a small sip of water." "The medication can take up to 15 minutes to take effect." "Avoid taking the medication prior to exercising." "Stop taking the medication and notify your provider if you develop a headache."

"Place the tablet under your tongue, and then take a small sip of water." A client who takes a sublingual medication should place it under his tongue. A sip of water can help the medication dissolve.

A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. Which of the following instructions should the nurse include? "Take daily to prevent headaches." "Chew tablet well before swallowing." "Report swelling of eyelids after dosage." "Repeat dose in 1 hour for unrelieved headache."

"Report swelling of eyelids after dosage." The client should report swelling of eyelids and lips to provider, which can indicate an allergic reaction to this medication.

A nurse is providing teaching to a client who has a new prescription for furosemide. Which of the following instructions should the nurse include? "You should expect to experience weight gain." "You should have your potassium level monitored." "You should not crush this medication." "You might develop high blood pressure."

"You should have your potassium level monitored." The nurse should instruct the client to have their potassium levels monitored because furosemide can cause potassium loss and hypokalemia.

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Glucocorticoid medications Dextrose 5% in 0.45% sodium chloride Oral hypoglycemic medications 0.9% sodium chloride IV bolus

0.9% sodium chloride IV bolus The nurse should expect a prescription for an IV bolus of 0.9% sodium chloride to be administered at 15 to 20 mL/kg/hr for the first hour to restore volume and maintain perfusion to the vital organs.

A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 1L to infuse at 100 mL/hr. The nurse is using microtubing. The nurse should set the manual IV infusion to deliver how many gtt/min?

100 gtt/min

A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5 mg/kg PO every 12 hr for 5 days. The client weights 88lb. How many mg should the nurse administer per dose?

200mg

A nurse is preparing to administer dextrose 5% in water (d5w) 150 ml IV to infuse over 3 hr. The drop factor of the manual iv tubing is 10 gtt/ml. The nurse should set the manual iv infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. use a leading zero if it applies. Do not use a trailing zero.)

8 gtt/min STEP 1: What is the unit of measurement the nurse should calculate? gtt/min STEP 2: What is the volume the nurse should infuse? 150 mL STEP 3: What is the total infusion time? 3 hr STEP 4: Should the nurse convert the units of measurement? Yes (min does not equal hr) 1 hr/60 min = 3 hr/X min X = 180 min STEP 5: Set up an equation and solve for X. Volume (mL)/Time (min) x drop factor (gtt/mL = X 150 mL/180 min x 10 gtt/mL = X gtt/min X = 8.3333 STEP 6: Round if necessary. 8.3333 = 8STEP 7: Reassess to determine whether the amount to administer makes sense. If the prescription reads D5W 150 mL IV to infuse over 3 hr, it makes sense to administer 8 gtt/min. The nurse should set the manual IV infusion to deliver D5W IV at 8 gtt/min.Dimensional AnalysisSTEP 1: What is the unit of measurement the nurse should calculate? gtt/min STEP 2: What is the quantity of the dose available? 10 gtt/min STEP 3: What is the total infusion time? 3 hr STEP 4: What is the volume the nurse should infuse? 150 mLSTEP 5: Should the nurse convert the units of measurement? Yes (min does not equal hr) 1 hr/60 minSTEP 6: Set up an equation and solve for X. X = Quantity/1 mL x Conversion (hr)/Conversion (min) x Volume (mL)/Time (min) X gtt/min = 10 gtt/1 mL x 1 hr/60 min x 150 mL/3 hrX = 8.3333 STEP 7: Round if necessary. 8.3333 = 8STEP 8: Reassess to determine whether the amount to administer makes sense. If the prescription reads D5W 150 mL IV to infuse over 3 hr, it makes sense to administer 8 gtt/min. The nurse should set the manual IV infusion to deliver D5W IV at 8 gtt/min.

A nurse is planning care for a group of clients. For which of the following clients should the nurse perform a medication reconciliation? A client who refused a newly prescribed medication. A client who required additional pain medication following surgery. A client who experienced an adverse reaction to a new medication. A client who was recently transferred from the intensive care unit.

A client who was recently transferred from the intensive care unit. The nurse should identify that a medication reconciliation should be performed on admission, at discharge, and when a client is transferred from one unit to another. Therefore, the nurse should perform a medication reconciliation for this client.

A nurse is caring for a client who is in her third trimester of pregnancy. The client asks the nurse about over-the-counter medications. The nurse should recognize which of the following medications is a pregnancy risk category B? Acetaminophen Aspirin Ibuprofen Naproxen

Acetaminophen Acetaminophen is a pregnancy risk category B. Animal studies do not show fetal risk or controlled studies in women do not show a fetal risk.

A nurse is providing teaching to a client who has cirrhosis. The nurse should instruct the client that which of the following medications can cause hepatotoxicity? Calcium carbonate Acetaminophen Ibuprofen Omeprazole

Acetaminophen The nurse should instruct the client that acetaminophen can cause hepatotoxicity and should be avoided in a client who has cirrhosis.

A nurse is preparing to administer vancomycin IV to a client. Which of the following actions should the nurse take? Instruct the client to monitor for altered taste. Dilute the medication in 50 mL of 0.9% sodium chloride. Administer the medication over 1 hr. Monitor the client for liver failure.

Administer the medication over 1 hr. The nurse should administer vancomycin over at least 1 hr to reduce the risk of thrombophlebitis and hypotension.

A nurse is caring for a client who has a new prescription for disulfiram and asks why they are receiving the medication. The nurse should explain that the medication is given for which of the following reasons? Alcohol abstinence Infection Hypoglycemia Rheumatoid arthritis

Alcohol abstinence Disulfiram is a medication that is approved to assist with maintaining abstinence from alcohol.

A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? Cardiac dysrhythmia Metabolic alkalosis Renal failure Aplastic anemia

Aplastic anemia Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.

A nurse is assessing a client after administering a dose of losartan. The client has a hoarse voice, and swollen lips and tongue. In which order should the nurse take the following actions? Move the nursing actions into the box on the right, placing them in the selected order of performance. Assess the client's airway. Call the emergency response team. Apply high-flow oxygen. Initiate IV access. Administer IV epinephrine. Administer IV antihistamines.

Assess the client's airway. Call the emergency response team. Apply high-flow oxygen. Initiate IV access. Administer IV epinephrine. Administer IV antihistamines. The nurse should first assess the client's airway and oxygen saturation to determine the need for respiratory support. Intubation or tracheotomy is considered if adequate oxygenation is not maintained. The second step the nurse should take is to call the rapid response team to provide emergency treatment in case of cardiac or respiratory arrest. Next, the nurse should apply high-flow oxygen to increase oxygenation and then initiate an IV site, if one is not present, and administer isotonic IV fluids to prevent hypotension and provide access for IV medications. The nurse should then administer IV epinephrine to constrict blood vessels, dilate bronchioles, and increase cardiac function. And finally, the nurse should administer IV antihistamines and corticosteroids to block the effects of histamine and decrease edema.

A nurse is assessing a client after administering IV vancomycin. Which of the following findings is the nurse's priority to report to the provider? Localized redness at the catheter insertion site Client report of a headache Client report of tinnitus Audible inspiratory stridor

Audible inspiratory stridor When using the airway, breathing, circulation approach to client care the nurse determines the priority finding is inspiratory strider. The client is at risk for bronchospasms, hypotension and circulatory collapse due to anaphylaxis. The nurse should contact the rapid response team, discontinue the vancomycin, and administer epinephrine.

A nurse is preparing to administer a new prescription for a beta blocker to a client who has hypertension. Which of the following adverse effects should the nurse monitor the client for? Elevated BUN Bradycardia Migraine headache Increased salivation

Bradycardia This is an anticipated adverse effect of beta blockade therapy. Anticipating adverse drug reactions can help minimize their effects.

A nurse is caring for a client who has a prescription for potassium chloride (KCL) 20 mEq/L PO daily. the nurse reviews the clients most recent laboratory results and finds the clients potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? Give the ordered KCL as prescribed. Omit the KCL dose and document it was not given. Call the prescribing physician and inform her of the client's serum potassium level results. Call the lab to verify the client's results.

Call the prescribing physician and inform her of the client's serum potassium level results. As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication and notify the provider of the client's serum potassium level.

A nurse is caring for four clients. After administering morning meds, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? Notify the client's provider. Check the client's vital signs. Fill out an occurrence form. Administer the medication to the correct client.

Check the client's vital signs. The first action the nurse should take using the nursing process is to assess the client. The nurse should know that the action of nifedipine is to lower blood pressure. Immediately upon realizing the error, the nurse should check the client's vital signs (especially the client's blood pressure) to ensure that the client is not hypotensive as a result. Only after ensuring that the client is safe and has stable vital signs should the nurse take other actions.

A nurse is caring for a client who is receiving TPN. The pharmacy is delayed in supplying the client's next container of TPN. Which of the following fluids should the nurse infuse until the next container arrives? Dextrose 5% in water 0.9% sodium chloride Dextrose 10% in water Lactated Ringer's solution

Dextrose 10% in water TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse dextrose 10% or 20% in water until the next container of TPN solution arrives.

A nurse is preparing to administer medication to a client who has difficulty swallowing tablets. The nurse should identify that which of the following medication can be crushed and administered in applesauce? Aspirin EC 81 mg tablet Diazepam 10 mg tablet Pantoprazole DR 40 mg tablet Potassium chloride 12 mEq effervescent tablet

Diazepam 10 mg tablet The nurse should identify that diazepam tablets can be crushed and administered in applesauce for a client who has difficulty swallowing.

A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? Expect to have a fever for the first days of therapy. Drink 2 to 3 L of water per day while on the medication. Administer the medication with an NSAID to enhance effectiveness. Take the medication in the morning to prevent insomnia.

Drink 2 to 3 L of water per day while on the medication. Methotrexate can cause renal toxicity. Adequate hydration promotes its excretion and helps prevent this adverse effect.

A nurse is assessing a client who has a peripheral IV with a continuous infusion. Which of the following findings is a manifestation of phlebitis? (select all that apply) Erythema Damp dressing Throbbing Warmth at insertion site Streak formation

Erythema Throbbing Warmth at insertion site Streak formation Erythema is correct. Erythema is a reddened area at the insertion site and is a manifestation of phlebitis. Other manifestations can include throbbing, burning, and increased skin temperature.Damp dressing is incorrect. A damp dressing is a manifestation of infiltration. Other manifestations include pallor, local swelling, and decreased skin temperature. Throbbing is correct. Throbbing and pain at the insertion site are manifestations of vein inflammation and phlebitis. Warmth at insertion site is correct. Responses to inflammation include warmth and redness of the affected tissue. Streak formation is correct. Streak formation is a classic indicator of advanced phlebitis.

A nurse is obtaining a medical history from a client who is to start warfarin therapy and currently uses herbal supplements at home. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin? Feverfew Black cohosh Echinacea Flaxseed

Feverfew The nurse should instruct the client to avoid taking feverfew while taking warfarin because it will increase the anticoagulant effect.

A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply) Furosemide Telmisartan Duloxetine Clopidogrel Atorvastatin

Furosemide Telmisartan Duloxetine Furosemide is correct. This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension.Telmisartan is correct. This medication is used to control hypertension, and an adverse effect is orthostatic hypotension.Duloxetine is correct. This medication is used to treat depression and anxiety disorder, and an adverse effect is orthostatic hypotension.Clopidogrel is incorrect. This medication is used to reduce the risk of MI and stroke and does not cause orthostatic hypotension.Atorvastatin is incorrect. This medication is used to decrease cholesterol and does not cause orthostatic hypotension.

A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? Heart rate 46/min Oxygen saturation 95% Respiratory rate 18/min Blood pressure 160/94 mm Hg

Heart rate 46/min The nurse should check the client's heart rate prior to administering a beta-blocker. If the client's heart rate is less than 50/min, the nurse should hold the medication and contact the provider. Atenolol is a beta-blocker and is used in the treatment of hypertension and angina, and following a myocardial infarction. This medication works by slowing the heart rate, decreasing the speed of electrical impulses through the atrioventricular node, and decreasing the force of contraction.

A nurse is caring for a client who is receiving IV heparin therapy. Which of the following findings should the nurse identify as the priority to report to the provider? Increased PTT Rash Bleeding IV site Hematuria

Hematuria When using the urgent vs. nonurgent approach to client care, the nurse should identify that hematuria is the priority finding to report to the provider because this can indicate active bleeding, which requires immediate intervention.

A nurse is reviewing a client's new prescription for piperacillin/tazobactam. The client has an allergy to penicillin documented in their medical record. Which of the following actions should the nurse take? Consult the pharmacist for an alternative medication. Hold the medication and clarify the prescription. Administer the medication at a reduced flow rate. Administer the medication using the Five Rights of Medication Administration.

Hold the medication and clarify the prescription. Piperacillin/tazobactam is in the penicillin family. The client would likely have a similar response to piperacillin as to penicillin. Confusion over drug names or not identifying the same category of medications accounts for many medication errors and adverse drug events.

A nurse is preparing to administer ampicillin and gentamicin sulfate via iv infusion. Which of the following resource should the nurse consult first regarding medication compatibility? Nurse manager Hospital pharmacist Health care provider Medication sales representative

Hospital pharmacist The greatest risk to the client is injury form medication error; therefore, the nurse should consult the hospital pharmacist first. The pharmacist will have information about medications, including adverse effects, recommended dosages, and drug incompatibilities.

The nurse should instruct the client to avoid taking feverfew while taking warfarin because it will increase the anticoagulant effect. Inject air into regular insulin vial Inject air into the NPH. Inspect vials for contaminants. Roll NPH vial between palms of hands. Add intermediate insulin to syringe Withdraw short-acting insulin into syringe

Inspect vials for contaminants. Roll NPH vial between palms of hands. Inject air into the NPH. Withdraw short-acting insulin into syringe Inject air into regular insulin vial Add intermediate insulin to syringe Inspect vials for contaminants: With the exception of NPH insulin, all insulin available today is supplied as a clear, colorless solution. Do not use insulin that is colored, cloudy, or has formed a precipitate. The first step is to observe the characteristics of the regular and NPH insulin to determine whether they are safe to use. Roll NPH vial between palms of hands: Because NPH insulin is a suspension, the particles must be evenly dispersed by rolling the vial gently between the palms of the hands. This should be done gently because vigorous mixing may cause the solution to become frothy and cause inaccurate dosing. If granules or clumps are present after mixing, discard the solution. This should be done prior to withdrawing the solution into the syringe. Inject air into NPH insulin vial: This creates a pressure in the vial for accuracy in measuring the amount prescribed. • Inject air into regular insulin vial: The amount of air injected into the vial of short-acting insulin is equal to the amount to be administered. Withdraw short-acting insulin into syringe: When the prescription requires the administration of two types of insulin, it is preferable to mix the solutions into one syringe if they are compatible to prevent the client from receiving two injections. Of the longer-acting insulin available, only NPH insulin is mixed with short-acting insulin. When two insulins are to be mixed, withdraw the short-acting insulin first to avoid contaminating the stock vial with NPH insulin. Add intermediate insulin to syringe: The mixture is stable for 28 days.

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Check what before administering? Offer the client a light snack. Measure the client's blood pressure. Measure the client's apical pulse. Weigh the client.

Measure the client's apical pulse. Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min before administering. The nurse should hold the medication and notify the provider if the client's heart rate is below 60/min or if a change in heart rhythm is detected.

A nurse is preparing to administer heparin to a client who has a deep vein thrombosis. Which of the following actions should the nurse take? Monitor the client's aPTT. Have vitamin K available in case of toxicity. Administer the medication intramuscularly. Instruct the client to expect blood in their stools.

Monitor the client's aPTT. The nurse should monitor the client's aPTT to evaluate the effectiveness of the heparin. The aPTT should be 1.5 to 2.5 times the control for therapeutic effects.

A nurse is reviewing a client's medication orders. Which of the following orders should the nurse clarify with the provider? Metoclopramide 10 mg IV every 6 hr Pantoprazole 40 mg IV daily Morphine 20 mg IV every 2 hr Cefotaxime 1 g IV every 12 hr

Morphine 20 mg IV every 2 hr A dosage of morphine should not exceed 15 mg and not be administered sooner than 3 to 4 hr.

A nurse is caring for a client who is taking atorvastatin. Which of the following manifestations should the nurse identify as the priority to report to the provider? Muscle aches Nausea Headache Insomnia

Muscle aches The greatest risk to this client is myopathy, which can progress to rhabdomyolysis, a potentially life-threatening condition. Indications of myopathy include muscle aches, pain, and tenderness. Therefore, the nurse should identify that muscle aches are the priority manifestation to report to the provider.

A nurse is caring for a newborn who has respiratory depression. Which of the following medications should the nurse anticipate administering? Flumazenil Physostigmine Terbutaline Naloxone

Naloxone Naloxone is an opioid antagonist and is administered to reverse opioid toxicity or reverse neonatal respiratory depression. Dosage for a newborn is 0.01 mg/kg, and is repeated every 2 to 3 min until adequate respiratory function returns.

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? Follow a low-sodium diet. Limit daily fluid intake. Obtain a daily weight. Avoid foods that have a high tyramine content.

Obtain a daily weight. Clients who are taking lithium should monitor their daily weight due to the risk of fluid imbalance.

A nurse is preparing to administer warfarin to a client who had a myocardial infarction. Which of the following laboratory values should the nurse review before administering medication? HbA1c aPTT TSH PT/INR

PT/INR Warfarin is a delayed-onset oral anticoagulant and the client's PT/INR values should be monitored regularly before administration. Typically, an INR between 2.0 to 3.0 is recommended for those who have had an acute myocardial infarction. PT therapeutic range is 18 to 24 seconds.

A nurse is preparing to administer medications to a client who has Parkinson's disease and a prescription for levodopa. The nurse should recognize that which of the following medications is contraindicated with levodopa? Phenelzine Furosemide Erythromycin Amiodarone

Phenelzine The administration of levodopa with a nonselective monoamine oxidase inhibitor, such as phenelzine, can cause a hypertensive crisis.

A nurse is caring for a client who is experiencing warfarin toxicity. Which of the following medications should the nurse anticipate administering? Protamine sulfate Phytonadione Calcium gluconate Atropine

Phytonadione Phytonadione, or Vitamin K, is the antidote for warfarin toxicity.

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? Ranitidine Guaifenesin Prednisone Atorvastatin

Prednisone Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.

A nurse is caring for a client who is receiving IV heparin. The nurse notes that the client has received twice the normal heparin dose over the past 48 hr. The nurse should anticipate that the provider will prescribe which of the following medication for the client? Flumazenil Acetylcysteine Protamine sulfate Potassium iodide

Protamine sulfate Protamine sulfate is the antidote for heparin toxicity. It binds to heparin, which stops it from working.

A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following should the nurse identify as the purpose of the medication? Reduce edema of the brain. Provide fluid hydration. Increase cell size in the brain. Expand extracellular fluid volume.

Reduce edema of the brain. An osmotic diuretic is used to decrease intracranial pressure by moving fluid out of the ventricles into the bloodstream.

A nurse is providing discharge teaching to a client who has a new prescription for alendronate. Which of the following instructions should the nurse include in the teaching? Remain sitting upright for at least 30 min after taking the medication. Thoroughly chew the medication to ensure proper absorption. Dissolve the medication in 4 oz of flavored water. Take the medication at breakfast with food.

Remain sitting upright for at least 30 min after taking the medication. A client should remain upright (either sitting or standing) for at least 30 min after consuming alendronate to reduce the risk for esophagitis.

A nurse is preparing to administer an intramuscular (IM) injection of meperidine to a client. Which of the following is the priority assessment the nurse should complete? Apical pulse rate Blood pressure Level of consciousness Respiratory rate

Respiratory rate Airway, breathing, and circulation are the priority focus of the nurse at this time. Meperidine can cause respiratory depression and the client's respiratory rate should be monitored prior to administering this medication.

A nurse is caring for a client who has a prescription for citalopram. Which of the following supplements on the client's home medication record increases the risk of serotonin syndrome? Vitamin C Ginkgo biloba St. John's wort Fish oil

St. John's wort Combined use of an SSRI and St. John's wort can increase the risk for serotonin syndrome, which can be life-threatening.

A nurse is instructing a client who has diabetes mellitus about regular insulin storage. Which of the following instructions should the nurse include? Store open insulin vials at room temperature for up to 1 month. Store unopened insulin vials in the freezer. Store prefilled insulin syringes at room temperature. Store prefilled insulin syringes with the needle pointing down.

Store open insulin vials at room temperature for up to 1 month. The nurse should instruct the client to store opened regular insulin vials at room temperature for up to 1 month.

A nurse is interviewing a client regarding home medications, including supplements. Which of the following should alert the nurse to a possible interaction? The client reports taking echinacea and metoprolol. The client reports taking furosemide and a potassium supplement. The client reports taking a probiotic 3 hr after taking azithromycin. The client reports taking ginkgo and warfarin.

The client reports taking ginkgo and warfarin. Ginkgo is an herbal supplement used to increase blood flow. When it is combined with an anticoagulant medication such as warfarin, there is an increased risk of bleeding.

A nurse is assessing a client who is receiving intermittent IV fluid therapy. Which of the following is a manifestation of fluid volume excess? Hypotension Elevated hematocrit levels Flat neck veins Weight gain

Weight gain The nurse should expect a client who has fluid volume excess to experience weight gain. The nurse should monitor the client for edema and shortness of breath.