ATI Pharmacology Proctored Exam 2019
- A nurse is caring for a client who has alcohol use disorder and was admitted with lower-extremity fractures following a motor-vehicle crash. A few
hours after admission, the client develops restlessness and tremors. Which
of the following medications should the nurse anticipate administering to
the client first?
A. Acamprosate
B. Naltrexone
C. Chlordiazepoxide
D. Disulfiram✅✅✅ Chlordiazepoxide - A nurse is reinforcing teaching with a client who is premenopausal and has
a prescription for a combination oral contraceptive. Which of the following
findings should the nurse include as an adverse effect of oral contraceptives?
A. Bone Fractures
B. Deep-Vein Thrombosis
C. Increased LDL cholesterol
D. Increased risk of breast cancer✅✅✅ Deep-Vein Thrombosis
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- A nurse is collecting data from a client who has heart failure and is
receiving digoxin.Which of the following findings should indicate to the
nurse the client is experiencing digoxin toxicity?
A. Suppression of dysrhythmias
B. Increase in atrioventricular (AV) conduction
C.Visual disturbances
D.Weight gain✅✅✅ Visual disturbances - A nurse is caring for a client who has been receiving medication through
a transdermal patch.The client is experiencing therapeutic benefits from the
medication even though the medication in the patch is no longer active.The
nurse should recognize that this is an example of which of the following?
A. Pharmacodynamic tolerance
B. Placebo effect
C. Metabolic tolerance
D.Tachyphylaxis✅✅✅ Placebo effect - A nurse is caring for a client who is 12 hours postoperative following a
total hip arthroplasty. Which of the following medications should the nurse
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anticipate administering to this client to prevent deep vein thrombosis (DVT)
A. Aspirin
B. Warfarin
C.Ticagrelor
D. Enoxaparin✅✅✅ Enoxaparin
- A nurse is collecting data from a client who is taking duloxetine to treat
diabetic neuropathy pain. For which of the following manifestations should
the nurse monitor for as a potential adverse effect of the medication?
A. Urinary frequency
B. Increased appetite
C. Dry mouth
D. Decreased sweating✅✅✅ Dry mouth - A nurse in a long-term care facility is administering medications to a group
of older adult clients. Which of the following factors of pharmacokinetics
should the nurse consider when caring for this age group?
A. the excretion of the medication is reduced
B.The percentage of medication absorbed is increased.
C.The liver metabolizes medication more quickly
D. Less medication is stored in fatty tissue✅✅✅ the excretion of the
medicationis reduced
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- A nurse is collecting data from a client who is receiving a continuous
morphine IV infusion and finds the client’s respiratory rate has decreased
from 20 to 12/min.Which of the following actions should the nurse take?
A. Flush the IV line with saline
B. Administer flumazenilopioid toxicity
C. Lower the head of the bed
D. Slow the rate of the infusion✅✅✅ Slow the rate of the infusion - A nurse is caring for a client who has multiple sclerosis and neurogenic
bladder and is receiving bethanechol.The nurse should identify that which
of the following client statements indicate a therapeutic action of the medication?
A. “My mouth seems very dry lately.”
B. “I’ve noticed my heart beating faster.”
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What is/are the action(s) of the drug metformin?
a. Decreases Hepatic glucose production and intestinal glucose absorption
b. Increases sensitivity to insulin
c. Short term sedation
d. Both A and B
d. Both A and B
When administering the drug senna to a patient, a health care provider must inform
the patient of which of the following
a. This drug is intended to lower blood pressure and is best used in combination
with other antihypertensives
b. This drug is not intended for long term use
c. The patient must limit his/her fiber intake
d. Advise patient to change positions slowly to limit the risk of
orthostatic hypotension
b. This drug is not intended for long term use
When giving digoxin (Lanoxin) to a patient, the health care provider notices various
signs and symptoms of an overdose. The health care provider knows to give which of the
following to reverse digoxin toxicity
a. Naloxone
b. Vitamin K
c. Digibind
d. Fluemanzil
c. Digibind
While providing an Angiotensin-converting enzyme (ACE) inhibitor, the patient asks
what the action of the drug is. As a health care provider, you explain that the action of
an ACE inhibitor is
a. To lower blood pressure by blocking the conversion of angiotensin I
to vasoconstrictor angiotensin II
b. To inhibit reabsorption of sodium back into the body, ultimately increasing
urine output and lowering blood pressure
c. To decrease heart rate and blood pressure by competing with Beta1 and Beta2
receptors in the heart and lungs
d. To lower blood glucose by stimulating the release of insulin
a. To lower blood pressure by blocking the conversion of angiotensin I
to vasoconstrictor angiotensin II
Which of the following types of insulin is “long-acting”?
a. Lispro (Humalog)
b. NPH (Humulin N)
c. Regular insulin (Humulin R)
d. Glargine (Lantus)
d. Glargine (Lantus)
- What is the therapeutic use of metformin?
A. Lower blood pressure.
B. To diminish seizure activity.
C. The maintenance of a person’s blood glucose.
D. Increase heart rate and decrease gastrointestinal secretions.
C. The maintenance of a person’s blood glucose. - What is the correct definition for absorption of a drug?
A. Movement of drug from site of administration to various tissues of the body.
B. Describes the absorption, distribution, metabolism & excretion of drugs.
C. These types of drugs can be taken over the counter.
D. This addresses how various drugs affect different forms of the body
A. Movement of drug from site of administration to various tissues of the body - What do you assess for in a patient who is on Valproate? Select all that apply.
A. Suicidal thoughts
B. Monitor for seizures.
C. Bipolar disorder.
D. Migraines.
E. Anorexia
A. Suicidal thoughts
B. Monitor for seizures. C. Bipolar disorder.
D. Migraines.
What is true about food and drug precautions? Select all that apply.
A. You must limit certain types of food or concurrent administration of certain types of drugs.
B. Certain combinations of food and drugs can cause adverse reactions. C. Precautions may require limiting certain types of food or concurring drugs rather than restricting the drug itself.
D. When one drug changes the way, another drug affects that drug.
A. You must limit certain types of food or concurrent administration of certain types of drugs.
B. Certain combinations of food and drugs can cause adverse reactions. C. Precautions may require limiting certain types of food or concurring drugs rather than restricting the drug itself.
- ACE Inhibitors are used in the treatment of all EXCEPT:
a. Hypertension
b. Heart Failure
c. Hypotension
d. Diabetic nephropathy
c. Hypotension - Which of the following is used to treat migraine headaches?
a. Beta-blockers
b. Cholinesterase Inhibitors
c. ACE inhibitors
d. Anti-epileptic drugs (AEDs)
a. Beta-blockers - When administering a Serotonin Antagonist it is important to monitor for
a. Intake and output
b. Mental status changes
c. Respiratory rate
d. Anorexia
b. Mental status changes - Which of the following is the antidote for Heparin?
a. Protamine sulfate
b. Vitamin K
c. Naloxone
d. Toradol
a. Protamine sulfate
A patient has been taking hydrocodone, and opioid analgesic for their moderate pain, and they have taken over their prescribed dose. What should you give as the antidote if they experience toxicity? A. Naloxone
B. N-acetylcysteine
C. Atropine
D. Digoxin immune Fab
A. Naloxone
A patient is being educated on taking levothyroxine, a drug used to balance thyroid activity. What should you include in their education?
A. Don’t bother your health care professionals if you experience side effects
B. Take this at the same time every day
C. Thyroid tests are unnecessary while taking this drug
D. It is okay to take this drug if you have recently had a myocardial infarction
B. Take this at the same time every day
A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?
A. Phenytoin (Dilantin)
B. Lithium
C. Alprazolam (Xanax)
D. Spironolactone
C. Alprazolam (Xanax)
Which of the following is NOT an opioid or NSAID?
A. Morphine
B. Ibuprofen
C. Hydromorphone
D. Acetaminophen
D. Acetaminophen
Why is it important to monitor ins and outs with patients using ACE inhibitors?
A. To assess for renal impairment
B. You must make sure the patient is receiving adequate fluid intake
C. To assess the patient for potential heart failure
D. You must assess for NSAID use
E. To assess for decreased blood pressure
C. To assess the patient for potential heart failure
) Which drug goes through extensive first-pass hepatic metabolism?
A. Heparin
B. Insulin
C. Propranolol
D. Nitroglycerine
E. Warfarin
C. Propranolol
What nursing interventions should you do when a patient is on Albuterol (select all that apply)
A. Assess lung sounds, Pulse, and Blood pressure before administering
B. Monitor for changes in behavior C. Observe for paradoxical bronchospasms
D. Assess for abdominal distention E. Note sputum color and texture
A. Assess lung sounds, Pulse, and Blood pressure before administering
C. Observe for paradoxical bronchospasms
E. Note sputum color and texture
What patient could potentially take the drug Senna?
A. A patient with an eating disorder B. A patient who has not passed stool in 5 days
C. A patient with anal fissures
D. A patient with a history of hemorrhoids
E. A patient who has hypersensitivity
B. A patient who has not passed stool in 5 days
What is the category class of Lithium?
A. Antidiabetics, biguanides
B. Mood stabilizers
C. Antiarrhythmics, anticonvulsants D. Vascular headache suppressants
B. Mood stabilizers
What do you need to teach your patient if they are taking sennosides? Select All That Apply. A. Laxatives should be used for short-term therapy
B. The medication does not cure hypothyroidism
C. The color of the urine may change to a pink, red, violet, yellow, or brown
D. Make sure other forms of bowel regulation are being used
A. Laxatives should be used for short-term therapy
C. The color of the urine may change to a pink, red, violet, yellow, or brown
D. Make sure other forms of bowel regulation are being used
What is the therapeutic use of Phenytoin?
A. Replacement in hypothyroidism to restore normal hormonal balance
B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
C. Diminished seizure activity, termination of ventricular arrhythmias
D. Prevention of thrombus formation, prevention of extension of existing thrombi
C. Diminished seizure activity, termination of ventricular arrhythmias
At what amount does Acetaminophen stop controlling pain?
A. Over 1,000 mg
B. 750 mg
C. Over 1,500 mg
D. 150 mg
A. Over 1,000 mg
When should the drug Montelukast be taken
A. Use at least two hours before exercise
B. Daily in evening
C. Use two hours before exercise or daily in evening
D. None of the above
C. Use two hours before exercise or daily in evening
How should the oral form of albuterol be taken
A. Administer with meals to minimize gastric irritation
B. Administer before meals with water
C. Administer after meals with water D. Administer in the morning with milk
A. Administer with meals to minimize gastric irritation
What should a Client taking Omeprazole report to the Heath Care Provider
A. Black, tarry stools
B. Diarrhea
C. Abdominal pain
D. All of the above
D. All of the above
When administering an Antiulcer Agents, you should be more cautious when administering it to
A. A healthy 27 year old patient
B. Patient with renal failure
C. Elderly patients
D. All of the above
E. Choices B & C
E. Choices B & C
What is the common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation?
a. Abdominal cramps
b. Calf pain
c. Headache
d. Blurred vision
c. Headache
Two tests should be monitored for a patient currently on Warfarin. What are those two tests? Select ALL that apply.
a. PT
b. aPTT
c. INR
d. BMP
a. PT
c. INR
Which of the following diuretics inhibits sodium reabsorption in the kidneys while saving K+ and Hydrogen ions?
a. Spironolactone
b. Furosemide
c. Hydrochlorothiazide
d. Bumetanide
a. Spironolactone
A nurse is about to administer Propanolol to a patient. The nurse takes the patient’s apical pulse and documents it as 58 bmp. How should the nurse continue?
a. Administer the medication as normal
b. Cut the tablet in half and administer half of the normal dose c. Give the XR form of the medication
d. Withhold administration of the medication and notify physician
d. Withhold administration of the medication and notify physician
Which of the following should be monitored for patients taking diuretics? (select all that apply)
a. Daily weight
b. Intake and output
c. Amount and location of edema
d. Appetite
e. Lung sounds
a. Daily weight
b. Intake and output
c. Amount and location of edema
e. Lung sounds
Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate? .
a. Heparin
b. Alprazolam
c. Digoxin
d. Levothyroxine
c. Digoxin
Which of the following is a potassium-sparing diuretic?
a. Furosemide
b. Spironolactone
c. Hydrochlorothiazide
d. Bumetanide
b. Spironolactone
What is the antidote for Warfarin?
a. Vitamin D
b. Vitamin C
c. Vitamin K
d. Vitamin B6
c. Vitamin K
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
A. “I will clean the site with an alcohol swab before I apply the patch.”
B. “I will rotate the application sites weekly.”
C. “I will apply the patch to an area of skin with no hair.”
D. “I will place the new patch on the site of the old patch.
C. “I will apply the patch to an area of skin with no hair.”
.A nurse is teaching a client who has a prescription for a long-term use of oral prednisone for chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects?
A. Weight Gain
B. Nervousness
C. Bradycardia
D. Constipation
A. Weight Gain
- A nurse is caring for a patient who is taking Digoxin. The nurse should instruct the patient to monitor and report which of the following adverse effects? ( select all the apply)
A. Fatigue
B. Constipation
C. Anorexia
D. Rash
E. Diplopia
A. Fatigue
C. Anorexia
E. Diplopia
What is the antidote for Heparin?
A. Atropine
b. Protamine sulfate
C. Calcium Carbonate
D. Ferrous Sulfate
b. Protamine sulfate
Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:
A. headaches
B. cold remedy
C. neuropathic pain
D. antianxiety
C. neuropathic pain
When taking Digoxin, low levels of what can cause toxicity?
A. potassium
B. calcium
C. sodium
D. magnesium
A. potassium
When taking Nitroglycerine (transdermal), you should have how many hours nitrate free each day? A. 1-2 hours
B. 5-10 hours
C. 3-4 hours
D. 10-12 hours
D. 10-12 hours
Lithium is used to?
A. Lower blood glucose
B. slow the heart rate
C. stabilize mood
D. heal ulcers
C. stabilize mood
When administering Phenytoin you should monitor?
A. behavior
B. therapeutic blood levels
C. for Steven Johnson syndrome
D. all of the above
D. all of the above
Angiotensin II receptor agents medications usually end in?
A. sar-tan
B. ase
C. olol
D. pril
A. sar-tan
What is the Therapeutic Effects of Lithium?
A.) Prevents/decreases incidence of acute manic episodes
B.) Maintenance of blood glucose C.) Control of hyperglycemia in diabetic patients
D.) Diminished seizure activity
A.) Prevents/decreases the incidence of acute manic episodes
What is the action of Metformin? A.)Decrease intestinal glucose absorption
B.) Increase sensitivity to insulin
C.) Decrease hepatic glucose production
D.) All of the above
D.) All of the above
What is the medication effectiveness of Propranolol? Select all that apply.
A.) Decrease in BP
B.) Prevention of MI
C.) Decrease tremors
D.) Decrease in GI pain and irritation
A.) Decrease in BP
B.) Prevention of MI
C.) Decrease tremors
What is a common side effect of Albuterol?
A.)Paradoxical Bronchospasm
B.)Diarrhea
C.) Seizures
D.) Vision loss
A.)Paradoxical Bronchospasm
What is the therapeutic use of Albuterol? •
A) Bronchodilation •
B) Anti-coagulant •
C) Anti-arrhythmic •
D) Proton-pump inhibitor
A) Bronchodilation •
What medication is a contraindication to Nitroglycerin • A) Hydrochloroquinone
B) Methylprednisolone
C) Phenazopyridine
D) Erectile dysfunction drugs
D ) Erectile dysfunction drugs
What is the classification of Ondansetron?
a. Antihypertensive
b. Antiarrthymia
c. Antiemetic
d. Antiulcer agent
c. Antiemetic
Before administering Digoxin, the nurse should complete which task? A. Obtain an ECG
B. Count apical Pulse for 1 minute C. Take temperature
D. Obtain I/O
B. Count apical Pulse for 1 minute
What serious adverse reaction can occur with the loop diuretic Furosemide?
A. Stevens-Johnsons syndrome
B. GI bleeding
C. Hypertension
D. Bradycardia
A. Stevens-Johnsons syndrome
If a patient is taking an ACE inhibitor, the nurse should monitor for signs of angioedema which include?
A. Vomiting
B. Dyspnea
C. Constipation
D. Epistaxis
B. Dyspnea
Ace Inhibitors often end in?
A) -ale
B) -olol
C) -pril
D) -ide
C) -pril
What is a side effect for Phenytoin? a) Suicidal thoughts
b) Dry mouth
c) Blood in urine
d) Tremor
a) Suicidal thoughts
A patient with_____ should stop taking NSAIDs
A. Peptic Ulcers
B. Headaches
C. Cramps
D. Nausea
A. Peptic Ulcers
When administering the opioid Morphine to a patient, it is given in doses of
a. 2-5 mg every 3-4 hours
b. 10-12 mg every 4 hours
c. 1-2mg every 8 hours
d. 25 mg every 6 hours
a. 2-5 mg every 3-4 hours
If you are treating a patient that has renal failure, what type of pain medications should you avoid?
a. Opioids
b. NSAIDs
c. Nonopioids
d. Short-acting analgesics
b. NSAIDs
A common side effect of Angiotensin-Converting Enzyme (ACE) Inhibitors is
a. Suicidal thoughts
b. Toxic epidermal necrosis
c. Heart failure
d. cough
d. cough
How can Ondansetron be administered? Select all that apply. A. PO
B. IV
C. Subcutaneous
D. IM
A. PO
B. IV
D. IM
Albuterol can be given in all but which of these forms:
a. extended-release
b. inhalation
c. intravenously
d. orally
c. intravenously
A side effect given off by omeprazole is:
a. bloody stools
b. change in stomach pH
c. thirst
d. constipation
a. bloody stools
The classification of digoxin is:
a. antithrombic
b. nitrates
c. antiplatelet agent
d. cardiac glycosides
d. cardiac glycosides
Orthostatic hypotension is a common side effect in which of these drugs (select all that apply)? a. ACE Inhibitors
b. Anticoagulants
c. Beta Blockers
d. Calcium Channel Blockers
e. Antidiarrheal
f. Diuretics
a. ACE Inhibitors
c. Beta Blockers
d. Calcium Channel Blockers
f. Diuretics
What is the effect of Beta Blockers? a. Relief of diarrhea
b. Relief of symptoms associated with allergies
c. Decreases blood pressure and heart rate
d. Prevents constipation
c. Decreases blood pressure and heart rate
What is the therapeutic levels for digoxin?
a. 0.2 – 0.5 ng/mL
b. 0.5 – 2 ng/mL
c. 1.0 – 1.8 ng/mL
d. 2.0 – 5.0 ng/mL
a. 0.2 – 0.5 ng/mL
What is the therapeutic effect of Montelukast?
a) decreased incidence and severity of nausea and vomiting
b) decreased frequency and severity of acute asthma attacks
c) laxative action
d) protects ulcers with subsequent healing
b) decreased frequency and severity of acute asthma attacks
Which of these is a platelet aggregation inhibitor?
a) Albuterol
b) Montelukast
c) Clopidogrel
d) Ondansetron
c) Clopidogrel
hich of these is a side effect of Sennosides? (Select all that apply.) a) cramping
b) bruising
c) diarrhea
d) headaches
a) cramping
c) diarrhea
Amlodipine manages what?
a) constipation
b) hypertension
c) migraines
d) hypercholesterolemia
b) hypertension
At what blood pressure would you hold Digoxin in an adult?
A. <60 B. >60
C. >80
D. <80
A. <60 (less than)
When administering Propranolol through an IV, what should be done
before?
A. Nothing, there is no importance
B. The patient should eat
C. The patient should drink a lot of water
D. Have a second practitioner check the original order, calculations, and infusion pump
D. Have a second practitioner check the original order, calculations, and infusion pump
A client forgot to take their Levothyroxine when directed. The client should…
A. Notify health care professional
B. Take the missed dose as soon as possible unless it is almost time for next dose
C. Skip the dose
D. Stop taking Levothyroxine all together
B. Take the missed dose as soon as possible unless it is almost time for next dose
A patient is taking Digoxin to slow his heart rate down. The nurse suggests that he take his oral medication:
a. when awakening
b. by itself
c. in the evening
d. with meals
d. with meals
Common side effects of iron supplements include (select all that apply):
a. constipation
b. drowsiness
c. upset stomach
d. nausea
a. constipation
c. upset stomach
d. nausea
The nurse is administering Penicillin to a patient who has tested positive for strep throat. The nurse knows to look for which of the following adverse effects as a sign of an acute allergic reaction?
a. blurred vision
b. tinnitus
c. skin rash/hives
d. vomiting
c. skin rash/hives
What is the pharmacological action of metformin?
A. Biguanides
B. Benzodiazepines
C. Nitrates
D. Digitalis glycosides
A. Biguanides
What is the therapeutic use of levothyroxine?
A. Suppression of seizure activity
B. Decreased frequency of migraines
C. Replacement in hypothyroidism to restore normal hormonal balance
D. Treatment of ulcers
C. Replacement in hypothyroidism to restore normal hormonal balance
Which of the following is a common adverse effect of the bronchodilator albuterol?
A) nausea
B) vomiting
C)stomach cramps
D)chest pain
D)chest pain
When teaching a patient about their new medication montelukast which of the following statements made by the patient would indicate they are in need of further teaching?
A) “I can skip a dose if I do not feel asthma symptoms”
B) “I should take the medication 2 hours before exercising”
C) “I should not double the dosage” D) “this medication may increase suicidal thoughts
A) “I can skip a dose if I do not feel asthma symptoms”
When educating a patient about Regular Insulin, you should include which instruction:
A. Shake the vial vigorously
B. Expect the solution to appear cloudy
C. Store unopened vials at room temperature
D. Inject the insulin subcutaneously
D. Inject the insulin subcutaneously
Select all the early manifestations of lithium toxicity
A. Nausea
B. Hypotension
C. Renal Failure
D. Muscle Weakness
A. Nausea
D. Muscle Weakness
How would you evaluate the medical effectiveness of Metformin?
a. assess serum electrolytes. ketones, glucose, blood PH, lactate, pyruvate levels, monitor serum glucose
b. check for resolution of hypothyroidism and normalization of hormone levels
c. check patient for pain reduction d. Assess patient alertness
a. assess serum electrolytes. ketones, glucose, blood PH, lactate, pyruvate levels, monitor serum glucose
What are the drug natural interactions for phenytoin?
a. Echinacea
b. St.Johns Wort
c. Valerian
d. Jeff Salernos War
b. St.Johns Wort
What type of diuretic is furosemide? a. Loop
b. potassium sparing
c. Thiazide
d. Hypertensive
a. Loop
Which of the following are complications of Warfarin? (select all that apply)
a. bleeding
b. cramps
c. fever
d. nausea
e. all of the above
e. all of the above
When a company develops a new drug and gives it an official name, this name is the .
a. Brand name
b. Generic name
c. prototype
d. prescription
b. Generic name
What is/are the major adverse/side effects of regular insulin? Select all that apply
a. hypoglycemia
b. hypokalemia
c. drowsiness
d. anaphylaxis
a. hypoglycemia
b. hypokalemia
d. anaphylaxis
Which of the following drugs can suppress seizure activity and decrease the frequency of migraine headache?
a. glipizide
b. hydrochlorothiazide
c. atropine
d. valproate
d. valproate
Which is the only type of insulin that can be given IV?
a. Regular
b. NPH
c. Long-acting
d. Rapid-acting
a. Regular
Which drug is the antidote of Alprazolam?
a. Physostigmine
b. Protamine sulfate
c. Flumazenil
d. Acetylcysteine
c. Flumazenil
What does it mean when a medication has a half-life?
a. It only lasts for 30 mins after the medication is given
b. How long it takes for half of the dose to be eliminated from the blood stream
c. It is the peak of how effective the medicine is
d. Drug is greatly reduced before it reaches the systemic circulation
b. How long it takes for half of the dose to be eliminated from the blood stream
A patient with hypertension is taking an ACE inhibitor to lower his blood pressure. What should the nurse tell the patient to avoid in his diet?
a. vinegar
b. apples
c. salt substitutions
d. tomatoes
c. salt substitutions
What is Nitroglycerin’s Action?
a. Dilates the Bronchi
b. Reduce Blood Glucose
c. Reduce Nausea
d. Dilates Coronary Arteries
d. Dilates Coronary Arteries
What does a patient need to avoid while taking Angiotensin-converting enzymes?
a. Salt substitutes
b. Foods high in potassium
c. Foods high in sodium
d. All of the above
d. All of the above
What is the most life threatening adverse reaction while taking Omeprazole?
a. Chest pain
b. Constipation
c. Clostridium Difficile Associated Diarrhea
d. Acute interstitial nephritis
c. Clostridium Difficile Associated Diarrhea
What is one therapeutic use for Nitroglycerine?
a. Relief or prevention of anginal attacks
b. Diuresis and mobilization of excess fluid
c. Decrease nausea and vomiting
d. Relief of anxiety
a. Relief or prevention of anginal attacks
What is the peak range of regular insulin?
a. 30 – 2 ½ hours
b. 1 – 3 hours
c. 6 – 14 hours
d. 1 – 5 hours
d. 1 – 5 hours
What is pharmacodynamics?
a. The medical reference summarizing standards of drug purity, strength and directions for synthesis
b. The drugs actions at receptor site and the physiological, chemical, and behavioral effects produced by these actions
c. The maximum response that a drug can produce
d. Movements of the drugs throughout the body
b. The drugs actions at receptor site and the physiological, chemical, and behavioral effects produced by these actions
What is Alprazolam therapeutic use?
a. Prevent thrombus formation
b. Relief of anxiety
c. Decrease risk of stroke
d. Increase urinary output
b. Relief of anxiety
What is the expected pharmacological action of propranolol?
a. Block stimulation of beta1
b. Alter water & electrolyte transport in the large intestine
c. Block stimulation of beta 2
d. Both A and C are correct
d. Both A and C are correct
What should you monitor when given a patient Clopidogrel?
a. Signs of thrombotic thrombolytic purpura
b. Bleeding during therapy
c. CBC with differential and platelet count
d. All the above
d. All the above
Patients should avoid what drink while taking Alprazolam?
a. Water
b. Grapefruit juice
c. Green Tea
d. Milk
b. Grapefruit juice
What is a high alert nursing implication for Morphine?
a. Assessing type of pain
b. Assess level of consciousness, BP, pulse, & respiration
c. Assess bowel function
d. Assess patient for confusion
b. Assess level of consciousness, BP, pulse, & respiration
How would you teach a patient how to prep an inhaler?
a. Tell them to spray the inhaler 4 times and discard after 150 puffs.
b. Tell them to shake the inhaler for 5 seconds.
c. Tell them to spray the inhaler 4 times and discard after 200 puffs.
d. You do not need to prime it.
c. Tell them to spray the inhaler 4 times and discard after 200 puffs.
Advise patient to avoid taking antacids or antidiarrheals for how long after taking digoxin?
a. 30 minutes
b. 2 hours
c. 4 hours
d. 3 hours
b. 2 hours
What is the pharmacologic classification of Amlodipine
a. Beta blocker
b. 5-HT3 antagonist
c. Nonopioid analgesic
d. Calcium channel blocker
d. Calcium channel blocker
When administering the medication Spironolactone, when is the best time to administer it?
a. Evening
b. Noon
c. At bedtime
d. Morning
d. Morning
What is the theraputic classification of Atropine?
a. Antipsychotic
b. Antidepressants
c. Antiarryhthmics
d. Anticonvulsants
c. Antiarryhthmics
is the main glucocorticoid produced by the adrenal glands.
a. Fluticasone
b. Hydrocortisone
c. Fludrocortisone
d. Dexamethasone
e. Prednisone
b. Hydrocortisone
All benzodiazepines reduce and produce .
A. anxiety, sedation
B. hunger, food coma
C. sedation, anxiety
D. drowsiness, wakefulness
C. sedation, anxiety
A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects
A. urinary health promotion
B. immune system stimulation
C. decreased leg pain from arterial disease
D. prevention of nausea caused by motion sickness
A. urinary health promotion
Saw palmetto is used primarily for manifestations related to prostatic conditions, such as benign prostatic hypertrophy (BPH). Its effectiveness has not been scientifically proven, however. The nurse should teach the client to check with the provider about interactions between saw palmetto and other medications.
A nurse is providing teaching to a group of new parents about medications. The nurse
should include that aspirin is contraindicated for children who have a viral infection due
to the risk of developing which of the following adverse effects?
a. Reye’s syndrome
b. Visual disturbances
c. Diabetes mellitus
d. Wilm’s tumor
a. Reye’s syndrome
A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?
a. Reduces blood pressure
b. Inhibits clotting of fistula
c. Promotes RBC production
d. Stimulates growth of neutrophils
c. Promotes RBC production
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer?
a. Ibuprofen (NSAIDS)
b. Naproxen (NSAIDS)
c. Aspirin (NSAIDS)
d. Acetaminophen (anlagesics)
d. Acetaminophen (anlagesics)
A nurse is caring for a client who has prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?
a. Insomnia
b. Hypotension
c. Bleeding
d. Constipation
c. Bleeding
A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as contraindication to ceftriaxone?
a. Gentamicin
b. Clindamycin
c. Piperacillin
d. Sulfamethoxazole-trimethroprim
c. Piperacillin
A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a
contraindication to this medication?
a. Hyperthyroidism
b. Intestinal obstruction
c. Glaucoma
d. Low blood pressure
b. Intestinal obstruction
A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?
a. Amantadine
b. Bupropion (aytpical antidepressant)
c. Phenelzine (MAOI)
d. Hydroxyzine (Antihistamine)
a. Amantadine
A nurse is administering subQ epinephrine for a client who is experiencing anaphylaxis.
The nurse should monitor the client for which of the following adverse effects?
a. Hypotension
b. Hyperthermia
c. Hypoglycemia
d. Tachycardia
d. Tachycardia
A nurse is providing teaching to a client who has UTI and new prescription for
phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?
a. If the phenazopyridine upsets my stomach, I can take it with meals.
b. The phenazopyridine will relieve my discomfort, but the cipro will get rid of the
infections.
c. I need to drink2 liters of fluid per day while I am taking cipro.
d. I should notify my provider immediately if my urine turns an orange color.
d. I should notify my provider immediately if my urine turns an orange color.
A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following
adverse effects?
a. Ecchymosis
b. Decreased urine output
c. Increased blood pressure
d. Dizziness
d. Dizziness
A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of
the following medications?
a. Methimazole
b. Somatropin
c. Levothyroxine
d. Propylthiouracil
c. Levothyroxine
A nurse is providing teaching to a client who has a new prescription for
hydrochlorothiazide 50mg po daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?
a. Take the hydrochlorothiazide as needed for edema
b. Check your weight once each week
c. Take the hydrochlorothiazide on an empty stomach
d. Take the hydrochlorothiazide in the morning.
d. Take the hydrochlorothiazide in the morning.
A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer?
a. Oxytocin
b. Nifedipine
c. Dinoprostone
d. Misoprostol
b. Nifedipine
A nurse is providing teaching to a client who has cirrhosis and new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?
a. Increases blood pressure
b. Prevents esophageal bleeding
c. Decreases heart rate
d. Reduce ammonia levels
d. Reduce ammonia levels
A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?
a. Hearing examination
b. Glucose tolerance test
c. Electrocardiogram
d. Pulmonary function test
c. Electrocardiogram
A nurse is providing teaching to a client who has gout and new prescription for
allopurinol. The nurse should instruct client to discontinue taking the medications for which of the following adverse effects?
a. Nausea
b. Metallic taste
c. Fever
d. Drowsiness
c. Fever
A nurse is assessing a client who is receiving IV gentamicin 3 x daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?
a. Hypoglycemia
b. Proteinuria
c. Nasal congestion
d. Visual disturbances
b. Proteinuria
A nurse is providing teaching to a newly nurse about caring for a client who has prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests?
a. Platelet count
b. Electrolyte levels
c. Thyroid functions
d. Liver function
d. Liver function
A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?
a. Raynaud’s phenomenon
b. Migraine headaches
c. Ulcerative colitis
d. Anemia
b. Migraine headaches
A nurse is reviewing the lab values for a client who is receiving a continuous IV heparin infusion and has an aPTT (TR-60-80 sec) of 90 seconds. Which of the following actions should the nurse prepare to take?
a. Administer Vit K
b. Reduce the infusion rate
c. Give the client a low dose aspirin
d. Request an INR
b. Reduce the infusion rate
A nurse is providing teaching to a client who had rheumatoid arthritis and a prescription for long term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?
a. Stress fractures
b. Orthostatic hypotension
c. Gingival ulcerations
d. Weight loss
a. Stress fractures
A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?
a. Antiestrogenic
b. Antimicrobial
c. Androgenic
d. Anti-inflammatory
a. Antiestrogenic
A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?
a. Hyperkalemia
b. Hypertension
c. Constipation
d. Nephrotoxicity
d. Nephrotoxicity
A nurse is administering subQ heparin to a client who is at risk for DVT. Which of the following should the nurse take?
a. Administer the medication into the client’s abdomen
b. Inject the medication into a muscle
c. Massage the site after administering the medication
d. Use a 22 gauge needle to administer the medication
a. Administer the medication into the client’s abdomen
A nurse is reviewing the lab results for a client who has prescription for filgastrim. The nurse should recognize that an increase in which of the following values indicates a
therapeutic effect of this medication?
a. Erythrocyte count
b. Neutrophil count
c. Lymphocyte count
d. Thrombocyte count
b. Neutrophil count
A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
a. Jaundice
b. Constipation
c. Oral candidiasis
d. Sedation
a. Jaundice
A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following lab values should the nurse plan to monitor? Select
all that apply.
a. BUN
b. PTT
c. Aspartate aminotransferase (AST)
d. Urinalysis
e. Alanine aminotransferase (ALT)
b. PTT
c. Aspartate aminotransferase (AST)
e. Alanine aminotransferase (ALT)
A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?
a. Allergic response
b. Superinfection
c. Renal toxicity
d. Hepatotoxicity
b. Superinfection
A nurse is caring for a client who has a prescription for chlorothiazide to treat
hypertension. The nurse should plan to monitor the client for which of the following adverse effects?
a. Thrombophlebitis
b. Hyperactive reflexes
c. Muscle weakness
d. Hypoglycemia
c. Muscle weakness
A nurse on a medical unit is preparing to administer alendronate 40mg po for an older adult client who has Paget’s disease of the bone. Which of the following actions should be the nurse’s priority?
a. Administer the medication to the client’s before breakfast in the morning.
b. Ambulate the client to a chair prior to administering the medication.
c. Give the medication to the client with water rather than milk.
d. Teach the client how to take the medication at home.
b. Ambulate the client to a chair prior to administering the medication.
A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary TB. The client reports his urine is an orange color.
Which of the following statements should the nurse make?
a. Stop taking isoniazid for 3 days and the discoloration should go away.
b. Rifampin can turn body fluids orange.
c. I’ll make an appointment for you to see the provider this afternoon.
d. Isoniazid can cause bladder distention.
b. Rifampin can turn body fluids orange.
A nurse is caring for a client who had a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?
a. Ecchymosis
b. Jaundice
c. Hypotension
d. Hypokalemia
c. Hypotension
A nurse is preparing a discharge teaching plan for a 6 year old client who has asthma and several prescription medication using metered dose inhalers (MDIs). Which of the
following interventions should the nurse include in the plan?
a. Add a spacer to each MDI.
b. Instruct the child to inhale more rapidly than usual when using an MDI.
c. Request that the provider change the child’s medications from inhaled to oral
formulation.
d. Administer oxygen by facemask along with the MDI.
a. Add a spacer to each MDI.
A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?
a. I will give my child a dose as soon as wheezing starts.
b. My child should rinse out his mouth after using the inhaler.
c. My child should exhale completely before placing the inhaler in his mouth.
d. If my child has difficulty breathing in the dose, a spacer can be used.
a. I will give my child a dose as soon as wheezing starts.
A nurse is providing teaching to a newly licensed nurse about administering morphine via
IV bolus to a client. Which of the following information should the nurse include in the teaching?
a. Respiratory depression can occur 7 min after the morphine is administered.
b. The morphine will peak in 10 min
c. Withhold the morphine if the client has a respiratory rate of less than 16/min
d. Administer the morphine over 2 min
a. Respiratory depression can occur 7 min after the morphine is administered
A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several prescription medications using metered dose inhalers [MDIs]. Which of the following interventions should the nurse include in the plan?
A. add spacer to each MDI
B. instruct the child to inhale more rapidly
C. request that the provider change the child’s medications from inhaled to oral formulations
D. administer oxygen by facemask along with the MDI
A. add spacer to each MDI
MDIs are difficult to use correctly and, even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.
A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching?
A. I will administer a spray into each nostril daily
B. I should expect nasal bleeding for the first week
C. I will need to depress the side arms to activate the pump
D. I should expect to take this medication for a short-term course of treatment
C. I will need to depress the side arms to activate the pump
The nurse should instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two white side arms toward the bottle six times.
A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?
A. urine specific gravity 1.035
B. distended neck veins
C. BUN 18 mg/dL
D. bounding radial pulse
A. urine specific gravity 1.035
Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.
A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin 25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)
18 mL/hr
A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain?
Wait for 5 min
Stop activity
Call 911 if the pain is not relieved
Place a tablet under the tongue
Stop activity
Place a tablet under the tongue
Wait for 5 min
Call 911 if the pain is not relieved
A nurse is providing teaching to a client who is to start taking Hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?
A. this medication will not work unless I have enough potassium
B. potassium will increase the therapeutic effect of my blood medication
C. potassium will lower my blood pressure
D. this medication can cause a loss of potasium
D. this medication can cause a loss of potassium
Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion by the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.
A home health nurse is visiting an older adult client who has Alzheimer’s disease. His caregiver tells the nurse she has been administering prescribed Lorazepam, 1 mg three times per day, to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess the client?
A. low-grade fever
B. sedation
C. diuresis
D. tonic-clonic seizures
B. sedation
Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients, especially, are at risk for central nervous system depression even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.
A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is Digoxin 0.25 mg/1ml. How many ml should the nurse administer?
0.8 mL
A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching?
A. I will be able to stop taking this medication 6 months after my surgery
B. I am likely to develop higher bp while taking this medication
C. I am likely to lose my hair while taking this medication
D. I am taking this medication to boost my immune system
B. I am likely to develop higher bp while taking this medication
Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.
A nurse is caring for a client who is in preterm labor and has a new prescription for Nifedipine. The client states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the client that Nifedipine works for clients who are pregnant by which of the following mechanisms?
A. it decreases the incidence of bacterial vaginosis, thus preventing uterine contractions
B. it inhibits uterine contraction by blocking entry of calcium into uterine cells
C. it decreases the activity within the CNS, which regulates all smooth muscles
D. it stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions
B. it inhibits uterine contractions by blocking entry calcium into uterine cells
Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.
A nurse is administering Adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during administration of Adenosine?
A. seizures
B. cinchonism
C. dyspnea
D. transient pallor of the face
C. dyspnea
Dyspnea can occur during administration of adenosine due to bronchoconstriction. Since adenosine has a very short half-life of about 10 seconds, this effect should be short-lived.
A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect?
A. diarrhea
B. anxiety
C. nausea and vomiting
D. dry mouth
D. dry mouth
Hydroxyzine has anticholinergic properties. Dry mouth is a common adverse effect of this medication. The nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.
A nurse is planning discharge teaching for a client who has Major Depressive Disorder and a new prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine?
A. broiled beef steak
B. macaroni and cheese
C. pepperoni pizza
D. smoked samon
A. broiled beef steak
Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?
A. nasal congestion
B. tremors
C. tinnitus
D. frontal headache
C. tinnitus
Loop diuretics, such as furosemide, can cause ototoxicity. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?
A. choose an IV port for IV bolus injection for the diphenhydramine as near as possible to the client’s hanging IV bag
B. flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine
C. allow IV infusion to keep running while administering the diphenhydramine via IV bolus
D. aspirate to check the IV patency before administering the diphenhydramine
D. aspirate to check for IV patency before administering the diphenhydramine
it is important to confirm IV patency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.
A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refused to eat breakfast. Which of the following actions should the nurse take first?
A. encourage the client to eat the toast on the breakfast tray
B. administer the antiemetic
C. inform the client’s provider
D. check the client’s apical pulse
D. check the client’s apical pulse
Nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias, often caused by a slow pulse rate, are possible findings in digoxin toxicity. Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider about a change in the client’s status, she must first collect adequate data from the client. Assessing will provide the nurse with knowledge to make an appropriate decision.
A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for Isoniazid. The nurse should teach the client that which of the following laboratory values should be monitored while taking Isoniazid?
A. thyroid stimulating hormone level
B. asperate aminotransferase
C. potassium
D. sodium
B. aspartate aminotransferase
Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes, such as AST, during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine or other findings indicating hepatitis.
A nurse is preparing a discharge teaching plan for a client who is to being long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?
A. stop taking the medication if a rash occurs
B. take the medication of an empty stomach to enhance absorption
C. schedule the medication on alternate days to decrease adverse effects
D. treat shortness of breath with an extra dose of the medication
C. schedule the medication on alternate days to decrease adverse effects
Some of the adverse effects caused by long-term glucocorticoid therapy, such as suppression of the adrenal gland, can be avoided by using alternate-day therapy.
A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first?
A. acamprosate
B. naltrexone
C. chlordiazepoxide
D. disulfiram
C. chlordiazepoxide
Chlordiazepoxide, a long-acting oral benzodiazepine, is a first-line medication to use for a client who is experiencing manifestations of acute alcohol withdrawal. For clients who are nauseated or vomiting, another benzodiazepine, such as lorazepam, can be administered via IV. The nurse should apply the acute versus chronic priority-setting framework when caring for this client. Using this framework, acute needs (manifestations of acute alcohol withdrawal) are typically the priority need because they pose more of a threat to the client. Because chronic needs usually develop over a period of time, the client has more of an opportunity to adapt to the alteration in health.
A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first?
A. notify the provider
B. contact the nursing supervisor
C. assess the client’s apical pulse
D. complete an incident report
C. assess the client’s apical pulse
Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider about a change in the client’s status, she must first collect adequate data from the client. Assessing will provide the nurse with knowledge to make an appropriate decision. Therefore, the first action the nurse should take is to assess the client.
A nurse is planning to administer Diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of Diltiazem.
A. hypotension
B. tachycardia
C. decreased level of consciousness
D. history of diuretic use
A. hypotension
Diltiazem can be a treatment option for essential hypertension. This medication will lower blood pressure and is contraindicated for a client who is hypotensive. The nurse should teach the client to self-monitor blood pressure and keep a record of the readings.
A nurse is caring for a client who was brought to the emergency department by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to assess?
A. temperature 39.2 C (102.6 F)
B. respiratory rate 30/min
C. pinpoint pupils
D. severe abdominal cramping
C. pinpoint pupils
Pinpoint pupils are an expected finding in opioid toxicity. Increased pupil size is seen in opioid withdrawal.
A nurse is preparing to administer Chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is Chlorothiazide oral suspension 250 mg/5ml. how many ml should the nurse administer per dose?
2.6 mL
A nurse is preparing to administer dextrose 5& in 0.45% sodium chloride 400 ml IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many ml/hr? (round to the nearest whole number)
50 mL/hr
A nurse is providing teaching to a client who has hypertension and a new prescription for oral Clonidine. Which of the following instructions should the nurse include in the teaching?
A. discontinue the medication if a rash develops
B. expect increased salivation during the first few weeks of therapy
C. minimize fiber intake to prevent diarrhea
D. avoid driving until the client’s reaction to the medication is known
D. avoid driving until the client’s reaction to the medication is known
Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client’s response to the medication is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment. Over time, these effects are likely to decrease.
A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water [D5W] to infuse over 15 minutes. The drop factor of the manual IV tubing is 10 gtt./ml. The nurse should set the manual IV infusion to deliver how many gtt./min?
33 gtt/min
A nurse is assessing a client who has hypothyroidism and takes Levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute Levothyroxine overdose?
A. bradycardia
B. cold intolerance
C. tremor
D. hypothermia
C. tremor
Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism.
A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr. to a client who is dehydrated. The nurse should set the IV pump to deliver how many ml/hr.?
500 mL/hr
A nurse is administering insulin glulisine 10 units subcutaneously at 0720 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times?
A. 0800
B. 0745
C. 0900
D. 1030
B. 0745
Insulin glulisine has a very short onset of action of 15 min. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following administration of the insulin.
A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription or Amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?
A. I will take amitriptyline in the morning because I’m likely to have trouble falling asleep if I take it in the evening
B. I will move slowly when I stand up because amitriptyline can cause my bp to decrease
C. I can drink a glass of beer or wine with my evening meal because amitriptyline doesn’t interact with alcohol
D. I will avoid foods high in fiber because amitriptyline can cause diarrhea
B. I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease
Amitriptyline can cause orthostatic hypotension. The nurse should instruct the client to take precautions to prevent injury due to falls while taking amitriptyline.
A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg three times daily PO and gabapentin 1,800 mg three times daily PO to manage pain. The client tells the nurse, “I’m having pain that keeps me from doing what I’d like most of the time.” Which of the following additions should the nurse anticipate to the client’s medication regimen?
A. oral meperidine
B. parenteral naloxone
C. parenteral diazepam
D. oral oxycodone
D. oral oxycodone
The client’s current pain regimen consists of a nonopioid analgesic, naproxen, and an adjuvant medication for neuropathic pain, gabapentin. According to the WHO analgesic ladder for cancer pain management, the next addition to the pain regimen is an opioid for moderate pain. Oxycodone is an oral opioid that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client’s pain regimen.
A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to watch for and report to the provider?
A. weight gain
B. myalgia
C. hypoglycemia
D. severe constipation
B. myalgia
Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occur while taking metformin due to blockage of lactic acid oxidation. The nurse should instruct the client to report these findings promptly to the provider.
A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?
A. place oxytocin from a pre-filled syringe into the posterior fornix of the vagina every 10 min until effective labor occurs
B. check the client’s bp and pulse every 15 min while induction of labor is occurring
C. stop oxytocin for contractions that continue longer than 30 min
D. increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min
D. increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min
Effective uterine contractions should occur every 2 to 3 min.
A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea [IBS-D] and a new prescription for Alosetron. Which of the following interventions should the nurse include in the plan of care?
A. the client must sign an agreement with the provider before beginning alosetron
B. the client must stop taking alosetron if diarrhea continues 1 week after beginning the medication
C. the client should expect to have a slower heart rate while taking alosteron
D. the client should use a barrier birth control method because alosteron interacts with oral contraceptives
C. the client must sign an agreement with the provider before beginning alosteron
Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron.
A nurse is providing teaching to the parents of a school-age child who has asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve and acute asthma attack?
A. salmeterol
B. cromolyn
C. fluticasone
D. albuterol
D. albuterol
Albuterol is a short-acting beta2-adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One or two puffs every 4 to 6 hr PRN is the usual prescribed dose for a school-age child. If higher or more frequent doses are needed, the provider should evaluate the client for worsening asthma.
A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, “My brother take verapamil for high blood pressure. Do you think the provider made a mistake?” Which of the following responses should the nurse make?
A. verapamil is used to treat both high blood pressure and angina
B. you should talk to your provider to make sure the prescription is correct for you
C. are you concerned that you might have high blood pressure
D. your provider has prescribed verapamil so that you will not develop high blood pressure
A. verapamil is used to treat both high blood pressure and angina
Verapamil is a calcium channel blocker that is used for both hypertension and anginal pain because of its ability to dilate arteries and decrease afterload.
A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed Omeprazole. Which of the following statements should the nurse include in the teaching?
A. you will need to take this medication for the next 6 months
B. taking this medication will decrease your risk for acquiring pneumonia
C. you should take this medication before breakfast every day
D. watch for serious adverse effects of tachycardia and heart palpations while taking this medication
C. you should take this medication before breakfast every day
Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food.
A nurse is preparing to administer codeine 30 mg PO every 4 hr. PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 ml. How many ml should the nurse plan to administer per does?
10 mL
A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider?
A. BUN 18 mg/dL
B. platelets 78,000/mm3
C. hemoglobin 14.2 g/dL
C. aspartate aminotransferase 35 units/L
B. platelets 78,000/mm3
The nurse should monitor the platelet count of a client who is taking methotrexate because the medication can cause thrombocytopenia. This client’s platelet count is very low and puts the client at risk for severe bleeding. The nurse should report this finding promptly to the provider.
A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler who weighs 33 lbs. available is ampicillin 125 mg/5ml oral solution. How many ml should the nurse administer per dose?
7.5 mL
A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?
A. administer a small test dose before giving the full dose
B. infuse the medication over 30 sec
C. monitor the client closely for hypertension after the infusion
D. administer cyanocobalamin as an antidote if iron dextran toxicity occurs
A. administer a small test dose before giving the full dose
A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. It is recommended that a small test dose be administered over 5 min before giving the full dose. The client should be monitored carefully for an allergic reaction during and for a period of time following the test dose.
A nurse is providing discharge teaching to a client who has heart failure and a prescription for Digoxin 0.125 mg PO daily and Furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?
A. I know that blurred vision is something I will expect to happen while taking digoxin
B. I will measure my urine output each day and document it in my diary
C. I will skip a dose of my digoxin if my resting heart rate is below 72 bpm
D. I will eat fruits and veggies that have high potassium content every day
D. I will eat fruits and veggies that have high potassium content every day
Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain the potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity.
A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?
A. bp
B. temp
C. blood glucose levels
D. total protein level
A. bp
Epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. The nurse should monitor the client’s blood pressure and notify the provider about increases. The client who receives epoetin alfa frequently requires concurrent use of antihypertensive medication.
A nurse is administering Ciprofloxacin and Phenazopyridine to a client who has a severe urinary tract infection [UTI]. The client asks why both medications are needed. Which of the following responses should the nurse make?
A. phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride
B. combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy.
C. the use of phenazopyridine allows for a lower dosage of ciprofloxacin hydrochloride
D. ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain
D. ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain
Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation.
A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching?
A. “I should take naproxen if I have a headache because aspirin can cause lithium toxicity.”
B. “I can develop lithium toxicity if I eat foods with lots of sodium.”
C. “I can develop lithium toxicity if I experience vomiting or diarrhea.”
D. “I might need to take a daily diuretic along with my lithium to prevent lithium toxicity.”
C. “I can develop lithium toxicity if I experience vomiting or diarrhea.”
Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys and the risk for lithium toxicity increases.
A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching?
A. “I might have difficulty recognizing when my blood sugar is low.”
B. “I will have less risk for developing an infection while I take this medication.”
C. “I should be concerned about losing excess weight while I take this medication.”
D. “I could have more problems with high blood sugars while taking this medication.”
A. “I might have difficulty recognizing when my blood sugar is low.”
Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases heart rate, this common manifestation of hypoglycemia can be masked and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations, such as hunger, nausea, and sweating.
A nurse is assessing a client who has oral Theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline?
A. constipation
B. tremors
C. fatigue
D. bradycardia
B. tremors
Theophylline is a xanthine derivative bronchodilator. An early manifestation of toxicity is CNS stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.
A nurse is providing teaching to a client who has heart failure and is taking Spironolactone. Which of the following statements by the client indicates an understanding of the teaching?
A. “I will increase my intake of citrus fruits, bananas, and potatoes.”
B. “I will use salt substitutes on my food.”
C. “I will drink as much water as I can while taking this medication.”
D. “I will watch for increased breast tissue growth while taking this medication.”
D. “I will watch for increased breast tissue growth while taking this medication.”
Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as gynecomastia, impotence in men and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur.
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?
A. Take ibuprofen as needed for headache or other minor pains.
B. Carry a medic alert ID card.
C. Report to the laboratory weekly to have blood drawn for aPTT.
D. Increase intake of dark green vegetables.
B. Carry a medic alert ID card.
A client who is taking warfarin is at increased risk for bleeding. In the case of an emergency, it is important that any medical personnel are aware of the client’s medication history.