Pharmacology Practice 2019 A

24 July 2022
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question
A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 Ib. How many mg should the nurse administer per dose?
answer
300 mg
question
A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan?
answer
1. Report muscle pain to the provider. 2. Avoid taking the medication with grapefruit juice. 3. Expect therapy with this medication to be lifelong.
question
A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?
answer
Increase in ability to focus
question
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take?
answer
Administer the medication outside the 5 cm (2 in) radius of the umbilicus.
question
A nurse at a clinic is providing follow - up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?
answer
Sexual dysfunction
question
A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching?
answer
I should sit up for 30 minutes after taking the risedronate.
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A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?
answer
Report yellowing of the skin
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A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?
answer
I should tell my provider if I develop a sore throat (neutropenia)
question
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?
answer
Obtain the client's blood pressure (atenolol - hypotension)
question
A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor?
answer
Sedation
question
A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report?
answer
0830 (30 min before/ after)
question
A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)?
answer
Temperature of 39.7 (103.5)
question
A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?
answer
Blood in the urine (heparin toxicity)
question
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine?
answer
Constipation (due to morphine) ** sodium will promote increase water and fat in GI **
question
A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?
answer
Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
question
A nurse is caring for a client who received 0.9% sodium chloride 1L over 4hr instead of over 8hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?
answer
0.9 % sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified (type, amount, time, status)
question
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make?
answer
Aspirin will increase the risk of bleeding
question
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?
answer
Decreased respiration might occur
question
A nurse is an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?
answer
Atropine (reverse cholinergic toxicity)
question
A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate?
answer
Digoxin (increased toxicity)
question
A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?
answer
Increased neutrophil count (bone marrow stiumulated)
question
A nurse is reveiwing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia?
answer
Presence of U waves
question
A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over the counter medications?
answer
Ibuprofen (NSAID increase Li level)
question
A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications?
answer
Acetylcysteine (antidote that prevent injury when given orally or Iv within 8 to 10 hr)
question
A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching?
answer
A transition in care requires the nurse to conduct medication reconciliation
question
A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following intervention should the nurse include in the plan of care?
answer
Determine apical pulse prior to administering (pulse rate less than 60/min - notify provider for bradycardia)
question
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take?
answer
Monitor the client for constipation (can lead to fecal impaction)
question
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?
answer
Bibasilar crackles (heart failure and pulmonary edema)
question
A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective?
answer
The client rates pain as 3 on a scale from 0 to 10 (description of pain most accurate)
question
A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?
answer
Pregnancy test (must provide two negative pregnancy tests)
question
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately?
answer
Dyspnea (caused by bronchoconstriction due to increased Ach level)
question
A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first?
answer
Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
question
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?
answer
Miosis (pupillary constriction due to excessive muscarinic stimulation)
question
A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep - vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings?
answer
Platelets 96,000/mm^3 (expected range 150,000 - 400,000) indicate heparin induced thrombocytopenia
question
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching?
answer
Forms a protective barrier over ulcers (mucosal protectant)
question
A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge?
answer
The client's capnography has returned to baseline (gas exchange is adequate)
question
A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following result should the nurse report to the provider?
answer
Potassium level 2.8 (hypokalemia that increase risk of digoxin toxicity and cardiac dysrhythmias)
question
A nurse is providing teaching to a client who is begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching?
answer
dry mouth & dry eyes (anticholinergic) blurred vision (increase intraocular pressure)
question
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication?
answer
Tinnitus (monitor high pitched ringing in ear and headache and notify)
question
A nurse is an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering?
answer
Flumazenil (antidote to reverse benzodiazepine)
question
A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions?
answer
Take one tablet at onset of migraine
question
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first?
answer
Epinephrine (to induce vasoconstriction and bronchodilation during anaphylaxis)
question
A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching?
answer
hot flashes (due to estrogen receptor blocking action of tamoxifen)
question
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication?
answer
Insomnia (by atypical antidepressant of bupropion)
question
A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include?
answer
1. Blood glucose levels will be monitored during therapy ( medication increase serum glucose level & require management) 2. Avoid contact with people who has known infection (medication decreased immunity putting patient at increased risk for infection) 3. Grapefruit juice can increase the effects of the medication
question
A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurses should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives?
answer
Carbamazepine (cause accelerated inactivation of oral contraceptive by action on hepatic medication metabolizing enzymes)
question
A nurse is an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?
answer
Naloxone (to reverse respiratory depressive effect of heroin, but not too quick)
question
A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective?
answer
I will taper off the medication before discontinuing it (prevent abstinence syndrome or rebound insomnia)
question
A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry - flavored lozenges on a stick. Which of the following information should the nurse include in the teaching?
answer
Store unused medication sticks in a storage container
question
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching?
answer
I will take the patch off right after my evening meal (med free time 12-14 hr to avoid tolerance)
question
A nurse is caring for a client who is taking acetazolamide fr chronic open angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report?
answer
Tingling of fingers
question
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take?
answer
Document the refusal and inform the client's provider (verify understanding of refusing medication)
question
A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?
answer
100 gtt/min
question
A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication?
answer
Oral candidiasis
question
A nurse receives a verbal order from the provider to administer morphine 5 mg every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?
answer
Morphine 5 mg subcut every 4 hr PRN severe pain
question
A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages?
answer
2 months (1st dose)
question
A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?
answer
I have tendonitis, so I haven't been able to exercise (risk of tendon rupture)
question
A nurse administers a dose of metformin for a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?
answer
Check the client's blood glucose (assess first for hypoglycemia)
question
A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide?
answer
Prevent delirium tremens
question
A nurses is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?
answer
Heart rate (dec HR indicate digoxin toxicity)