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
(Ans- 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 (Ans- 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
(Ans- 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
(Ans- 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
(Ans- 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.