ATI Pharmacology Comprehensive Proctored 2019 B Exam Questions and Answers with Rationales (Verified by Expert)

ATI Pharmacology Comprehensive Proctored 2019 B Exam Questions and Answers with Rationales (Verified by Expert)

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ATI Pharmacology Comprehensive Proctored 2019 Exam B
Questions and Answers with Rationales

1. A nurse contacts a client’s provider on the telephone to obtain
   prescription for pain medication. Which of following actions should nurse
   take?
   A.Write the order on a prescription pad designated for the client’s provider
   B. Have the provider spell out the unfamiliar medication names
   C. Read the prescription back to the provider using abbreviations
   D. Consult with a second nurse for any questions regarding dosage
   ANS Have the provider spell out the unfamiliar medication names.
   Rationale – The nurse should ask the provider to spell out the name of
   the medication if the stated name is one the nurse is not familiar with.
2. Nurse in clinic is caring who is taking aspirin for the treatment of
   arthritis. The nurse should identify which of following findings as indication
   that the client is beginning to exhibit salicylism?
   A. Gastric distress
   B. Oliguria

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C. Excessive bruising
D.Tinnitus
ANS Tinnitus
Rationale – Tinnitus is a manifestation of aspirin toxicity, also called
salicylism. Other manifestations include sweating, headache, and
dizziness.

3. Circulating nurse is planning care for a client who is scheduled forsurgery and has latex allergy. Which of following actions should nurseinclude in plan of care?
   A. Schedule the client for the last surgery of the day
   B. Place monitoring cords and tubes in a stockinet
   C. Choose rubber injection ports for fluid administration
   D. Ensure phenytoin IV is readily available
   ANS Place monitoring cords and tubes in a stockinet.
   Rationale – The nurse should place monitoring devices in a stockinet to
   prevent direct contact with the client’s skin.
4. Nurse is assessing a client who is receiving epoetin alfa to treat
   anemia. Which of following findings should nurse monitor?

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A. Paresthesia
B. Increased blood pressure

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C. Fever
D. Respiratory depression
ANS Increased blood pressure
Rationale – The therapeutic effect of epoetin alfa is an increase in
hematocrit levels, which can result in an increase in a client’s blood
pressure. If the client’s hematocrit level rises too rapidly, hypertension
and seizures can result. The nurse should monitor the client’s blood
pressure and ensure hypertension is controlled prior to administering
the medication.

5. Nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client.
   Which of following actions should nurse take prior to administering the
   med- ication?
   A. Ask the client to drink 8oz of water
   B. Review the client’s most recent Hgb level
   C. Obtain the client’s blood pressure
   D. Determine if the client is allergic to NSAIDs
   ANS Obtain the client’s blood pressure.
   Rationale – HCTZ is a thiazide diuretic administered to promote urine
   output and reduce blood pressure and edema. The nurse should obtain
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T/F. A client taking trimpethoprim/sulfamethoxazole should store the medication in the refrigerator.
False. The nurse should inform the client to store trimethoprim/sulfamethoxazole in a light-resistant container at room temperature.

T/F. A client taking trimpethoprim/sulfamethoxazole should take the medication with food
False. The nurse should instruct the client to take the medicaiton on an empty stomach either 1 hour before or 2 hours after meals.

T/F. A client taking trimpethoprim/sulfamethoxazole should expect a fine, red rash as a transient effect
False. The nurse should instruct the client to notify the provider if a rash develops, as this can be an indication of Stevens-Johnsono syndrome. However, the client should not expect to have a fine, red rash as a transient effect.

T/F. A client taking trimpethoprim/sulfamethoxazole should drink 8 to 10 glasses of water daily
True. The nurse should instruct the client to increase water intake to 1920 to 2400 mL (64 to 80 oz) a day to decrease the chance of kidney damage from cryastallization.

T/F. For a patient with a UTI, a contraindication for ciprofloxacin would be “I have tendonitis, so I haven’t been able to exercise.
True. The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

T/F. For a patient with a UTI, a contraindication for ciprofloxacin would be “I take medicine for my thyroid.”
False. Ciprofloxacin does not affect thyroid function and is not contraindicated for the client who takes thyroid medication.

T/F. For a patient with a UTI, a contraindication for ciprofloxacin would be “I take a stool softener for chronic constipation”
False. Ciprofloxacin is not contraindicated for the client who takes a stool softener for chronic constipation. An adverse effect of the medication is diarrhea.

T/F. For a patient with a UTI, a contraindication for ciprofloxacin would be “I am allergic to sulfa”
False. Ciprofloxacin is a quinolone antibiotic. Therefore, the client who has a sulfa allergy can take this medication

T/F. A patient taking guaifenesin for an upper respiratory infection should store the medicaiton in the refrigerator.
False. The nurse should instruct the client to store the medication at room temperature. Refrigeration can alter the properties of the medication.

T/F. A patient taking guaifenesin for an upper respiratory infection should increase fluid intake to at least 2 liters each day while taking this medicaiton.
True. The nurse should instruct the client to increase fluid intake t o at least 2 L per day while taking guaifenesin. AN increase in fluid intake facilitiates the removal of secretions and helps to create a more productive coug.

T/F. A patient taking guaifenesin for an upper respiratory infection should know that constipation is an expected effect of this medication
False. The nurse should inform the client that diarrhea, not constipation, is an expected adverse effect of guaifenesin.

T/F. A patient taking guaifenesin for an upper respiratory infection can expect to experience insomnia while taking this medicaiton
False. The nurse should inform the client that drowsiness, not insomnia, is an expected adverse effect of this medicaiton. The client should avoid driving or other potentially hazardous activities while taking this medicaiton if drowsiness occurs.

T/F. Before administering clozapine for a client with schizophrenia, the nurse should revie lab tests for total cholesterol.
True. The nurse should review the client’s total cholesterol before administering clozapine, because this medicaiton can ause hyperlipidemia.

T/F. Before administering clozapine for a client with schizophrenia, the nurse should revie lab tests for troponin.
False. The nurse should review the troponin level of a client who has chest pain and possible myocardial infarction

T/F. Before administering clozapine for a client with schizophrenia, the nurse should revie lab tests for creatinine.
False. Cloazapine is not metabolized by the kidneys. Therefore, the nurse does not need to review the creatinine level before administering the medication.

T/F. Before administering clozapine for a client with schizophrenia, the nurse should revie lab tests for thyroid stimulating hormone.
False. The nurse should review the thyroid stimulating hormone level of a client who has hypothyroidism or hyperthyroidism.

T/F. A patient taking simvistatin should expect therapy with this medication to be lifelong.
True. If medicaiton therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months.

T/F. A patient taking simvistatin should report muscle pain to the provider.
True. Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis, so it should be reported to the provider.

T/F. A patient taking simvistatin should expect a flushin gof the skin as a reaction to the medication
False. The nurse should identify flushing of the skin as an adverse effect of the medication niacin, which can be used to decrease the client’s triglyceride levels.

T/F. A patient taking simvistatin should take the medication in the early morning
False. This medicaiton is most effective when taken in the evening because cholesterol production generally increases overnight.

T/F. A patient taking simvistatin should avoid taking the medication with grapefruit juice
True. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase.

T/F. For a client with heart failure receiving an IV infusion of dopamine, findings of decreased blood pressure indicate the medication is effective
False. Dopamine is an adrenergic that causes a receptor specificity effect, which increases blood pressure.

T/F. For a client with heart failure receiving an IV infusion of dopamine, findings of increased cardiac output indicate the medication is effective
True. Dopamine is an adrenergic that causes a receptor specificiyt effect, which increases cardiac output and improves perfusion.

T/F. For a client with heart failure receiving an IV infusion of dopamine, findings of increased heart rate indicate the medication is effective
False. Tachycardia is an adverse effect of dopamine, and it does not indicate the medication’s effectiveness.

T/F. For a client with heart failure receiving an IV infusion of dopamine, findings of decreased serum potassium indicate the medication is effective
False. Dopamine does not affect serum potassium levels.

T/F. A patient taking acetazolamide for chronic open-angle glaucoma should monitor and report oliguria.
False. Polyuria, rather than oliguria, is an adverse effect of acetazolamide.

T/F. A patient taking acetazolamide for chronic open-angle glaucoma should monitor and report weight gain.
False. Weight loss is an adverse effect of acetazolamide due to gastrointestinal disturbances causing reduced appetite.

T/F. A patient taking acetazolamide for chronic open-angle glaucoma should monitor and report tingling of fingers.
True. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremiities, when taking acetazolamide.

T/F. A patient taking acetazolamide for chronic open-angle glaucoma should monitor and report constipation.
False. Diarrhea is an adverse effect of acetazolamide due to gastrointestinal disturbances.

T/F. A nurse should note adverse side effects of amitriptyline include diarrhea.
False. Constipation is an adverse effect of amitriptyline.

T/F. A nurse should note adverse side effects of amitriptyline include urinary retention.
True. The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.

T/F. A nurse should note adverse side effects of amitriptyline include increased libido.
False. A decrease in libido is an adverse effect of amitriptyline.

T/F. A nurse should note adverse side effects of amitriptyline include cough.
False. Developing a cough is not an adverse effect of amitryptyline.

T/F. A patient receiving amphotericin B intermittent IV bolus for histoplasmosis should be monitored for adverse reactions including weight gain.
False. Weight loss, not weight gain, is an adverse effect of amphotericin B.

T/F. A patient receiving amphotericin B intermittent IV bolus for histoplasmosis should be monitored for adverse reactions including oliguria.
True. Oliguria can indicate renal compromise in a client who is taking amphotericin B. The nurse should report this finding to the provider.

T/F. A patient receiving amphotericin B intermittent IV bolus for histoplasmosis should be monitored for adverse reactions including hyperkalemia.
False. Hypokalemia, not hyperkalemia, is an adverse effect of aphotericin B due to the medication causing damage to the kidney.s

T/F. A patient receiving amphotericin B intermittent IV bolus for histoplasmosis should be monitored for adverse reactions including tachycardia.
False. Bradycardia, not tachycardia, is an adverse efect of amphotericin B.

T/F. A nurse preparing to administer a scheduled antibiotic at 0800 can administer the drug (without requiring an incident report) at 0900.
False. The nurse should identify that administering an antibiotic 1 hour after the scheduled time is too late and requires filing an incident report.

T/F. A nurse preparing to administer a scheduled antibiotic at 0800 can administer the drug (without requiring an incident report) at 0830.
True. The nurse should identify that an antibiotic can be administerd 30 min before or after the scheduled timeto maintain therapeutic blood levels without requiring an incident report.

T/F. A nurse preparing to administer a scheduled antibiotic at 0800 can administer the drug (without requiring an incident report) at 1000.
False. The nurse should identify that administering an antibiotic 2 hr after the scheduled time is too late and requires filing an incident report.

T/F. A nurse preparing to administer a scheduled antibiotic at 0800 can administer the drug (without requiring an incident report) at 1200.
False. The nurse should identify that administering an antibiotic 4 hr after the scheduled time is too late and requires filing an incident report.

T/F. A patient with heroin toxicity who is unresponsive with pinpoint pupils and a respiratory rate of 6/min should be administered diazepam.
False. The nurse should administer diazepam, a benzodiazepine, to a client who has alcohol toxicity to decrease the manifestations of alcohol withdrawal and prevent withdrawal seizures.

T/F. A patient with heroin toxicity who is unresponsive with pinpoint pupils and a respiratory rate of 6/min should be administered naloxone.
True. The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroni. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

T/F. A patient with heroin toxicity who is unresponsive with pinpoint pupils and a respiratory rate of 6/min should be administered bupropion.
False. The nurse should administer bupropion, an atypical antidepressant, for a client who is trying to quit smoking cigarettes to decrease the manifestations of nicotine withdrawal and ease the client’s cravings for nicotine

T/F. A patient with heroin toxicity who is unresponsive with pinpoint pupils and a respiratory rate of 6/min should be administered methadone.
False. The nruse should administer methadone, an opioid agonist, to a client who has heroin toxicity to decrease manifestations of opioid withdrawal and to suppress the euphoria the client feels when using heroin. However, the client should not receive methadone in an emergency

T/F. A client taking furosemide should know the medication increases riskfor hypertension.
False. The client who takes furosemide has an increased risk of hypotension due to the fluid loss from the diuretic effect of the medication.

T/F. A client taking furosemide should know to avoid potassium-rich foods in your diet.
False. The client who takes furosemide has an increased risk for potassium loss because of the diuretic effect of the medicaiton that causes excretion of potassium through the kidneys. The client should increase the intake of potassium-rich foods

T/F. A client taking furosemide should know to take each dose of medication in the evening before bed
False. The client should take each dose of medication in the morning to avoid sleep disturbances from nocturia.

T/F. A client taking furosemide should know to drink a glass of milk with each dose of medicaiton
True. The client should take furosemide with food or milk to reduce gastric irritation.

T/F. For a client taking clozapine for 6 months who reports lethargy and myalgia, the nurse should schedule the client for an electroencephalogram.
False. The client who develops seizures may have an electroencephalogram, but it is not used to treat or diagnose the client who has lethargy and myalgia.

T/F. For a client taking clozapine for 6 months who reports lethargy and myalgia, the nurse should place the client on a tyramine-free diet
False. The client can take clozapine with or without food and does not need to follow a tyramine-free diet. The client will follow a tyramine-free diet if taking monoamine oxidase inhibitors.

T/F. For a client taking clozapine for 6 months who reports lethargy and myalgia, the nurse should obtain WBC with absolute neutrophil count
True. The client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytopenia. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can be changed to occur every 2 weeks up to 1 ear.

T/F. For a client taking clozapine for 6 months who reports lethargy and myalgia, the nurse should infuse 0.9% sodium chloride 1,000 mL IV fluid bolus
False. The client who is dehydrated may receive 0.9% sodium chloride IV bolus, but it is not used to treat the adverse effects of lethargy, myalgia, and weakness from taking clozapine.

T/F. A patient taking diltiazem should report adverse effects including blurred vision.
False. The client who is taking diltiazem, a calcium channel blocker, has no visional adverse effects. Digoxin can have non-cardiac signs of toxicit, which can include blurred or yellow vision, nausea, vomiting, anorexia and fatigue.

T/F. A patient taking diltiazem should report adverse effects including dry cough.
False. The client who is taking diltiazem, a CCB, can have adverse effects of rhinitis, dyspnea, and pharyngitis. A cough is an adverse effect of an ACE inhibitor.

T/F. A patient taking diltiazem should report adverse effects including shortness of breath.
True. The client who is taking diltiazem, a CCB, can experience shortness of breath as an adverse effect and should report the finding to the provider immediately.

T/F. A patient taking diltiazem should report adverse effects including muscle twitching.
False. The client who is taking diltiazem, a CCB, can have weakness, insomnia, tremors and paresthesia, but not muscle twitching, which may indicate the client has hyponatremia.

T/F. A client taking phenytoin should expect to experience some unusual eye movement when taking this medication.
False. The client should not expectto experience unusual eye movement when taking phenytoion. However, nystagmus is a serious adverse effect when taking phenytoin that the clientn should report to the provider.

T/F. A client taking phenytoin should let their dentist know they’re taking this medication
True. Phenytoin commonly causes gingival hyperplasia. As a result, the client should notify his dentist.

T/F. A client taking phenytoin should take the medication with antacids to minimize gastric upset
False. The client should not take phenytoini with antacids because they can decrease the effects of phenytoin. If needed, antacids should be taken 2 hours before or after the phenytoin.

T/F. A client taking phenytoin should know this type of medication does not require blood monitoring
False. The client should receive instructions to have blood levels of phenytoin monitored to determine effective dosage. Subtherapeutic and toxic levels can result in poor outcomes.

T/F. A nurse caring for a client with a latex allergy should choose rubber injection ports for fluid administratoin.
False. The circulating nurse should ensure that latex-free products are used in the care of this client. Rubber injection ports contain latex, which would place the client at risk for a severe allergic reaction.

T/F. A nurse caring for a client with a latex allergy should place monitoring cords and tubes in a stockinet
True. The circulating nurse should place monitoring devices in a stockinet to prevent direct contact with the client’s skin.

T/F. A nurse caring for a client with a latex allergy should ensure phenytoin IV is readily available
False. The nurse should ensure that epinephrine is readily available in the operating room in case of anaphylactic reaction of accidental exposure to latex

T/F. A nurse caring for a client with a latex allergy should schedule the client for the last surgery of the day
False. The circulating nurse should schedule the client for the first surgery of the day to minimizethe client’s exposure to latex, inclding latex dust.

T/F. A patient taking insulin glargine for type 1 diabetes mellitus should not mix this medication in a syringe with other insulin.
True. The client should not mix insulin glarginewith any other type of insulin in the same syringe, because this procedure can alter the medication’s effects.

T/F. A patient taking insulin glargine for type 1 diabetes mellitus should rotate the bottle gently prior to drawing up the insulin
False. Insulin glargine is clear. Therefore, there is no need for the client to rotate the bottle prior to drawing up the insulin.

T/F. A patient taking insulin glargine for type 1 diabetes mellitus should observe for hypoglycemia when the insulin peaks
False. Insulin glargine does not cause peaks. Instead, it maintains a steady blood level up to a 24-hr period, which reduces the risk of hypoglycemia.

T/F. A patient taking insulin glargine for type 1 diabetes mellitus should administer the insulin immediately before meals
False. The client can inject glargine once or twice a day, any time during the day, but always at the same time every day.

T/F. For a patient who has taken large amount of diazepam, the nurse should prepare to administer ondansetron
False. Ondansetron is an antiemetic and the nurse should administer the medication to treat nausea and vomiting

T/F. For a patient who has taken large amount of diazepam, the nurse should prepare to administer magnesium sulfate
False. Magnesium sulfate is an electrolyte replacement and the nurse should administer the medication to treat the risk of seizure activity.

T/F. For a patient who has taken large amount of diazepam, the nurse should prepare to administer flumazenil
True. Flumazenil is an antidote and the nurse should administer the medication to reverse benzodiazepines, such as diazepam.

T/F. For a patient who has taken large amount of diazepam, the nurse should prepare to administer protamine sulfate
False. Protamine sulfate is an antidote for heparin and the nurse should administer the medication to reverse an elevated aPTT caused by the use of heparin

T/F. A patient in labor receiving oxytocin by continuous IV infusion with a maintenance IV solution, with the FHR monitor indicating late deceelerations. The nurse’s first action should be to apply oxygen to the client by face mask.
False. The nurse should apply oxygen by face mask to provide supplemental oxygen to the fetus. However, another action is the nurse’s priority.

T/F. A patient in labor receiving oxytocin by continuous IV infusion with a maintenance IV solution, with the FHR monitor indicating late deceelerations. The nurse’s first action should be to turn the client to a side-lying position
True. The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority intervention the nurse should take is to place the client in a lateral position.

T/F. A patient in labor receiving oxytocin by continuous IV infusion with a maintenance IV solution, with the FHR monitor indicating late deceelerations. The nurse’s first action should be to increase the client’s maintenance IV infusion rate
False. The nurse should increase the client’s maintenance IV infusion rate to maintain adequate blood flow and promote placental perfusion. However, another action is the nurse’s priority.

T/F. A patient in labor receiving oxytocin by continuous IV infusion with a maintenance IV solution, with the FHR monitor indicating late deceelerations. The nurse’s first action should be to disconnect the client’s oxytocin from the maintenance IV
False. The nurse should discontinue the oxytocin to reduce uterine contractions. However, another action is the nurse’s priority.

T/F. For a client taking oral contraceptives, the effectiveness would be interfered with by concurrent use of glipizide
False. There is no medication interaction between oral contraceptives and glipizide, an antidiabetic medication.

T/F. For a client taking oral contraceptives, the effectiveness would be interfered with by concurrent use of carbamazepine
True. Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

T/F. For a client taking oral contraceptives, the effectiveness would be interfered with by concurrent use of atenolol
False. There is no medication interaction between oral contraceptives and atenolol, abeta blocker.

T/F. For a client taking oral contraceptives, the effectiveness would be interfered with by concurrent use of sumatriptan
False. There is no medication interaction between oral contraceptives and sumatriptan, which is a medication to treat migraines.

T/F. A patient taking ketorolac should check for bruising while taking this medication
True. The nurse should instruct the client to check for bruising because ketorolac can increase the risk of bleeding by interfering with plateletaggregation.

T/F. A patient taking ketorolac should increase iron intake with this medication
False. There is no indication that the client should increase iron intake.

T/F. A patient taking ketorolac should know this medication can cause anxiety
False. There is no indication that ketorolac causes anxiety

T/F. A patient taking ketorolac should take the medication on an empty stomach
False. Ketorolac should be taken with food to prevent GI distress

T/F. A client taking extended release verapamil should avoid crowds.
False. Avoiding crowds is not necessary for the client who is taking verapamil because it does not cause an immunosuppression disorder.

T/F. A client taking extended release verapamil should discontinue the medication if palpitations occur
False. The nurse should instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client should never discontinue the medication abruptly because the client may experience chest pain.

T/F. A client taking extended release verapamil should change positions slowly
True. The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope.

T/F. A client taking extended release verapamil should take the medication on an empty stomach
False. The nurse should instruct the client to take extended release verapamil with food to minimize gastric distress.

T/F. A patient taking ethinyl estradiol/norelgestromin should aplpy the patch within 14 days of menses.
False. The client should apply the patch within 7 days of menses to prevent ovulation and the need for another contraceptive method.

T/F. A patient taking ethinyl estradiol/norelgestromin should apply the patch once a week for 2 weeks.
False. The client should apply the patch once a week for 3 weeks and then no patch for 1 week to promote menstruation.

T/F. A patient taking ethinyl estradiol/norelgestromin should leave the existing patch on for 4 hours after applying the new patch.
False. The client should remove and dispose the patch before applying a new patch to prevent an overdose of the medication by combining the remaining medication on the old patch with the medication on the new patch

T/F. A patient taking ethinyl estradiol/norelgestromin should fold the sticky sides of the old patch together before disposing it
True. The client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe dispoal of the patch

T/F. A nurse should monitor an older client with heart failure taking HCTZ for adverse effects including hypoglycemia.
False. HCTZ is an antihypertensive thiazide diuretic medicaiton, which can cause hyperglycemia.

T/F. A nurse should monitor an older client with heart failure taking HCTZ for adverse effects including orthostatic hypotension.
True. The nurse should identify that HCTZ is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness in clients who are taking the medication. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position.

T/F. A nurse should monitor an older client with heart failure taking HCTZ for adverse effects including bradycardia.
False. The nurse should identify palpitations as an adverse effect of HCTZ, which is an antihypertensive thiazide diuretic medication.

T/F. A nurse should monitor an older client with heart failure taking HCTZ for adverse effects including xanthopsia.
False. The nurse should identify that HCTZ is an antihypertensive thiazide diuretic medication and has an adverse effect of blurred vision. Xanthopsia causes objects to appear yellow and is not an adverse effect of this medication.

T/F. A patient receiving prednisone as long term treatment for systemic erythematosus should monitor for long-term complications of prednisone by undergoing pulmonary function tests.
False. Pulmonary function tests are not indicated for a client who is taking prednisone.

T/F. A patient receiving prednisone as long term treatment for systemic erythematosus should monitor for long-term complications of prednisone by undergoing liver function studies
False. Liver function studies are not indicated for a client who is taking prednisone.

T/F. A patient receiving prednisone as long term treatment for systemic erythematosus should monitor for long-term complications of prednisone by undergoing bone density scans
True. The client who is taking prednisone, which is a glucocorticoid, should have regularly scheduled bone density scans to monitor for the adverse effects of osteoporosis.

T/F. A patient receiving prednisone as long term treatment for systemic erythematosus should monitor for long-term complications of prednisone by undergoing electrocardiograms
False. Routine echocardiograms are not indicated for a client who is taking prednisone

T/F. A client taking temazepam should plan to withdraww from the medication gradually.
True. The nurse should include in the teaching to have the client plan to withdraw from taking temazepam graduall to avoid mild withdrawal syndrome.

T/F. A client taking temazepam should expect that it will take 4 nights before benefits are noticed
False. The nurse should include in the teaching that it will take 2 nights before benefits are noticed.

T/F. A client taking temazepam should schedule doses for early morning before breakfast
False. The nurse should instruct the client to administer temazepam at bedtime to treat insomnia.

T/F. A client taking temazepam should limit continuous use to 7 to 10 weeks.
False. The nurse should include in the teaching to limit use of temazepam to 7 to 10 days.

T/F. A patient with myasthenia gravis taking neostigmine should report adverse effects including tachycardia.
False. Neostigmine can cause bradcardia, rather than tachycardia, due to the excessive muscarinic stimulation

T/F. A patient with myasthenia gravis taking neostigmine should report adverse effects including miosis.
True. Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.

T/F. A patient with myasthenia gravis taking neostigmine should report adverse effects including oliguria.
False. Neostigmine can cause urinary urgency, rather than decreased urinary output, due to the excessive muscarinic stimulation

T/F. A patient with myasthenia gravis taking neostigmine should report adverse effects including xerostomia.
False. Neostigmine can cause increased salivation, rather than dry mouth, due to the excessive muscarinic stimulation

T/F. A client self-administering insulin at home should avoid getting rid of the air bubble in the syringe.
False. The nurse should instruct the client to expel all air bubbles in the sringe to ensure an accurate dosage is delivered.

T/F. A client self-administering insulin at home should shake the insulin before using it to make sure it is well mixed.
False. The nurse should instruct the client to mix insulin by rolling the insulin in the palm of his hand to prevent frothing, which can cause the drawing up of an inaccurate dose of insulin.

T/F. A client self-administering insulin at home should inject the insulin into their thigh for the fastest absorption
False.The nurse should instruct the client that the fsatest absorption of insulin occurs with abdominal injections. Absorption is slowest when the injection is into the thigh.

T/F. A client self-administering insulin at home should store unopened bottles of insulin in the refrigerator
True. The client should store unopened vials of insulin in the refrigerator to maintain medication viability. Once opened, the insulin may remain at room temperature for up to 1 month.

T/F. A patient taking aspirin daily for a year should immediately report to the provider hyperventilation.
True. When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

T/F. A patient taking aspirin daily for a year should immediately report to the provider anorexia.
False. Anorexia is nonurgent because the client who is taking aspirin can experience a decrease in appetite. Therefore, there is another finding that is the nurse’s priority.

T/F. A patient taking aspirin daily for a year should immediately report to the provider heartburn
False. Heartburn is nonurgent because the client who is taking aspirin can experience gastrointestinal distress. Therefore, there is another finding that is the nurse’s priority.

T/F. A patient taking aspirin daily for a year should immediately report to the provider swollen ankles.
False. Swollen ankles are nonurgent because the client who is taking aspirin can experience sodium and fluid retention. Therefore, there is another finding that is the nurse’s priority.

T/F. A client with diabetes mellitus taking glyburide reports feeling confused and anxious. The nurse should FIRST schedule an early meal tray.
False. The nurse should schedule the client an early meal tray to maintain the client’s blood glucose level following the initial interventions for hypoglycemia. However, there is another action the nurse should take first.

T/F. A client with diabetes mellitus taking glyburide reports feeling confused and anxious. The nurse should FIRST give the client 120 mL (4 oz) of orange juice
False. The nurse should give the client 10 to 15 g of carbohydrates, such as 4 oz of orange juice, to treat hypoglycemia. However, there is another action that the nurse should take first.

T/F. A client with diabetes mellitus taking glyburide reports feeling confused and anxious. The nurse should FIRST provide theclient with a protein-rich snack
False. The nurse should provide the client with a protein-rich snack after determining the client’s blood glucose value and providing a carbohydrate first. However, there is another action that the nurse should take first.

T/F. A client with diabetes mellitus taking glyburide reports feeling confused and anxious. The nurse should FIRST perform a capillary blood glucosetest
True. The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determinethe client’s blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

T/F. A patient taking atropine eye drops during an eye examination should be monitored for adverse effects including difficulty seeing in the dark.
False. The client who has received atropine eye drops can have photosensitivity, which causes difficulty seeing in brightly lit areas due to the muscarinic receptors causing mydriasis.

T/F. A patient taking atropine eye drops during an eye examination should be monitored for adverse effects including pinpoint pupils.
False. Dilation of the pupils, or mydriasis, is an expected finding following the administration of atropine eye drops.

T/F. A patient taking atropine eye drops during an eye examination should be monitored for adverse effects including blurred vision.
True. Blurred vision is an expected finding following the administration of atropine ey drops. This is due to the cycloplegic effects of the medication, which cause distant objects to appear blurry to the client.

T/F. A patient taking atropine eye drops during an eye examination should be monitored for adverse effects including excessive tearing.
False. Excessive tearing is not an expected finding following the administratoin of atropine eye drops.

T/F. A mother of a newborn asks when the baby should receive his first diptheria, tetanus and pertussis vaccine (DTaP). The nurse hould respond “at birth”
False. According to the current recommended immunization schedule, only the heptatitis B vaccine is given at birth

T/F. A mother of a newborn asks when the baby should receive his first diptheria, tetanus and pertussis vaccine (DTaP). The nurse hould respond “at 6 months”
False.The CDC recommends that newborns receive the third dose of the 5-dose series of the DTaP immunization at6 months of age

T/F. A mother of a newborn asks when the baby should receive his first diptheria, tetanus and pertussis vaccine (DTaP). The nurse hould respond “at 15 months”
False. The CDCrecommends that newborns receivethe fourth dose of the five-dose series of the DTaP immunization between 15 to 18 months of age.

T/F. A mother of a newborn asks when the baby should receive his first diptheria, tetanus and pertussis vaccine (DTaP). The nurse hould respond “at 2 months”
True. The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

T/F. A patient given cefotetan via intermittent IV bolus develops dyspnea and widespread hives. The nurse’s FIRST action should be to elevate the client’s legs above the level of the heart.
False. The nurse should elevate the client’s legs and feet to a level above the client’s heart to facilitate blood flow to the vital organs. However, there is another action the nurse should take first.

T/F. A patient given cefotetan via intermittent IV bolus develops dyspnea and widespread hives. The nurse’s FIRST action should be to collect a blood specimen for ABGs
False. The nurse should collecta blood specimen for ABG’s levels to evaluate the client’s respiratory status. However, there is another action the nurse should take first.

T/F. A patient given cefotetan via intermittent IV bolus develops dyspnea and widespread hives. The nurse’s FIRST action should be to discontinue the medication IV infusion
True. The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion

T/F. A patient given cefotetan via intermittent IV bolus develops dyspnea and widespread hives. The nurse’s FIRST action should be to administer epinephrine 0.5 mL via IV bolus
False. The nurse should administer epinephrine, which is a beta-adrenergic agonist that can stimulate the heart, cause vasoconstriction of blood vessels intheskin and mucous membranes, and cause bronchodilation in the lungs. However, there is another action the nurse should take first.

T/F. A client taking cyclobenzaprine should continue taking the medication until the rash disappears
False. The client should take cyclobenzaprine for treatment of muscle spasms. This medication does not have an effect on skin rashes.

T/F. A client taking cyclobenzaprine should taper off the medication before discontinuing it
True. The client should taper off cyclobenzaprine before discontinuing it to prevent the return of the musculoskeletal condition

T/F. A client taking cyclobenzaprine should expect increased saliva production
False. The client should use gum or sip on water to prevent dry mouth, which is an adverse effect of cyclobenzaprine.

T/F. A client taking cyclobenzaprine should reportan urinary incontinence
False. The client should report any urinary retention because of the anticholinergic effects created when taking cycobenzaprine

T/F. A patient taking ranitidine for peptic ulcer disease should know smoking makes ranitidine less effective
True. The nurse should instruct the client that smoking decreases the effectiveness of ranitidien by exacerbating the ulcer manifestations

T/F. A patient taking ranitidine for peptic ulcer disease should stop takng ranitidine when the stomach pain is gone
False. The nurse should instruct the client to take ranitidine on a continuous continuous basis for the prescribed time

T/F. A patient taking ranitidine for peptic ulcer disease should take ranitidine anytime my stomach hurts
False. The nurse should instruct the client to take ranitidine on a continuous continuous basis for the prescribed time

T/F. A patient taking ranitidine for peptic ulcer disease should know that ranitidine will turn their stools black
False. Ranitidine does not cause stools to appear black. However, a bleeding peptic ulcer can cause a client’s stools to turn black

T/F. A client taking zolpidem with insomnia should take this medication for 1 week before results are seen.
False. The client who takes zolpidem should haveimproved sleep within 2 days of starting this medication.

T/F. A client taking zolpidem with insomnia should get laboratory testing prior to a refill of the medication
False. Laboratory testing is not needed when taking this medicaiton for sleep.

T/F. A client taking zolpidem with insomnia should use the medication for a short period of time
True. Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription

T/F. A client taking zolpidem with insomnia should change the medications to prevent building up a tolerance
False. The client who takes zolpidem should not build up a tolerance with short-term use

T/F. A patient taking atenolol should know the medication is effective if they have an increase in libido
False. Atenolol, a beta=adrenergicblocking agent, can cause a decrease in libido and sexua ability.

T/F. A patient taking atenolol should know the medication is effective if they have an iprovement in memory
False. Atenolol, a beta-adrenergic blocking agent, has an adverse effect of memory loss.

T/F. A patient taking atenolol should know the medication is effective if they have an increase in urinary output
False. Atenolol, a beta-adrenergic blocking agent, has no direct effect on kidne function

T/F. A patient taking atenolol should know the medication is effective if they have a decreasein blood pressure
True. Atenolol, a beta-adrenergic blocking agent, lowers blood pressure by decreasing peripheral vascular resistance

T/F. A client taking lisinopril should report adverse effects including ringing in the ear.
False. Tinnitus, or ringing in the ears, is not an adverse effect of lisinopril

T/F. A client taking lisinopril should report adverse effects including hair loss.
False. Alopecia, or hair loss, is not an adverse effect of lisinopril

T/F. A client taking lisinopril should report adverse effects including dry cough.
True. A buildup of bradykinin from taking lisinopril can cause a client to have a dry cough and lead to life-threatening consequences. The client should report the finding to the provider

T/F. A client taking lisinopril should report adverse effects including facial flushing.
False. Facial flushing is not an adverse effect of lisinopril. However, facial edema is a serious effect that the client shouldreport to the provider

T/F. A nurse administering ceftazidime to a client who has a severe penicillin allergy would have to complete an incident report if the client reports shortness of breath
True. A severe penicillin allergy is a contraindicaiton for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. Shortness of breath can indicate the client is developing anaphylaxis.

T/F. A nurse administering ceftazidime to a client who has a severe penicillin allergy would have to complete an incident report if the client also is taking lisinopril
False. Lisinopril is an ACE inhibitor medication that has no known interaction with cephalosporins.

T/F. A nurse administering ceftazidime to a client who has a severe penicillin allergy would have to complete an incident report if the client’s WBC count is 14,000/mm^3
False. An elevated WBC count is an indicaiton the client has an infection and sould receive antibiotic therapy.

T/F. A nurse administering ceftazidime to a client who has a severe penicillin allergy would have to complete an incident report if the client’s pulse rate is 60/min
False. Cephalosporins do not affect the client’s pulse rate. The client’s pulse rate of 60/min is within the expected reference range

T/F. Before giving a refil of isotretinoin for severe nodulocystic acne vulgaris, the client requires an aspartate aminotransferase level test
False. The client does not need to have a laboratory test for aspartate aminotransferase levels when taking isotretinoin.

T/F. Before giving a refil of isotretinoin for severe nodulocystic acne vulgaris, the client requires a serum calcium test
False. The client does not need to have a laboratory test for serum calcium levels when taking isotretinoin.

T/F. Before giving a refil of isotretinoin for severe nodulocystic acne vulgaris, the client requires a pregnancy test
True. The client who is pregnant or might become pregnant must not take isotretinoin because this medication has teratogenic effets. Pregnancy testing is mandatory before the initial prescription (two tests) and before monthly refills (one test)

T/F. Before giving a refil of isotretinoin for severe nodulocystic acne vulgaris, the client requires a 24 hour urine collecton for protein
False. The client does not need to have a 24 hour urine test for protein levels when taking isotretinoini

T/F. A patient administered baclofen for a spinal cord injury should be monitored for the therapeutic outcome of increase in cognitive function
False. The client who takes baclofen can experience the adverse effect of memory impairment and a decrease in cognitive function

T/F. A patient administered baclofen for a spinal cord injury should be monitored for the therapeutic outcome of decrease in flexor and extensor spasticity
True. The client who has a spinal cord injury and takes baclofen can experience a decrease in the frequency and severity of muscle spasms and in flexor and extensor spasticity.

T/F. A patient administered baclofen for a spinal cord injury should be monitored for the therapeutic outcome of decrease in paralysis of the extremities
False. The client who takes baclofen can experience the adverse effect of inhibited reflexes at the spinal level, but the medication does not decrease the effects of paralysis.

T/F. A patient administered baclofen for a spinal cord injury should be monitored for the therapeutic outcome of increase in seizure threshold
False. The client who has a seizure disorder and takes baclofen can have a decrease in the seizure threshold, which can result in seizure activity

T/F. A nurse discovers a patient with gout was given atenolol instead of allopurinol. The nurse should FIRST inform the charge nurse.
False. The nurse should alert the charge nurse to the medication error. However, there is another action the nurse should take first.

T/F. A nurse discovers a patient with gout was given atenolol instead of allopurinol. The nurse should FIRST obtain the client’s blood pressure
True. The first action the nurse should take to prevent injury to the client when using the nursing process is to assess the client for adverse effects of atenolol, such as hypotension

T/F. A nurse discovers a patient with gout was given atenolol instead of allopurinol. The nurse should FIRST contact the client’s provider
False. The nurse should contact the provider, who can provide direction to the nurse to prevent injury to the client. However, there is another action the nurse should take first.

T/F. A nurse discovers a patient with gout was given atenolol instead of allopurinol. The nurse should FIRST complete an incident report
False. The nurse should complete an incident report, which is used as part of a facility’s quality assurance program. However, there is another action the nurse should take first

T/F. A patient taking an MAOI inhibitor should avoid eating cottage cheese.
False. The nurse should inform the client that it is safe to eat cottage cheese, which cntains little to no tyramine, when taking MAOI medications.

T/F. A patient taking an MAOI inhibitor should avoid eating smoked sausage.
True. The nurse should instruct the client to avoid eating smoked sausage because it contains tyramine. Tyramine can interact with MAOIs and result in hypertensive crisis.

T/F. A patient taking an MAOI inhibitor should avoid eating apple pie.
False. The nurse should inform the client that it is safe to eat apple pie, which contains little to no tyramine, when taking MAOI medications.

T/F. A patient taking an MAOI inhibitor should avoid eating green beans.
False. The nurse should inform the client that it is safe to eat green beans, which contains little to no tyramine, when taking MAOI medications.

T/F. A client taking oral transmucosal fentanyl raspberry flavored lozenges on a stick should store unused medication sticks in a storage container.
True. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.

T/F. A client taking oral transmucosal fentanyl raspberry flavored lozenges on a stick should leave the medication stick in one location of the mouth until melted
False. The nurse should instruct the client to periodically move the medication stick to a different location in the mouth for best absorptiono.

T/F. A client taking oral transmucosal fentanyl raspberry flavored lozenges on a stick should chew on the medication stick to release the medication
False. The nurse should instruct the client to place the fentanyl stick between her cheek and lower gum and to actively suck it for increased absorption of the medicaiton.

T/F. A client taking oral transmucosal fentanyl raspberry flavored lozenges on a stick should allow the medication 1 hour for analgesia effects to begin
False. The nurse should instruct the client to expect the medication’s analgesia effects to begin within 10 to 15 minutes.

T/F. A patient taking sumatriptan should report adverse effects including insomnia.
False. Sumatriptan can cause drowsiness and sedation as an adverse effect of the medication.

T/F. A patient taking sumatriptan should report adverse effects including chest pressure.
True. Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.

T/F. A patient taking sumatriptan should report adverse effects including bruising.
False. Ecchymosis can indicate thrombocytopenia, which is not an adverse effect of sumatriptan

T/F. A patient taking sumatriptan should report adverse effects including white patches on the tongue.
False. White patches on the tongue can indicate a fungal infection, which is not an adverse effect of sumatriptan

T/F. A client receiving end-of-life care who has a prescription for fentanyl patches should remove the patch to reverse adverse effects immediately.
False. After removing the patch, the effects will persist for several hours due to the absorption of the residual medication on the skin.

T/F. A client receiving end-of-life care who has a prescription for fentanyl patches should receive a prescription for naloxone at home for respiratory depression
False. Naloxone is only for use in an acute care setting for the reversal of severe respiratory depression.

T/F. A client receiving end-of-life care who has a prescription for fentanyl patches should take a stool softener on a daily basis
True. Constipation is an adverse effect of opioid use and stool softeners can decrease the severity of this adverse effect.

T/F. A client receiving end-of-life care who has a prescription for fentanyl patches should expect an increase in urinary output
False. Urinary retention is an adverse effect of opioids, including fentanyl

T/F. A patient with multiple sclerosis taking methlprednisolone should take the medication 1 hour before breakfast.
False. The nurse should instruct the client to take the medication with food or milk to decrease GI upset.

T/F. A patient with multiple sclerosis taking methlprednisolone should monitor blood glucose levels during therapy
True. The nurse should monitor the client for hyperglcemia while providing this medication to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics.

T/F. A patient with multiple sclerosis taking methlprednisolone should decrease dietary intake of foods containing potassium
False. The nurse should instruct the client to increase dietary intake of potassium-rich foods while taking this medication. Glucocorticoids, such as methylprednisolone, deplete potassium in the body, which manifests as hypokalemia.

T/F. A patient with multiple sclerosis taking methlprednisolone should avoid contact with people who have known infections
True. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune sytsem, placing the client at an increased risk for developing an infection.

T/F. A patient with multiple sclerosis taking methlprednisolone should know that grapefruit juice can increase the effects of the medicatiaono
True. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body

T/F. A client taking ferrous sulfate should promote absorption by taking it with orange juice.
True. The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice. However, increasing the dosage of ferrous sulfate can provide the same benefit to increase the amount of iron uptake

T/F. A client taking ferrous sulfate should promote absorption by taking it with antacids.
False. Antacids inhibit iron absorption.

T/F. A client taking ferrous sulfate should promote absorption by taking it with vitamin E.
False. Vitamin E has no effect on iron absorption.

T/F. A client taking ferrous sulfate should promote absorption by taking it with milk.
False. Milk inhibits iron absorption

T/F. A patient with cancer taking oral morphine and docusate sodium should know the docusate sodium minimizes the adverse morphine effect of itching.
False. Itching is not an adverse effect of morphine that will be minimized while taking docusate sodium.

T/F. A patient with cancer taking oral morphine and docusate sodium should know the docusate sodium minimizes the adverse morphine effect of drowsiness.
False. Drowsiness is not an adverse effect of morphine that will be minimized while taking docusate sodium.

T/F. A patient with cancer taking oral morphine and docusate sodium should know the docusate sodium minimizes the adverse morphine effect of constipation.
True. Constipation is a common adverse effect of morphine that will minimize when the client takes docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine

T/F. A patient with cancer taking oral morphine and docusate sodium should know the docusate sodium minimizes the adverse morphine effect of facial flushing.
False. Facial flushing is not an adverse effect of morphine that will be minimized while taking docusate sodium.

T/F. A male client self-administering a transdermal nitroglycerin patch should know they can apply the patch to a chest area that has hair.
False. The client should apply the patch to an area of te skin that is hairless to enhance absorption of the medicaiton.

T/F. A male client self-administering a transdermal nitroglycerin patch should know they can take the medication if using an erectiledysfunction product
False. The client should not use erectile dysfunction products with nitroglycerin because this combination can cause severe hypotension and death.

T/F. A male client self-administering a transdermal nitroglycerin patch should know they need to apply a new patch to the same area every day
False. The client should rotate the locatoin of the patch daily to avoid irritation of the skin.

T/F. A male client self-administering a transdermal nitroglycerin patch should know they should remove the patch after 14 hours
True. The client should remove the patch after 12 to 14 hours to prevent tolerance of the medication.

T/F. A patient taking beclomethasone and albuterol inhalers for asthma should rinse their mouth after inhaling the beclomethasone.
True. The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

T/F. A patient taking beclomethasone and albuterol inhalers for asthma should use beclomethasone 5 minutes before using albuterol
False. The client should use the bronchodilator, albuterol, prior to taking beclomethasone, a glucocorticoid inhaler, to enhance its absorption.

T/F. A patient taking beclomethasone and albuterol inhalers for asthma should take beclometasone to avoid an acute attack
False. The client should take albuterol, a short-acting beta2-adrenergic agonist, to avoid an acute asthma attack.

T/F. A patient taking beclomethasone and albuterol inhalers for asthma should limit calcium and vitamin D intake when taking beclomethasone
False. The client should increase the intake of calcium and vitamin D to minimize bone loss while taking beclomethasone, a glucocorticoid inhaler

T/F. For a client with hypertension taking propranolol, the nurse should identify asthma as a conraindication to the drug
True. Asthma is a contraindication to receiving propranolol. Propranolol is an adrenergic antagonist which blocks the eta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.

T/F. For a client with hypertension taking propranolol, the nurse should identify tachycardia as a conraindication to the drug
False. Tachycardia is not a contraindication to receiving propranolol. Propranolol is administered to slow a client’s heart rate and decrease oxygen demand

T/F. For a client with hypertension taking propranolol, the nurse should identify cholelithiasis as a conraindication to the drug
False. Cholelithiasis is not a contraindication to receiving propranolol.

T/F. For a client with hypertension taking propranolol, the nurse should identify angina pectoris as a conraindication to the drug
False. The client who has angina pectoris can receive propranolol to decrease heart rate and contractility, resulting in a reduction of oxygen demand. Propranolol is contraindicated for use when aclient has vasospastic angina.

T/F. A patient might treat tuberculosis with temazepam.
False. This medication is given to treat insomnia.

T/F. A patient might treat tuberculosis with infliximab.
False. This medication is given to treat moderate tosevere Crohn’s disease or arthritis.

T/F. A patient might treat tuberculosis with rifampin.
True. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria.

T/F. A patient might treat tuberculosis with mirtazapine.
False. This medication is given to treat depression.

T/F. A patient might treat tuberculosis with isoniazid.
True. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria.

T/F. A client taking clindamycin should report adverse effects including watery diarrhea
True. The client who takes clindamycin can have an adverse effect of watery diarrhea that can lead to clostriduim difficile-associated idarrhea or pseudomembranous colitis. The client should report these findings immediately to the provider.

T/F. A client taking clindamycin should report adverse effects including weight gain
False. The client who takes clindamycin can have the adverse effect of weight loss.

T/F. A client taking clindamycin should report adverse effects including headache
False. The client who takes clindamycin will not have adverse effects that involve the central nervous system or cause a headache.

T/F. A client taking clindamycin should report adverse effects including orange urine
False. The client who takes clindamycin can develop jaundice, which can cause the urine to turn dark brown in color.

T/F. A nurse administering heparin subcutaneously to a patient should aspirate for blood return before injecting.
False. The nurse should not aspirate by pulling back on the plunger of the heparin syringe to check for a blood return, because it will cause the injection site to bruise.

T/F. A nurse administering heparin subcutaneously to a patient should place a pressure dressing on the injectoino site to prevent bleeding.
False The nurse does not need to apply a dressing over the injection site if pressure is held for at least 1 minute to p reent bleeding.

T/F. A nurse administering heparin subcutaneously to a patient should administer the medication outside the 5-cm (2-in) radius of the umbilicus
True. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 2 inchesaway from the umbilicus

T/F. A nurse administering heparin subcutaneously to a patient should rub vigorously after the injection to promote absorption
False. The nurse should aplpy firm pressure to the injection site for 1 to 2 minutes after the administration of the heparin to prevent bruising.

T/F. A patient with pneumonia finds out she is pregnant. This is a contraindication to receiving ipratropium
False. Ipratropium is a long-acting bronchodilator and is a category B medication of the FDA pregnancy risk categories, indicating the client should use ipratropium with caution during pregnancy. The nurse should inform the provider of the client’s pregnancy. However, this medicaiton is not contraindicated for the client at this time.

T/F. A patient with pneumonia finds out she is pregnant. This is a contraindication to receiving acetaminophen
False. Acetaminophen treats mild pain and is a category B medicaiton of the FDA pregnancy risk categories indicating the client should use acetaminophen with caution during pregnancy. The nurse should inform the provider of the client’s pregnancy. However, this medication is not contraindicated for the client at this time.

T/F. A patient with pneumonia finds out she is pregnant. This is a contraindication to receiving benzonatate
False. Benzonatate is a cough suppressant and is not contraindicated for the client who is pregnant.

T/F. A patient with pneumonia finds out she is pregnant. This is a contraindication to receiving doxycycline
True. Doxycycline is a tetracycine antibiotic and is contraindicated for a client who is pregnant because the medication is a category D medicaiton of the FDA pregnancy risk categories, which indicates the medication has fetal risks that can cause fetal damage The client should only take doxycycline for a life-threatening condition.

T/F. A client recovering from a DVT is taking warfarin. The nurse should monitor for adverse effects of warfarin including hypertension.
False. The nurse should monitor for hypotension, which may indicate bleeding.

T/F. A client recovering from a DVT is taking warfarin. The nurse should monitor for adverse effects of warfarin including bleeding gums.
True. The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant.

T/F. A client recovering from a DVT is taking warfarin. The nurse should monitor for adverse effects of warfarin including low INR.
False. The nurse should monitor the INR daily until it increases to a therapeutic level.

T/F. A client recovering from a DVT is taking warfarin. The nurse should monitor for adverse effects of warfarin including constipation.
False. The nurse should monitor for GI irritation, which can include diarrhea, nausea, and vomiting

T/F. For a patient with sickle cell anemia taking hydroxyurea, the nurse should report to the provider a creatinine of 1 mg/dL
False. A creatinine level of 1 mg/dL is within the expected reference range

T/F. For a patient with sickle cell anemia taking hydroxyurea, the nurse should report to the provider a hemoglobin of 7.0 g/dL
True. A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider.

T/F. For a patient with sickle cell anemia taking hydroxyurea, the nurse should report to the provider a RBC of 4.7 million/mm^3
False. An RBC level of 4.7 x 10^12/L is within the expected reference range.

T/F. For a patient with sickle cell anemia taking hydroxyurea, the nurse should report to the provider a potassium of 5.2 mEq/L
True. A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it ot the provider.

T/F. For a patient with sickle cell anemia taking hydroxyurea, the nurse should report to the provider a platelets 75,000/mm^3
True. A platelet level of 75,000/mm^3 indicates hydroxyurea toxicity, and the nurse should report it to the provider

T/F. A nurse should hold heparin IV infusion for a patient with DVT with a hemoglobin of 15 g/dL
False. An Hgb of 15 g/dL is within the expected reference range and is not an indication to stop the heparin infusion.

T/F. A nurse should hold heparin IV infusion for a patient with DVT with platelets of 96,000/mm^3
True. A platelet count less than 100,000/mm^3 while receving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition, which requires stopping the infusion.

T/F. A nurse should hold heparin IV infusion for a patient with DVT with an aPTT 2 times the control
False. This is a therapeutic aPTT level for a client receiving heparin, which is not an indication to stop the heparin infusion

T/F. A nurse should hold heparin IV infusion for a patient with DVT with a potassium 5.0 mEq/L
False. Although heparin can cause an increase in potassium levels, the client’s potassium level is within the xpected reference range

T/F. A patient taking oxybutynin for urinary incontinence should report adverse effects including dry eyes.
True. Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation.

T/F. A patient taking oxybutynin for urinary incontinence should report adverse effects including blurred vision.
True. Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure.

T/F. A patient taking oxybutynin for urinary incontinence should report adverse effects including bradycardia.
False. Oxybutynin can cause several cardiovascular adverse effects such as a prolongatoin of the QT interval, palpitations, hypertension, and tachycardia.

T/F. A patient taking oxybutynin for urinary incontinence should report adverse effects including tinnitus.
False. Oxybutynin can cause several sensory adverse effects including increased intraocular pressure. The nurse should instruct the client to report eye pain, seeing colored halos around lights, and a decreased ability to perceive light changes. However, tinnitus is not an adverse effect associated with oxybutynin administraiton.

T/F. A patient taking oxybutynin for urinary incontinence should report adverse effects including dry mouth.
True. Oxybutynin is an anticholinergic agent that can cause dry mouth.

T/F. A client experiencing acute alcohol withdrawal should be administered chlordiazepoxide to prevent delirium tremens
True. The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal

T/F. A client experiencing acute alcohol withdrawal should be administered chlordiazepoxide to minimize diaphoresis
False. The client should take clonidine or a beta-adrenergic blocker, such as atenolol, to minimize autonomic components, such as diaphoresis, during alcohol withdrawal.

T/F. A client experiencing acute alcohol withdrawal should be administered chlordiazepoxide to lessen craving
False. The client should take propranolol to decrease craving during alcohol withdrawal

T/F. A client experiencing acute alcohol withdrawal should be administered chlordiazepoxide to maintain abstinence
False. The client should take acamprosate to help maintain abstinence from alcohol by decreasing anxiety and other uncomfortable manfestations

T/F. A patient taking amitriptyline for depression should report adverse effects including diarrhea.
False. The nurse should assess the client for GI anticholinergic effects such as constipation. However, diarrhea is not an expected finding.

T/F. A patient taking amitriptyline for depression should report adverse effects including tinnitus.
False. Amitriptyline is a tricyclic antidepressant medication that has anticholinergic properties. The nurse should assess for sensory-neurologic adverse effects such as blurred vision or an increased sensitivity to light. However, tinnitus is not an expected finding.

T/F. A patient taking amitriptyline for depression should report adverse effects including urinary frequency.
False. The nurse should assess the client for genitourinary anticholinergic effects such as urinary hestitancy or retention due to the blocking of acetylcholine receptors that cause anticholinergic responses. However, urinary frequency is not an expected finding.

T/F. A patient taking amitriptyline for depression should report adverse effects including dry mouth.
True. The nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses.

T/F. A client taking lisinopril should report adverse effects including weight gain.
False. Lisinopril can cause a number of GI adverse effects including vomiting, anorexia, constipation, pancreatitis, and liver failure. However, lisinopril has not been associated with weight gain.

T/F. A client taking lisinopril should report adverse effects including persistent cough.
True. Lisinopril is an ACE inhibitor that can cause a persistent, dry, irritating, nonproductive cough from an excessive buildup of bradykinin. The client should report this adverse effect to the provider.

T/F. A client taking lisinopril should report adverse effects including hallucinations.
False. Lisinopril can cause a number of neurologic adverse effects including depression, paresthesia, and stroke. However, hallucinations are not an adverse effect of lisinopril.

T/F. A client taking lisinopril should report adverse effects including drowsiness.
False. Lisinopril is an ACE inhibitor used in the treatment of hypertension, heart failure, and myocardial infarction. Lisinopril can cause a number of neurologic adverse effects including insomnia. However, drowsiness is not an adverse effect of lisinopril.

T/F. A patient receiving gentamicin IV should report adverse effects including hypoglycemia.
False. Gentamicin, an aminoglycoside used to treat serious infectoins, can cause alternations in the functions of the liver and spleen. However, pancreatic function, mainly insuin production, is not affected by this medicaiton.

T/F. A patient receiving gentamicin IV should report adverse effects including constipatoin.
False. Gentamicin, an aminoglycoside used to treat serious infections, can cause several GI adverse effects, such as inflammaiton of the liver and spleen

T/F. A patient receiving gentamicin IV should report adverse effects including tinnitus.
True. Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high pitched ringing in the ears and headaches and should notify the provider if these occur.

T/F. A patient receiving gentamicin IV should report adverse effects including joint pain.
False. Aminoglycosides, such as gentamicin, can result in neuromuscular adverse effects such as twitching or flaccid paralysis. However, joint pain is not an adverse effect of gentamicin

T/F. A client taking hydrocodone with acetaminophen tablets for pain should know that tablets should not be crushed or chewed.
False. The client should avoid crushing, chewing, or breaking the extended release or immediate release hydrocodone tablets to prevent an immediate increase in CNS effects. Hydrocodone with acetaminophen tablets can be crushed if needed.

T/F. A client taking hydrocodone with acetaminophen tablets for pain should know that it takes 48 hours for therapeutic effects to occur
False. The nurse should instruct the client that she should experience the effects of hydrocodone with acetaminophen within 20 min of administration and that pain relief should last for 4 to 6 hr.

T/F. A client taking hydrocodone with acetaminophen tablets for pain should know that the medication should be taken 1 hour prior to eating
False. The client should take hydrocodone and acetaminophen with food or milk to decrease gastric irritation.

T/F. A client taking hydrocodone with acetaminophen tablets for pain should know that decreased respirations might occur
True. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking OTC medications or newly prescribed medications without consulting her provider to avoid increased respiratory depression

T/F. An older patient with a UTI taking ciprofloxacin should take the medication with milk
False. The client should take ciprofloxacin with water and increase fluids to 2 to 3 L daily to avoid the development of crystals in the kidneys. Milk products will decrease the absorption of the medication.

T/F. An older patient with a UTI taking ciprofloxacin should take the medication with an antacid to prevent GI upset.
False. The client should avoid taking the ciprofloxacin with an antacid containing aluminum, magnesium, or calcium because the effectiveness of the medication could be decreased. The nurse should instruct the client ot take antacids 2 hours before or 6 hours after the ciprofloxacin.

T/F. An older patient with a UTI taking ciprofloxacin should report any signs of tendon pain or swelling
True. Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling.

T/F. An older patient with a UTI taking ciprofloxacin should stop taking the medication when they no longer have pain upon urination
False. The client should take the full course of ciprofloxacin to prevent reoccurring colonization of bacteria.

T/F. A patient with a gastric ulcer taking ranitidine should report yellowing of the skin.
True. Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

T/F. A patient with a gastric ulcer taking ranitidine should store the medication in the refrigerator.
False. The client should store ranitidine at room temperature

T/F. A patient with a gastric ulcer taking ranitidine should discontinue the medication when stomach discomfort subsides
False. For clients who have a gastric ulcer, ranitidine is p rescribed to inhibit gastric secretion and must be taken for the full course of therapy in order to be effective

T/F. A patient with a gastric ulcer taking ranitidine should take the medicaiton on an empty stomach for full effectiveness
False. The client can take ranitidine with or without food because the medication’s effectiveness is the same with or without food

T/F. A client taking IV cefazolin could have nephrotoxicity if concurrently taking levofloxacin.
False. Levofloxacine, a fluroquinolone used to treat infections, can cause hepatotoxicity. However, it will not potentiate renal damage if administered concurrently with cefazolin.

T/F. A client taking IV cefazolin could have nephrotoxicity if concurrently taking metoclopramide.
False. Metoclopramide is an antiemetic that can cause tardive dyskinesia. However, it will not potentiate renal damage if administered concurrently with cefazolin.

T/F. A client taking IV cefazolin could have nephrotoxicity if concurrently taking gentamicin.
True. Gentamicin, an aminoglycoside antibiotic, can damage renal function. When combined with a penicillin or cephalosporin, such as cefazolin, the client is at increased risk for nephrotoxicity

T/F. A client taking IV cefazolin could have nephrotoxicity if concurrently taking famotidine.
False. Famotidine, an H2-histamine receptor antagonist used in the treatment of GERD, is primarily metabolized in the liver. Although it is excreted in the kidneys, it is not nephrotoxic and will not potentiate renal damage if administered concurrently with cefazolin

T/F. A patient taking furosemide twice daily should obtain their weight weekly.
False. Loop diuretics cause an increase in fluid excretion and can cause dehydration. While manifestations of dehydration, such as increased thirst and decreased urine output, can assist in the diagnosis of dehydration, the most reliable method of identifying the onset of dehydration is by loss of weight. The client should obtain daily weights to monitor for the diuresis effect of the medication

T/F. A patient taking furosemide twice daily should monitor for muscle weakness
True. Furosemide, a loop diuretic, causes a loss of potassium which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider

T/F. A patient taking furosemide twice daily should dangle their legs from the side of the bed before standing
True. Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position. The client should change positions slowly to minimize orthostatic hypotension.

T/F. A patient taking furosemide twice daily should take the second dose at bedtime
False. Furosemide is a loop diuretic that causes diuresis. When taken twice daily,the client should take the secnd dose of furosemide by 1400 hr to prevent nocturia.

T/F. A patient taking furosemide twice daily should increase intake of potassium-rich foods
True. Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse ffect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts.

T/F. A client with myastheniagravis in a cholinergic crisis should be given protamine.
False. Protamine is a heparin antagoinst that is administered to reverse heparin toxicity evidenced by an aPTT greater than 70 seconds.

T/F. A client with myastheniagravis in a cholinergic crisis should be given atropine.
True. A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. Th enurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity

T/F. A client with myastheniagravis in a cholinergic crisis should be given potassium chloride.
False. Potassium iodide is a thyroid hormone antagonist used in the treatment of radioactive iodine exposure

T/F. A client with myastheniagravis in a cholinergic crisis should be given glucagon.
False. Glucagon is an antihypoglycemic medication used in the treatment of low blood glucose levels.

T/F. A patient taking allopurinol for gout should drink 2 L of water daily.
True. The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury because allopurinol is eleminated through the kidneys

T/F. A patient taking allopurinol for gout should plan to increase the dosage each week by 200 mg increments
False. The nurse should instruct the client to increase the dosage each week by 50 to 100 mg until he experiences relief or reaches a maximum of 800 mg daily.

T/F. A patient taking allopurinol for gout should exect a fine red rash that is transient and can be treated with antihistamines
False. The nurse should instruct the client to report a rash to the provider immediately as this can be an indication of hypersensitivity syndrome, a life-threatening toxicity. Treatment for allopurinol toxicity can require hemodialysis or the administration of glucocorticoid medications.

T/F. A patient taking allopurinol for gout should know that prolonged use of the medication can cause glaucoma
False. The nurse should teach that prolonged use of allopurinol can cause cataracts. Therefore, the client should have periodic ophthalmic check-ups

T/F. A client using nitroglycerin transdermal patches should discard the used patch by flushing it down the toilet.
False. Medication remains in the transdermal patch after removing it from the body and must be discarded safely. The nurse should instruct the client to fold the patch ends together with the medication on the inside and place the discarded patch in a closed container so that children and pets cannot gain access to the medication.

T/F. A client using nitroglycerin transdermal patches should leave the patch off at least 1 day each week
False. Nitroglycerin is an antianginal medicaiton that results in dilation of the coronary vessels. Clients should apply the patch daily to sustain prphylaxis.

T/F. A client using nitroglycerin transdermal patches should take the patch of right after the evening meal
True. Clients should remove the patch each evening for a medicaiton free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication’s effects.

T/F. A client using nitroglycerin transdermal patches should apply a patch every 5 minutes if they develop chest pain
False. Nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses sublingual tablets should place one tablet under his tongue at the onset of angina pain and continue taking a tablet every 5 min for a total of 3 doses of nitroglycerin. The effects of a nitroglycerin patch will take 30 to 60 min to occur and are not useful to prevent an ongoing angina attack

T/F. A patient with peptic ulcer disease taking sucralfate should know the drug decreases stomach acid secretion.
False. Peptic ulcer disease manifests as an erosion of the gastric or duodenal mucosa. The acid production in the stomach causes further irritation and pain. H2 receptor antagonists, such as famotidine, decrease stomach and secretion

T/F. A patient with peptic ulcer disease taking sucralfate should know the drug forms a protective barrier over ulcers
True. Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.

T/F. A patient with peptic ulcer disease taking sucralfate should know the drug treats ulcers by eradicating H. pylori
False. A common cause of peptic ulcers is a bacterial infection with helicobactor pylori. Treatment of the ulcer includes a combination of antibiotics, such as metronidazole, tetracycline, clarithromycin, or amoxicillin, to eradicate the H. pylori infection.

T/F. A patient with peptic ulcer disease taking sucralfate should know the drug neutralizes acids in the stomach
False. Acid production in the stomach causes further irritation and pain to a client who has a petpic ulcer. Antacids, such as aluminum hdroxide, neutralize acids in the stomach and prevent pepsin formation, a digestive enzyme that can further damage the eroded epithelium

T/F. A client planning pregnancy can help prevent neural tube defects by starting to take thiamine before becoming pregnant.
False. Thiamine, or vitamin B1 deficiency, can cause beriberi or Wernicke-Korsakoff syndrome that affect the CNS. However, thiamine does not prevent neural tube defects in the developing fetus.

T/F. A client planning pregnancy can help prevent neural tube defects by starting to take pyridoxine before becoming pregnant.
False pyridoxine, or vitamin B6 can help a client who is predisposed to neuropathy from diabetes or alcohol use disorder. However, pyridoxine does not prevent neural tube defects in the developing fetus.

T/F. A client planning pregnancy can help prevent neural tube defects by starting to take folic acid before becoming pregnant.
True. The nurse should instruct all female clients who could become pregnant to take at least 400 mcg of folic acid daily in addition to foods containing folic acid to prevent neural tube defects in the developing fetus. Enriched rice and breakfast cereals are good sources of folic acid but might not provide enough folic acid without supplements

T/F. A client planning pregnancy can help prevent neural tube defects by starting to take riboflavin before becoming pregnant.
True. Riboflavin, or vitamin B2, can help a client who has a vitamin deficiency and can be used to treat migraine headaches. However, riboflavin does not prevent neural tube defects in the developing fetus.

T/F. A patient taking oral amoxicillin/clavulanate reports urticaria. The nurse should check the client’s WBC count.
False. The client is experiencing a mild allergic reaction to the medicaiton and checking the client’s WBC count does not indicate why the client is having urticaria.

T/F. A patient taking oral amoxicillin/clavulanate reports urticaria. The nurse should check for pitting edema.
False. Pitting edema is not an expected manifestation of a mild allergic reaction. The nurse should assess the client’s heart rate and pulmonary status when the client is experiencing a mild allergic reaction.

T/F. A patient taking oral amoxicillin/clavulanate reports urticaria. The nurse should request a change in the type of the antibiotic
True. Manifestations of urticaria after taking a penicillin-based medication indicate a mild allergic reaction. Therefore, it is appropriate for the nurse to request a change in the type of antibiotic.

T/F. A patient taking oral amoxicillin/clavulanate reports urticaria. The nurse should ask for a change in the route of the administration
False. The client is experiencing a mild allergic reaction to the medication. Changing the route of administration puts the client at risk for further manifestations of the allergy

T/F. A client with hypertension taking metoprolol should be monitored for jaundice.
False. The nurse should monitor the client for adverse effects such as hypotension, but jaundice is not associated with this medicaiton.

T/F. A client with hypertension taking metoprolol should be administered the m edication 30 minutes prior to breakfast
False. The nurse should administer metoprolol following meals or at bedtime if orthostatic hypotension occurs.

T/F. A client with hypertension taking metoprolol should have apical pulse determined p rior to administration
True. An adverse effect for this client is life-threatening bradycardia. Therefore, the nurse should assess the client’s apical pulse prior to administering the medication. If the pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

T/F. A client with hypertension taking metoprolol should be weighed weekly
False. The nurse should weigh the client daily to monitor for the development of heart failure and weight gain.

T/F. A patient with acute acetaminophen toxicity should be administered beztrophine.
False. Benztrophine is an anticholinergic medication used to treat parkinsonian adverse effects o f antipsychotic medications.

T/F. A patient with acute acetaminophen toxicity should be administered vitamin K.
False. Vitamin K is used to treat warfarin overdose, indicated by elevated levels of PT/INR.

T/F. A patient with acute acetaminophen toxicity should be administered physostigmine.
False. Physostigmine is an effective antidote for antimuscarinic poisoning, that is, toxic overdoses of atropine, scopolamine, some antihistamines, phenothiazines, and tricyclic antidepressants. It has no effect on acetaminophen overdose

T/F. A patient with acute acetaminophen toxicity should be administered acetylcysteine.
True. Acetylcysteine is a specific antidote for acetaminophen. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr of overdose.

T/F. A patient with ehart failure taking captopril should take the medication with food.
False. The client should take captopril on an empty stomach because food reduces absorption of the medicaiton. The nurse should instruct the client to take the medication 1 hour before or 2 hours after a meal.

T/F. A patient with ehart failure taking captopril should expect the medication to cause their urine to look orange.
False. Captopril affects the urinary system by causing dysuria, urinary frequency, and changes in th enormal amount of urine. However, captopril does not affect the color of the urine.

T/F. A patient with ehart failure taking captopril should tell their provider if they develop a sore throat
True. The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is recognized early and the medication is promptly discontinued

T/F. A patient with ehart failure taking captopril should take naproxen if they develop joint pain.
False. Naproxen and other NSAID’s can interact with captopril, decreasing the effect of the antihypertensive, which can result in renal impairment when used.

T/F. A precepting nurse should report if a newly licensed nurse administers digoxin to a client who has a heart rate of 92/min.
False. Digoxin is a cardiac glycoside used for clients with heart failure because it strengthens the contractility of the heart, increasing cardiac output. A slowing of the heart rate is an effect of digoxin, so it should be withheld if the client’s heart rate is less than 60/min.

T/F. A precepting nurse should report if a newly licensed nurse administers isosorbide mononitrate to a client who has BP 82/60 mm Hg
True. Isosorbide mononitrate is a nitrate used for clients with angina. Taking isosorbide mononitrate leads to vasodilation, which can result in hypotension. The nurse should withhold the medication and notify the provider if the client’s systolic blood pressure is below the expected reference range

T/F. A precepting nurse should report if a newly licensed nurse administers regular insulin to a client who has a blood glucose of 250 mg/dL
False. Insulin is a hormone that promotes the uptake of glucose into the cells, thereby decreasing circulating glucose. A blood glucose value of 250 mg/dL is above the expected reference range, so the nurse should administer regular insulin.

T/F. A precepting nurse should report if a newly licensed nurse administers heparin to a client who has an aPTT of 70 seconds
False. Heparin is an anticoagulant that dereases the coagulability of the blood and is used for clients with thrombus. Dosing of heparin is dependent upon achieving a therapeutic aPTT level. An aPTT of 70 seconds is within the expected reference range when administering heparin

T/F. A patient administered a second dose of cefazolin IV has anxiety, hypotension, and dyspnea. The nurse should FIRST administer prednisone.
False. The nurse should plan to administer prednisone, a glucocorticoid, for the urticaria following anaphylaxis and to prevent a delayed anaphylaxis reaction from occurring. However, evidence based practice indicates that administering another medicaiton is the priority.

T/F. A patient administered a second dose of cefazolin IV has anxiety, hypotension, and dyspnea. The nurse should FIRST administer epinephrine.
True. According to evidence-based practice, the nurse should first administer epinephrine to reduce vasoconstriction and bronchodilation during anaphylaxis.

T/F. A patient administered a second dose of cefazolin IV has anxiety, hypotension, and dyspnea. The nurse should FIRST administer diphenhydramine.
False. The nurse should administer diphenhydramine, an antihistamine, as a second-line medication to decrease angioedema and urticaria following anaphylaxis. However, evidence-based practice indicates that administering another medication is the priority.

T/F. A patient administered a second dose of cefazolin IV has anxiety, hypotension, and dyspnea. The nurse should FIRST administer albuterol inhaler.
False. The nurse should administer albuterol, a bronchodilator, for a client who has dyspnea from bronchospasms during anaphylaxis. However, evidence-based practice indicates that administering another medication is the priority

T/F. A nurse should teach a client taking warfarin that aspirin will increase the risk of bleeding.
True. Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, it increases the risk for bleeding, so the client should avoid taking aspirin.

T/F. A nurse should teach a client taking warfarin that acetaminophenmay be substituted for aspirin
False. Acetaminophen, an analgesic drug, can potentiate the action of the anticoagulant warfarin and is not a safe substitute for aspirin.

T/F. A nurse should teach a client taking warfarin that it is safe to take an enteric-coated aspirin
False. Although it is common for clients to consider an occasional aspirin harmless, salicylates inhibit platelet aggregation and increase the potential for hemorrhage. Therefore, the client should avoid taking entericcoated aspirin.

T/F. A nurse should teach a client taking warfarin that the INR lab work must be monitored more frequently if aspirin is taken
False. The client should continueto follow the provider’s prescription for monitoring the PT/INFR in order to adjust warfarin dosages. However, the nurse should discourage the client from using aspirin products as these medications increase the antiplatelet action of the warfarin and can result in bleeding.

T/F. A patient taking docusate sodium should know the drug causes rectal contractions.
False. Osmotic laxatives, such as glycerin suppositories, act by lubricating the lower colon and initiating reflex contractons of the rectum.

T/F. A patient taking docusate sodium should know the drug reduces the surface tension of the stools to change their consistency.
True. Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.

T/F. A patient taking docusate sodium should know the drug stimulates the motility of the intestines.
False. Stimulant laxatives, such as bisacodyl, stimulate the intestinal wall to cause peristalsis by pulling water into the intestines.

T/F. A patient taking docusate sodium should know the drug acts as a fiber agent, increasing bulk in the intestines.
False. Bulk-forming laxatives, such as methylcellulose, mimic the action of dietary fiber, forming a viscous compound that softens the fecal mass and increases its bulk, which stimulaltes peristalsis.

T/F. A client taking bupropion as an aid to quit smoking should watch for adverse effects including cough
False. Bupropion, an atypical antidepressant, does not cause coughing

T/F. A client taking bupropion as an aid to quit smoking should watch for adverse effects including alopecia
False. Bupropion can cause sensory adverse effects such as changes in vision and hearing. However, it does not cause alopecia.

T/F. A client taking bupropion as an aid to quit smoking should watch for adverse effects including joint pain
False. Bupropion can cause neurologic adverse effects such as bradykinesia. However, it does not cause joint pain.

T/F. A client taking bupropion as an aid to quit smoking should watch for adverse effects including insomnia
True. Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia.

T/F. A nurse preparing to administer dantrolene via IV bolus to a patient who developed malignant hyperthermia during surgery should reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.
True. The nurse should dilute themedication with 60 mL of sterile water without a bacteriostatic agent and inject rapidly.

T/F. A nurse preparing to administer dantrolene via IV bolus to a patient who developed malignant hyperthermia during surgery should administer the reconstituted medication slowly over 5 min.
False. The nurse should administer reconstituted dantrolene by IV bolus rapidly through a three-way stopcock.

T/F. A nurse preparing to administer dantrolene via IV bolus to a patient who developed malignant hyperthermia during surgery should use the reconstituted medication within 12 hr.
False. The nurse should use the reconstituted medicaiton within 6 hr.

T/F. A nurse preparing to administer dantrolene via IV bolus to a patient who developed malignant hyperthermia during surgery should reconstitute the initial dose with 60 mL of sterile water withotore the reconstituted medication in the refrigerator
False. The nurse should store the reconstituted medication at room temperature and protect it from the light until used.

T/F. A patient taking atorvastatin for hypertlipidemia should have regular labwork to monitor potassium
False. Potassium is a major electrolyte that maintains acid-base balance, oncotic pressure, and cardiac rhythm. The nurse should monitor potassium levels in clients who are receiving loop diuretics, such as bumetanide

T/F. A patient taking atorvastatin for hypertlipidemia should have regular labwork to monitor international normalized ratio
False. The INR measures clotting abilities of the blood. The nurse should monitor INR for clients who are receiving warfarin therapy.

T/F. A patient taking atorvastatin for hypertlipidemia should have regular labwork to monitor creatinine kinase
True. The client can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis. Creatinine kinase (CK) levels rise in response to enzymes released with muscle injury.

T/F. A patient taking atorvastatin for hypertlipidemia should have regular labwork to monitor erythrocyte sedimentation rate
False. Erythrocyte sedimentation rates (ESR) evaluate the speed at which red blood cells settle in plasma overa set amount of time. The nurse should monitor ESR for clients who have multiple myeloma, RA, and systemic lupus erythemotosus. However, it is not affected by statins, such as atorvastatin

T/F. A client with Graves’ disease taking propylthiouracil should note the medication is effective if they have a decrease in WBC count
False. Propylthiouracil is a thyroid hormone antagonist used in the treatment of hyperthyroidism or thyroid storms. A decreased WBC is an adverse effect of propylthiouracil, which can cause myelosuppresion.

T/F. A client with Graves’ disease taking propylthiouracil should note the medication is effective if they have a decrease in amount of time sleeping
False. Graves’ disease, a form of hyperthyroidism, has neurologic manifestations, including insomnia. Therefore, a decrease in the amount of time sleeping indicates the medication is not effective.

T/F. A client with Graves’ disease taking propylthiouracil should note the medication is effective if they have a increase in ability to focus
True. A client who has Graves’ disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medicaiton is effective.

T/F. A client with Graves’ disease taking propylthiouracil should note the medication is effective if they have a increase in appetite
False. Graves’ disease can result in GI manifestations such as increased appetite, weight loss, and increased GI motility. Therefore, this finding indicates the medication is not effective

T/F. A patient taking risedronate for osteoporosis should drink a glass of milk when they take the risedronate.
False. The nurse should reinforce that risedronate should be taken with a full glass of water, rather than any other liquid.

T/F. A patient taking risedronate for osteoporosis should take the risedronate 15 minutes after their evening meal
False. Although the delayed release form of the medication can be taken after eating, the immediate release form of the medication should be taken at least 30 min prior to consuming food or other liquids. Both forms of medication should be taken in the morning upon arising.

T/F. A patient taking risedronate for osteoporosis should sit up for 30 minutes after taking the risedronate
True. Sitting upright for at least 30 minutes after taking risedronate will reduce the adverse GI effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

T/F. A patient taking risedronate for osteoporosis should take an antacid with the risedronate to avoid nausea
False. The absorption of risedronate, a bisphosphonate, will be reduced if it is taken with antacids containing calcium, aluminum, or magnesium. The nurse should instruct the client to take the antacid 2 hours after taking risedronate

T/F. A client with a new diagnosis of exercise-induced asthma should take tiotropium prior to physical activity.
False. Tiotropium is an anticholinergic medication that decreases mucus production and produces bronchodilation. Tiotropium is used for maintenance therapy of bronchospasms and has a duration of 24 hours.

T/F. A client with a new diagnosis of exercise-induced asthma should take budesonide prior to physical activity.
False. Budesonide is a glucocorticoid medicaiton used to treat asthma as a long-term inhaled agent. This medicaiton is administered by inhalation twice daily, not prior to physical activity.

T/F. A client with a new diagnosis of exercise-induced asthma should take cromolyn prior to physical activity.
True. Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

T/F. A client with a new diagnosis of exercise-induced asthma should take beclomethasone prior to physical activity.
False. Beclomethasone is a prphylactic glucocorticoid inhalant medication that suppresses the inflammatory and humoral immune responses. Beclomethasone should be administered with a fixed schedule, not for PRN use before physical exercise

T/F. A patient taking lithium should discontinue OTC ibuprofen
True. Most NSAIDs can significantly increase lithium levels. Therefore, the client should nt take ibuprofen and lithium concurrently.

T/F. A patient taking lithium should discontinue OTC bisacodyl
False. There are no known medication interactions between bisacodyl and lithium

T/F. A patient taking lithium should discontinue OTC aspirin
False. Although most NSAIDs interact with lithium to increase lithium levels, aspirin and sulindac do not interact with lithium

T/F. A patient taking lithium should discontinue OTC ranitidine
False. There are no known medication interactions between ranitidine and lithium

T/F. A client administered 2 doses of betamethasone in preterm labor delivers a newborn. The nurse will know the medication was effective when the mother’s blood pressure is within the expected reference range.
False. Maternal hypertension can be treated with hydralazine, labetolol, or nifedipine. However, betamethasone is not used for treatment of preeclampsia

T/F. A client administered 2 doses of betamethasone in preterm labor delivers a newborn. The nurse will know the medication was effective when the newborn is free of infection
False. Betamethasone is a glucocorticoid medication. The newborn being free of infeciton is not an indication that the administration of betamethasone was effective.

T/F. A client administered 2 doses of betamethasone in preterm labor delivers a newborn. The nurse will know the medication was effective when the mother’s postpartum bleeding is minimial
False. Postpartum bleeding is controlled with the administration of oxytocin, a hormone that produces uterine contractions. However, betamethasone is not used for treatment of postpartum bleeding.

T/F. A client administered 2 doses of betamethasone in preterm labor delivers a newborn. The nurse will know the medication was effective when the newborn has normal respiratory patterns
True. The newborn having a normal respiratory pattern is an indication that the administration of betamethasone was effective. This medication stimulates surfactant production, which improves oxygenation and lung compliance in neonates.

T/F. A patient administered oprelvekin indicates effectiveness of the therapy with decreased triglycerides.
False. Triglycerides are a form of lipids found in the blood stream. Increased levels are associated with an increased risk for heart disease. Decreased levels can occur in clients who have malnutrition or malabsorptiondisorders. Oprelvekin is used to treat chemotherapy-induced thrombocytopenia and has no effect on a client’s triglyceride levels.

T/F. A patient administered oprelvekin indicates effectiveness of the therapy with increased RBC count.
False. Oprelvekin can cause a decrease in hemoglobin, hematocrit and red blood cells due to an increased plasma volume that results from this medication

T/F. A patient administered oprelvekin indicates effectiveness of the therapy with increased platelet count.
True. Oprelvekin stimulates the bone marrow to produce platelets. For clients receiving chemotherapy, thrombocytopenia is minimized so these clients will require fewer platelet transfusions.

T/F. A patient administered oprelvekin indicates effectiveness of the therapy with decreased prothrombin time
False. Prothrombin time measures the effectiveness of warfarin therapy and is not decreased by oprelvekin therapy.

T/F. A nurse assessing a client 1 hour after administering morphine for pain would note the morphine was effective if the client rates the pain at a 3 on a scale from 0 to 10.
True. The client’s description of the pain is the most accurate assessment of pain.

T/F. A nurse assessing a client 1 hour after administering morphine for pain would note the morphine was effective if the client is resting comfortably with eyes closed
False. The client might rest with his eyes closed as a method to try to manage pain. However, this does not indicate that the pain is controlled.

T/F. A nurse assessing a client 1 hour after administering morphine for pain would note the morphine was effective if the client’s vital signs are within normal limits
False. Vital signs can be within normal limits for clients who have pain.

T/F. A nurse assessing a client 1 hour after administering morphine for pain would note the morphine was effective if the client has not requested additional medication
False. Often times, clients do not request medicine even when they are experiencing pain.

T/F. A patient receiving IV heparin to treat pulmonary embolism should report adverse effecs including vomiting.
False. Vomiting is not an expectic adverse effect of heparin therapy The nurse should assess the client for other causes for vomiting. If vomiting continues for an extended period of time, the nurse should contact the provider.

T/F. A patient receiving IV heparin to treat pulmonary embolism should report adverse effecs including blood in the urine.
True. The nurse should report blood in the urine to the provider because this can be a manifestation of heparin overdose. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.

T/F. A patient receiving IV heparin to treat pulmonary embolism should report adverse effecs including ringing in the ears.
False. Ringing in the ears is not an expected adverse effect of heparin therapy. Aminoglycosides, such as vancomycin, are medications that cause ringing in the ears

T/F. A patient receiving IV heparin to treat pulmonary embolism should report adverse effecs including positive Chvostek’s sign.
False. A chvostek sign is seen in clients who have hypocalcemia or hypomagnesemia. The client wh ois recieiving helparin may develop hyperkalemia

T/F. In reviewing lab results for a client taking cetazadime via intermittent IV bolus, the nurse should report to the provider before administering the medication a creatinine of 2.6 mg/dL
True. Ceftazadime is excreted primarily by the renal system. A serum creatinine level above 1.3 mg/dL can indicate a kidney disorder requiring a reduction in the dosage administered. The nurse should notify the provider, who is likely to prescribe a lowered dose of medicaiton.

T/F. In reviewing lab results for a client taking cetazadime via intermittent IV bolus, the nurse should report to the provider before administering the medication an alanine aminotransferase 26 units/L
False. Ceftazadime can cause elevated liver function tests, such as alanine aminotransferase. However, an alanine aminotransferase value of 26 units/L is within the expected reference range.

T/F. In reviewing lab results for a client taking cetazadime via intermittent IV bolus, the nurse should report to the provider before administering the medication total bilirubin 0.4 mg/dL
False. Ceftazadime, a cephalosporin can cause elevated liver function tests, such as bilirubin. However, a total bilirubin value of 0.4 mg/dL is within the expected reference range.

T/F. In reviewing lab results for a client taking cetazadime via intermittent IV bolus, the nurse should report to the provider before administering the medication platelet count 360,000/mm^3
False. Ceftazadime can cause thrombocytopenia. However, a platelet count of 360,000/mm^3 is within the expected reference range

T/F. A patient prescribed amoxicillin/clavulanic tells the nurse he is allergic to penicillin. The nurse should FIRST withhold the medication.
True. When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority action is to withhold the medication in order to prevent injury to the client.

T/F. A patient prescribed amoxicillin/clavulanic tells the nurse he is allergic to penicillin. The nurse should FIRST notify the provider
False. It is important to notify the provider because the client will need a new prescription, but it is not the action the nurse should take first.

T/F. A patient prescribed amoxicillin/clavulanic tells the nurse he is allergic to penicillin. The nurse should FIRST inform the pharmacist of the client’s allergy to penicillin.
False. It is important to inform the pharmacist of the allergy to promote continuity of care, but it is not the action the nurse should take first.

T/F. A patient prescribed amoxicillin/clavulanic tells the nurse he is allergic to penicillin. The nurse should FIRST update the client’s medical record
False. It is important to update the client’s medical record to have complete information available, but this is not the action the nurse should take first.

T/F. A client receiving mannitol via continuous IV infusion should be monitored for adverse effects including bibasilar crackles
True. Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

T/F. A client receiving mannitol via continuous IV infusion should be monitored for adverse effects including auditory hallucinations
False. Mannitol has several neurologic adverse effects including increased intracranial pressure, seizures, confusion, and headaches. However, it does not cause auditory hallucinations.

T/F. A client receiving mannitol via continuous IV infusion should be monitored for adverse effects including increased intraocular pressure
False. An indicaiton for the use of mannitol is increased intraocular pressure. Mannitol decreases the intraocular pressure by creating an osmotic gradient between the intraocular fluid and the plasma.

T/F. A client receiving mannitol via continuous IV infusion should be monitored for adverse effects including weight loss
False. Mannitol is an osmotic diuretic used to promote diuresis, decrease intracranial pressure, and improve renal function. An expected therapeutic effect of mannitol is weight loss resulting from diuresis.

T/F. A patient taking aspirin for arthritis should be suspected of having salicylism if they have tinnitus
True. Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness.

T/F. A patient taking aspirin for arthritis should be suspected of having salicylism if they have oliguria
False. Kidney impairment is an adverse effect associated with aspirin use. Manifestations include reduced urinary output, weight gain, and elevated BUN and creatinine levels. However, oliguria is not an indicaiton of salcylism.

T/F. A patient taking aspirin for arthritis should be suspected of having salicylism if they have excessive bruising
False. Excessive bruising is a possible adverse effect of aspirin therapy, caused by the antiplatelet effects of the medication, but it is not an indication of salicylism

T/F. A patient taking aspirin for arthritis should be suspected of having salicylism if they have gastric distress
False. Gastric distress is a possible adverse effect of aspirin therapy, but it is not an indication of salicylism. Gastric distress can be minimized by taking aspirin with food or an enteric form of the medication.

T/F. A client who has overdosed on diazepam should be administered flumazenil.
True. Flumazenil is a benzodiazepine receptor antagonistthat can decrease the sedative ffects of benzodiazepines, such as diazepam. The nusre should administer the medication via IV bolus, titrating doses as needed, for a mzximum of 3 mg. However, the medicaiton can precipitate seizures and might not reverse respiratory depression, so airway support may be necessary

T/F. A client who has overdosed on diazepam should be administered naloxone.
False. Naloxone is an opioid antagonist used for the treatment of opioid-induced respiratory depression.

T/F. A client who has overdosed on diazepam should be administered neostigmine.
False. Neostigmine is a reversible cholinesterase inhibitor that increases the amount of acetylcholine available for neuromuscular and muscarinic responses. It is used in the treatment of myasthenia gravis and as a reversal agent for neuromuscular blockingagents, such as those used in surgery.

T/F. A client who has overdosed on diazepam should be administered leucovorin.
False. Leukovorin, a form of the vitamin folic acid, is used as an antidote for methotrexate toxicity.

T/F. A patient with tuberculosis taking isoniazid should report adverse effects including photosensitivity.
False. Isoniazid can cause sensory adverse effects including blurred vision and optic neuritis. However, photosensitivity is not an adverse reacton of isoniazid.

T/F. A patient with tuberculosis taking isoniazid should report adverse effects including yellowish skin tones.
True. Isoniazid is a hepatotoxic medicaiton that can cause hepatitis. The nurse should instruct the client to monitor for and report signs of hepatitis, such as malaise, nasusea, and yellowish skin tones, to the provider.

T/F. A patient with tuberculosis taking isoniazid should report adverse effects including headache.
False. Isoniazid is associated with a number of CNS adverse effects including dizziness, memory impairment, seizures, and psychosis. However, it does not cause headaches.

T/F. A patient with tuberculosis taking isoniazid should report adverse effects including reddish-orange urine.
False. Rifampin, another antituberculosis medication. Can cause body fluids to take on a reddish-orange color. However, isoniazid does not alter urine color.

T/F. A client with depression taking fluoxetine should continue to take St. John’s Wort to increase the effects of the medicaiton.
False. Concurrent use of St. John’s Wort and fluoxetine can increase the risk for serotonin syndrome, a potentially life-threatening complication. Manifestations of serotonin syndrome include confusion, hallucinations, hyperreflexia, excessive sweating, and fever.

T/F. A client with depression taking fluoxetine should start to feel better within 24 hours of starting this medication
False. The nurse should inform the client that the therapeutic levels of fluoxetine can take between 1 and 4 weeks to achieve desired efects. The client should take the medication as p rescribed and use other strategies to manage depression in the interim.

T/F. A client with depression taking fluoxetine should be sure to follow a strict diet to avoid foods with tyramine
False. Clients taking fluoxetine, which is a selective serotonin reuptake inhibitor, are not required to restrict their dietary intake of tyramine. A client who is taking an MAOI such as selegiline should avoid products containing tyramine

T/F. A client with depression taking fluoxetine should take acetaminophen instead of inbuprofen for headaches while taking this medication
True. Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking fluoxetine should take acetaminophen for headaches or pain, since acetamionphen does not suppress platelet aggregation

T/F. For a patient with Alzhemier’s administered donepezil, the nurse should immediately report to the provider dyspepsia.
False. The nurse should report dyspepsia to the provider because dyspepsia can cause discomfort and irritation to the esophageal tissues. However, there is another action the nurse should take first.

T/F. For a patient with Alzhemier’s administered donepezil, the nurse should immediately report to the provider dyspnea.
False. The first action the nurse should take when using the airway, breathing, circulation approach to client care is to report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.

T/F. For a patient with Alzhemier’s administered donepezil, the nurse should immediately report to the provider diarrhea.
False. The nurse should report diarrhea to the provider because diarrhea can result I n electrolyte and fluid imbalances. However, there is another action the nurse should take first.

T/F. For a patient with Alzhemier’s administered donepezil, the nurse should immediately report to the provider dizziness.
False. The nurse should report dizziness to the provider because the client can be at increased risk for falls. However, there is another action the nrurse should take first.

T/F. A patient taking tamoxifen to treat breast cancer should report adverse effects including bradycardia.
False. Tamoxifen is an antiestrogen medicaiton that works by blocking estrogen receptors. Cardiovascular adverse effects of the medicaiton include chest pain, flushing, and the development of thrombus. However, bradycardia is not an expected adverse effect of tamoxifen.

T/F. A patient taking tamoxifen to treat breast cancer should report adverse effects including constipation.
False. GI adverse effects of tamoxifen include nausea and vomiting. However, constipation is not an expected adverse effect of tamoxifen.

T/F. A patient taking tamoxifen to treat breast cancer should report adverse effects including hot flashes.
True. The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.

T/F. A patient taking tamoxifen to treat breast cancer should report adverse effects including urinary retention.
False. Tamoxifen can cause genitourinary adverse effects such as vaginal discharge and uterine cancer. However, urinary retention is not an expected adverse effect of tamoxifen.

T/F. A client taking diltiazem should expect to gain weight while taking this medicaiton.
False. Diltiazem, a CCB, can decrease myocardial contraction, which can lead to heart failure. If the client gains weight or develops shortness of breath, she sould notify the provider.

T/F. A client taking diltiazem should not drink orange juice while taking this medication
False. The client sould not drink grapefruit juice while taking diltiazem because it can interfere with metabolism of the medicaiton by increasing the blood levels of diltiazem and leading to toxicity.

T/F. A client taking diltiazem should stop taking the medication if they get dizzy
False. Diltiazem, a CCB that causes vascular dilation, which can result in orthostatic hypotension. The client should rise slowly when standing and avoid hazardous activities until there is a stabilization of the medication and dizziness no longer occurs.

T/F. A client taking diltiazem should check their heart rate before taking the medication
True. Diltiazem, a CCB, has cardio-suppressant effects at the SA and AV nodes, which can lead to bradycardia. The client should check her heart rate before taking the medicaiton and notify the provider if it falls below the expected reference range

T/F. A patient taking digoxin should monitor and report adverse effects including dry cough.
False. Clients taking an ACE inhibitor, such as captopril, might develop a dry cough due to a buildup of bradykinin and should report this to the provider. However, respiratory adverse efects are not associated with digoxin.

T/F. A patient taking digoxin should monitor and report adverse effects including bruising.
False. Clients taking an anticoagulant, such as enoxaparin, might develop bruising and should report this to the provider. However, hematologic adverse effects are not associated with digoxin.

T/F. A patient taking digoxin should monitor and report adverse effects including yellow-tinged vision.
True. The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity and should be reported to the provider. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.

T/F. A patient taking digoxin should monitor and report adverse effects including pedal edema.
False. Clients taking a CCB such as verapamil might develop pedal edema and should report this to the provider. However, peripheral edema is not associated with digoxin.

T/F. A client who is postoperative is receiving morphine via PCA. The nurse’s priority assessment is respiratory rate.
True. When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is the client’s respiratory rate due to the risk of respiratory depression. Morphine and other opioid medication can cause respiratory depression, constipation, and urinary retention.

T/F. A client who is postoperative is receiving morphine via PCA. The nurse’s priority assessment is wound appearance.
False. The nurse should assess the client’s wound following surgery to monitor for bleeding or separation of the incision. However, there is another assessment that is the nurse’s priority.

T/F. A client who is postoperative is receiving morphine via PCA. The nurse’s priority assessment is bowel sounds.
False. The nurse should monitor the bowel sounds for a cliennt who is postoperative following open cholecystectomy. The administration of anesthesia will slow bowel function and suppress bowel sounds. However, there is another assessment that is the nurse’s priority.

T/F. A client who is postoperative is receiving morphine via PCA. The nurse’s priority assessment is drainage amounts.
False. The nurse should assess the amount and characteristics of the client’s drainage to monitor for bleeding, fluid, and electrolyte imbalances. However, there is another assessment that is the nurse’s priority.

T/F. A child using a spacer for a fluticasone inhaler for chronic asthma should be taught that the spacer decreases risk for headache.
False. Fluticasone can cause neurologic adverse such as dizziness, fatigue, nervousness, and headaches. However, the use of a spacer will not decrease systemic adverse effects of fluticasone, such as headaches.

T/F. A child using a spacer for a fluticasone inhaler for chronic asthma should be taught that the spacer decreases risk for oral candidiasis.
True. The adverse effects of inhaled corticosteroids can include dysphonia and oral candidiasis. Using a spacer and rinsing the mouhth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development o f these adverse effects.

T/F. A child using a spacer for a fluticasone inhaler for chronic asthma should be taught that the spacer decreases risk for joint pain.
False. Fluticasone can cause musculoskeletal adverse effects such as bone loss, muscle aches, and joint pain. However, the use of a spacer will not decrease systemic adverse effects of fluticasone, such as joint pain

T/F. A child using a spacer for a fluticasone inhaler for chronic asthma should be taught that the spacer decreases risk for adrenal suppression.
False. Fluticasone is a glucocorticoid medicaiton that decreases bronchoconstriction. Inhaled glucocorticoids can have the adverse effect of adrenal suppression, although this occurs more often with oral glucocorticoids. The nurse should monitor the client for manifestationsofa drenal suppression such as weakness, fatigue, hypotension, and hypoglycemia. However,the use of a spacer will not decrease systemic adverse ffects of fluticasone, such as adrenal suppression

T/F. A patient with diabetes mellitus taking insulin should be identified as having potential difficulty safely self-administering insulin if they have right-sided heart failure.
False. A client who has right-sided heart failure has hypertension and peripheral edema because the right ventricle is unable to completely empty. However, this condition will not affect the client’s ability to prepare and administer insulin.

T/F. A patient with diabetes mellitus taking insulin should be identified as having potential difficulty safely self-administering insulin if they have hyperlipidemia.
False. A client who has hyperlipidemia has developed an accumulation of plaques and fat within the venous system placing the client at risk for hypertension, stroke, or myocardial infarction. However, the condition will not affect the client’s ability to prepare and adminiser insulin.

T/F. A patient with diabetes mellitus taking insulin should be identified as having potential difficulty safely self-administering insulin if they have stage II chronic kidney disease
False. A client who has diabetes mellitus can also have chronic kidney disease due to change sin the microvasculature caused by hyperglycemia. However, this condition will not affect the client’s ability to prepare and administer insulin.

T/F. A patient with diabetes mellitus taking insulin should be identified as having potential difficulty safely self-administering insulin if they have macular degeneration
True. A client who has macular degeneration loses central vision, making it difficult to accurately draw up insulin for self-administration or dial the insulin pen to the appropriate dosage. The nurse should determine that adaptive equipment is necessary for the client who has macular degeneration.

T/F. A client with multiple sclerosis taking methylprednisolone should know that grapefruit juice can increase the blood levels of the medicaiton.
True. The nurse should instruct the client that grapefruit juice increases the absorption of the medicaiton leading to toxicity and adrenal suppression.

T/F. A client with multiple sclerosis taking methylprednisolone should take the medicaiton 1 hour before a meal
False. The nurse should instruct the client to take the medicaiton with food or milk to avoid GI manifestations.

T/F. A client with multiple sclerosis taking methylprednisolone should know that blood glucose levels will need to be monitored during therapy.
True. The nurse hsould instruct the client that his blood glucose levels will be monitored during therapy because corticosteroids such as methylprenisolone can raise blood glucose levels.

T/F. A client with multiple sclerosis taking methylprednisolone should decrease intake of foods containing potassium
False. Methylprednisolone decreases potassium levels through urinary excretion, so the nurse should instruct the client to increase intake of foods containing potassium.

T/F. A client with multiple sclerosis taking methylprednisolone should avoid contact with persons who have known infections
True. The nurse should instruct the client to avoid contact with persons who have known infections because corticosteroids such as methylprednisolone, suppress the immune response and mask manifestations of infection.

T/F. A patient taking ergotamine sublingual for migraine headaches should take one tablet three times a day before meals.
False. Ergotamine, an alpha-adrenergic blocking m edicatoin, is not used prophylactically as this can result in ergotamine dependence.

T/F. A patient taking ergotamine sublingual for migraine headaches should take one tablet every 15 minutes until migraine subsides
False. The client can take one sublingual tablet every 30 minutes for a maximum of three tablets in a 24 hour period to mangae a migraine.

T/F. A patient taking ergotamine sublingual for migraine headaches should take up to eight tablets as needed within a 24 hour period
False. The client can take up to a maximum of three tablets in a 24 hour period. Excessive dosing can lead to ergotism, which can pause peripheral gangrene due to vasoconstriciotn and ischemia.

T/F. A patient taking ergotamine sublingual for migraine headaches should take one tablet at onset of migraine
True. The client should take one tablet immediately after the onset of aura or headache.

T/F. A client taking metoclopramide following bowel surgery should be monitored for adverse effects including tinnitus.
False. Metoclopramide does not cause ringing in the ears.

T/F. A client taking metoclopramide following bowel surgery should be monitored for adverse effects including muscle weakness.
False. Metoclopramide is a central dopamine receptor antagonist that increases GI motility and prevents nausea. An adverse effect of metoclopramide is tardive dyskinesia. However, metoclopramide does not cause muscle weakness.

T/F. A client taking metoclopramide following bowel surgery should be monitored for adverse effects including peripheral edema.
False. Metoclopramide does not cuase peripheral edema.

T/F. A client taking metoclopramide following bowel surgery should be monitored for adverse effects including sedation.
True. Metoclopramide has multiple effects on the CNS< including dizziness, fatigue, and sedation

T/F. For a patient taking epoetin alfa for anemia, the nurse should monitor for fever.
False. Adverse effects of epoetin alfa include neurological manifestations such as coldness and sweating. However, it does not cause fever.

T/F. For a patient taking epoetin alfa for anemia, the nurse should monitor for respiratory depression.
False. An adverse effect of epoetin alfa is heart failure. The nurse should monitor the client’s respiratory status and notify the provider if the client develops crackles or rhonchi. However, epoetin alfa does not cause respiratory depression.

T/F. For a patient taking epoetin alfa for anemia, the nurse should monitor for paresthesia.
False. Epoetin alfa stimulates the bone marrow to increase production of red blood cells. Adverse effects include neurological manifestations such as seizures, headache, and dizziness. However, it does not cause paresthesia.

T/F. For a patient taking epoetin alfa for anemia, the nurse should monitor for increased blood pressure.
True. The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client’s blood pressure. If the client’s hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client’s blood pressure and ensure hypertension is controlled prior to administering the medication.

T/F. A nurse teaching a group of nurses about medication reconciliation should include that a transition in care requires the nurse to conduct medication reconciliation.
True. The nurse should conduct medication reconciliation anytime the client is undergoing a change in care (admission, transfer from one unit to another, discharge). A complete listing of all prescribed and OTC medications should be reviewed.

T/F. A nurse teaching a group of nurses about medication reconciliation should include that the client’s provider is required to complete medicaiton reconciliation
False. The nurse is required to complete medication reconciliation.

T/F. A nurse teaching a group of nurses about medication reconciliation should include that medication reconciliation at discharge is limited to the medicaiton ordered at the time of discharge.
False. Medication reconciliation at discharge includes medications ordered at the time of discharge, OTC medications, vitamins, herbal supplements, nutritional supplements, and other medications the client is taking.

T/F. A nurse teaching a group of nurses about medication reconciliation should include that medical reconciliation is limited to the name of the medications that the client is currently taking
False. The name of the current medicaiton and new medication, OTC medicaitons, vitamins, herbal supplements, and nutritional supplements are included at the medication reconciliation. The indication, route, dosage size, and dosing interval are also required for medicaiton reconciliation

T/F. A client taking fluoxetine for depression should report adverse effects including tingling toes
False. Fluoxetine is an SSRI that can cause muscle twitching. However, distorted sensations in the extremities are not adverse effects of fluoxetine.

T/F. A client taking fluoxetine for depression should report adverse effects including sexual dysfunction
True. Sexual dysfunciotn, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of client swho take this SSRI antidepressant.

T/F. A client taking fluoxetine for depression should report adverse effects including pica
False. Fluoxetine can cause a number of neurologic adverse effect sincluding agitation, euphoria, and sedation. However, an eating disorder such as pica is not associated with fluoxetine

T/F. A client taking fluoxetine for depression should report adverse effects including absence of dreams
False. Fluoxetine can cause a number of CNS adverse effects including sedation, delusions, hallucinations, and psychosis. However, an absence of dreams is not associated with fluoxetine.

T/F. A patient receiving haloperidol should be monitored for adverse effects including akathisia.
True. A significant adverse effect associated with haloperidol is the development of extrapyramidal symptoms such as dystonia, pseudoparkinsonism, and akathisia.

T/F. A patient receiving haloperidol should be monitored for adverse effects including paresthesia
False. Haloperidol, an antipsychotic neuroleptic medication, can cause a number of CNS adverse effects including seizures, confusion, and neuroleptic syndrome. However, paresthesia is not an adverse effect of haloperidol

T/F. A patient receiving haloperidol should be monitored for adverse effects including excess tear production
False. Haloperidol has anticholinergic properties that can cause sensory adverse effects such as an increased intraocular pressure, blurred vision, and dry eyes

T/F. A patient receiving haloperidol should be monitored for adverse effects including anxiety
False. Haloperidol can be prescribed for relief of severe agitation as well as psychotic symptoms. In the CNS, haloperidol can result in sedation

T/F. A client with heart failure taking enalapril should be monitored for adverse effects including hyperkalemia.
True. Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys.

T/F. A client with heart failure taking enalapril should be monitored for adverse effects including hypoglycemia.
False. Enalapril does not cause hypoglycemia

T/F. A client with heart failure taking enalapril should be monitored for adverse effects including loss of smell.
False. Enalapril has several sensory adverse effects including tinnitus, double vision, and a loss of taste. However, it does not cause a loss of smell.

T/F. A client with heart failure taking enalapril should be monitored for adverse effects including bradycardia.
False. Enalapril is an ACE inhibitor that has several cardiovascular adverse effects including hypotension, tachycardia, and dysrhythmias