RN VATI Pharmacology 2019
A nurse is preparing to administer diclofenac to a client who has chronic bursitis.
Which of the following actions should the nurse take?
a. administer the medication at bedtime
b. avoid administering the medication with antacids
c. administer the medication with food
d. crush the medication prior to administration
Administer the medication with food
Diclofenac is an NSAID and can cause gastric irritation. Clients should take NSAIDs
with food or milk to minimize gastric irritation.he nurse should not administer the
medication at bedtime because the client should remain upright for 15 to 30 min
after administration to prevent esophageal irritation. Diclofenac is available as an
enteric-coated tablet for delayed release. Clients should not crush or chew
sustained-release medications because doing so will increase gastrointestinal
adverse effects and decrease the effectiveness of the medication.
A nurse is planning care for a client who has asthma and a prescription for
methylprednisolone. Which of the following laboratory values should the nurse
monitor while the client is receiving this medication?
a. Aspartate aminotransferase (AST)
b. Fibrin split products
c. BUN
d. Glucose
Glucose
Methylprednisolone therapy increases the synthesis of glucose and decreases the
uptake of glucose by the muscles and adipose tissues, resulting in increased
circulating glucose. Therefore, it is important for the nurse to monitor blood
glucose levels regularly while clients are receiving corticosteroid therapy.
Aspartate aminotransferase is an enzyme that is present in the heart, liver,
skeletal muscles, and other highly metabolic tissues. AST levels are increased in
conditions that cause cellular injury, such as liver disease; however,
methylprednisolone therapy does not affect AST levels. Fibrin split products are
present in the serum when thromboses are present. Increased levels of fibrin split
products can increase disseminated intravascular coagulation (DIC); however,
methylprednisolone therapy does not affect blood clotting. BUN levels reflect
kidney function and glomerular filtration. Hydration status and nephrotoxic
medications can alter BUN levels; however, methylprednisolone therapy does not
affect renal function.
A nurse is caring for a client who is postmenopausal and has a prescription for
raloxifene. The nurse should instruct the client that raloxifene is prescribed for
which of the following reasons?
a. To treat irritable bowel syndrome
b. To reduce the risk for breast cancer
c. To reduce the occurrence of hot flashes
d. To lower the risk of pulmonary embolism
To reduce the risk for breast cancer
Raloxifene can lower the risk for breast cancer in postmenopausal clients who
have a high risk for developing estrogen-receptive types of breast cancer. The
medication also reduces the risk for and can treat postmenopausal
osteoporosis.Raloxifene is a selective estrogen receptor modulator. In clients who
are postmenopausal, it can reduce the risk for and treat osteoporosis and protect
against breast cancer.
Hot flashes are an adverse effect of raloxifene. Raloxifene reduces the occurrence
of fractures related to osteoporosis and reduces the cholesterol level in clients
who are postmenopausal.Raloxifene can cause several significant cardiovascular
and respiratory adverse effects, such as thromboembolism, stroke, peripheral
edema, pneumonia, and the development of pulmonary emboli. Clients should
not take this medication prior to periods of prolonged immobilization, such as
surgery. A history of thromboembolic events is a contraindication for taking this
medication.
A nurse is caring for a client who is receiving heparin by continuous IV infusion for
treatment of venous thrombosis. Which of the following laboratory values should
the nurse monitor for in order to titrate the heparin dose?
a. platelet function assay
b. aPTT
c. INR
d. Amylase
aPTT
The nurse should monitor the aPTT of a client who is receiving heparin by
continuous IV infusion. When beginning heparin therapy, the nurse should
monitor the aPTT every 4 to 6 hr. Once the client has achieved the desired range,
the nurse should monitor the aPTT daily.
The nurse should monitor the platelet function assay of a client who has a
bleeding disorder. This test evaluates platelet function and ability to cause
hemostasis; however, heparin does not affect it.The nurse should monitor a
client’s INR to evaluate the effects of warfarin therapy. The nurse should ensure
the collection of the client’s blood specimen prior to administering the daily
warfarin dose.The nurse should review the amylase levels of a client who has
pancreatitis. Amylase is a pancreatic enzyme that increases in clients who have
acute or chronic pancreatitis; however, heparin does not affect this enzyme.
A nurse is assessing a client who has a positive Trousseau’s sign. Wich of the
following medications should the nurse plan to administer?
a. sodium bicarbonate
b. manesium sulfate
c. calcium gluconate
d. potassium chloride
Calcium gluconate
The nurse should identify that a positive Trousseau’s sign is a manifestation of
hypocalcemia. Therefore, the nurse should plan to administer calcium gluconate
to treat hypocalcemia.
Sodium bicarbonate is administered to treat metabolic acidosis. The nurse should
recognize that sodium bicarbonate is not used to treat a positive Trousseau’s
sign.Magnesium sulfate is administered to treat hypomagnesemia. The nurse
should recognize that magnesium sulfate is not used to treat a positive
Trousseau’s sign. Potassium chloride is administered to treat hypokalemia. The
nurse should recognize that potassium chloride is not used to treat a positive
Trousseau’s sign.
A nurse is preparing to administer morphine 0.3 mg/kg PO to a school-aged child
who weighs 88 lb. Available is morphine oral solution 2mg/ml. How many mL
should the nurse administer?
6 mL
A nurse is administering haloperidol to a client who has schizophrenia. For which
of the following adverse effects should the nurse monitor?
a. gingival hyperplasia
b. muscle rigidity
c. polyuria
d. bruising
Muscle rigidity
A client who is taking haloperidol, a first-generation antipsychotic agent, can
develop extrapyramidal effects, such as parkinsonism, which manifests as
tremors, bradykinesia, loss of balance, mask-like facial expression, shuffling gait,
and muscle rigidity.
Haloperidol is an antipsychotic agent that can cause akathisia (motor restlessness)
within hours of receiving the first dose; however, gingival hyperplasia is not an
adverse effect of haloperidol. Phenytoin is an example of a medication that
causes gingival hyperplasia.Haloperidol has several genitourinary adverse effects,
including urinary retention and impotence; however, urinary output does not
typically increase.Haloperidol has significant cardiovascular effects, including
dysrhythmias, myocardial infarction, severe heart failure, and hypotension;
however, it does not affect blood coagulation.
A nurse receives a verbal prescription from the provider for hydrochlorothiazide
25 mg by mouth daily for a client who has hypertension. Which of the following
indicates how the nurse should transcribe the prescription in the client’s medical
record?
a. Hydrochlorothiazide 25.0 mg orally q.d.
b. Hydrochlorothiazide 25 mg PO daily