Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pharm 2
| Question | Answer |
|---|---|
| Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? | Dexamethasone. Rationale Dexamethasone is a palliative treatment modality to manage symptoms related to compression due to tumor growth. |
| A female client with rheumatoid arthritis takes ibuprofen 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? | Use contraception during intercourse. Rationale Misoprostol, a synthetic form of a prostaglandin, is classified as pregnancy Category X and can act as an abortifacient, so the client should be instructed to use contraception during intercourse to preven |
| An antacid, calcium carbonate, is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to? | Maintain a gastric pH of 3.5 or above. Rationale The objective of antacids is to neutralize gastric acids and keep a pH of 3.5 or above which is necessary for pepsinogen inactivity. |
| Which instruction(s) should the nurse give to a female client who just received a prescription for oral metronidazole for treatment of Trichomonas vaginalis? (Select all that apply.) | Increase fluid intake, especially cranberry juice. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. |
| When assessing an adolescent who recently overdosed on acetaminophen, it is most important for the nurse to assess for pain in which area of the body? | Abdomen Rationale Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse to assess for pain in the right upper quadrant of the abdomen, which might indicate liver damage, along with nausea and vomiting. |
| A client with osteoarthritis receives a new prescription for celecoxib orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? | Notify the healthcare provider. Rationale Celecoxib contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies. |
| A client's dose of isosorbide dinitrate is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? | Administer the 60 mg dose of isosorbide dinitrate and a PRN dose of acetaminophen. Rationale Isosorbide dinitrate is a nitrate which causes vasodilation. This vasodilation can result in headaches, which can generally be controlled with acetaminophen unt |
| The nurse is assessing a client prior to administering the prescribed dose of atenolol PO. The client's blood pressure is 120/68 mmHg, and the telemetry monitor shows sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Based on t | Give the medication as prescribed and continue to monitor the client. Rationale Since the BP (blood pressure) is within normal limits, and the pulse is above 50 with a first-degree block, the medication can be administered. Atenolol is a beta-blocker, |
| A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? | Use a reliable form of birth control. Rationale Drugs classified in the category X, place a client who is in the first trimester of pregnancy at risk for teratogenesis, so women in the childbearing years should be counseled to use a reliable form of b |
| A client with hyperlipidemia receives a prescription for niacin. Which client teaching is most important for the nurse to provide? | Expected duration of flushing. Rationale Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching may promote compliance in taking the medication. While nutritio |
| A client is receiving clonidine 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? | Blood pressure has changed from 180/120 to 140/70 mmHg. Rationale Clonidine acts as a centrally-acting analgesic and antihypertensive agent. A reduction of the blood pressure to 140/70 mmHg indicates a reduction in hypertension. |
| The nurse is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the nurse expect? | improved pulse oximetry values. |
| A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride. What is the expected outcome for this client following the administration of this pharma | Decreased muscle weakness. Rationale Administration of edrophonium chloride, a cholinergic agent, will temporarily reduce muscle weakness, the most common complaint of newly-diagnosed clients with myasthenia gravis. This medication is used to diagnose m |
| The nurse is preparing the 0900 dose of losartan, an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. | Withhold the scheduled dose. Rationale The nurse should first withhold the scheduled dose of losartan because the client is hyperkalemic (normal range 3.5 to 5 mEq/l). Although hypokalemia is usually associated with diuretic therapy in heart failure, hy |
| The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? | Do not get up quickly. Always rise slowly. Rationale An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to prevent it by rising slowly. |
| A client is being treated for osteoporosis with alendronate, and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? | Take medication, go for a 30 minute morning walk, then eat breakfast. Rationale Alendronate is best absorbed when taken thirty minutes before eating in the morning. The client should also be advised to remain in an upright position for at least thirty |
| A postoperative client has been receiving a continuous IV infusion of meperidine 35 mg/hr for four days. The client has a PRN prescription for meperidine 100 mg PO every 3 hours. The nurse notes that the client has become increasingly restless, irritable, | Decrease the IV infusion rate of the meperidine per protocol. Rationale The client is exhibiting symptoms of meperidine toxicity which is consistent with the large doses of meperidine received over four days. Decreasing the infusion rate of the meperidi |
| Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan? | Risk for injury. Rationale Irbesartan is an antihypertensive agent, which acts by blocking vasoconstrictor effects at various receptor sites. This can cause hypotension and dizziness, placing the client at high risk for injury. |
| A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. Which adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? | Tachycardia and chest pain. Rationale Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of toxicity include tachycardia and chest pain. |
| An adult client is given a prescription for a scopolamine patch to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? | Apply the patch at least 4 hours prior to departure. Rationale Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before depar |
| An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? | Distribution. Rationale A decreased lean body mass in an older adult affects the distribution of drugs which affects the pharmacokinetics of drugs. In contrast, decreased gastric pH, delayed gastric emptying, decreased splanchnic blood flow, decreased g |
| A client with giardiasis is taking metronidazole 2 grams PO. Which information should the nurse include in the client's instruction? | Take the medication with food. Rationale Metronidazole, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be instructed to take the medication on a full stomach. Urine may be red-brown or dark from Flagyl, but this |
| The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medica | Rise slowly when getting out of bed or a chair. Rationale The client's new medication is an angiotensin-converting enzyme (ACE) inhibitor, which has the side effect of orthostatic hypotension. Instructing the client to rise slowly from a sitting or lyin |
| A peak and trough level must be drawn for a client receiving antibiotic therapy. Which is the optimum time for the nurse to obtain the trough level? | Immediately before the next antibiotic dose is given. Rationale Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given. |
| A client is being treated for hyperthyroidism with propylthiouracil. The nurse knows that the action of this drug is to? | Inhibit synthesis of T3 and T4 by the thyroid gland. Rationale Propylthiouracil is an adjunct therapy used to control hyperthyroidism by inhibiting the production of thyroid hormones. It is often prescribed in preparation for thyroidectomy or radioactiv |
| A client asks the nurse if glipizide is an oral insulin. Which response should the nurse provide? | No, it is not an oral insulin and can be used only when some beta cell function is present." Rationale An effective oral form of insulin has not yet been developed because when insulin is taken orally, it is destroyed by digestive enzymes. Glipizide is |
| A client who was prescribed atorvastatin one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? | Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. Rationale Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of atorvastat |
| The healthcare provider prescribes naproxen twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? | Another type of nonsteroidal antiinflammatory drug may be indicated. ationale Individual responses to nonsteroidal antiinflammatory drugs vary from person to person, so another nonsteroidal antiinflammatory drug (NSAID) may be indicated for this particu |
| Which method of medication administration provides the client with the greatest first-pass effect? | Rationale The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After oral medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal c |
| A client is receiving metoprolol. Which assessment is most important for the nurse to obtain? | Blood pressure. Rationale It is most important to monitor the blood pressure of clients taking this medication because metoprolol is an antianginal, antiarrhythmic, antihypertensive agent. |
| A client receiving albuterol tablets complains of nausea every evening with her 9:00 p.m. dose. Which action can the nurse take to alleviate this side effect? | Administer the dose with a snack. Rationale Administering oral doses of albuterol with food helps minimize GI discomfort. |
| In evaluating the effects of lactulose, which outcome would indicate that the drug is performing as intended? | Two or three soft stools per day. Rationale The medication lactulose can be administered for either chronic constipation or for portal-systemic encephalopathy in clients with hepatic disease. Two to three stools a day indicate that lactulose is performi |
| A client with dysrhythmia is to receive procainamide in 4 divided doses over the next 24 hours. Which dosing schedule is best for the nurse to implement? | Every 6 hours. Rationale Procainamide is a class 1A antidysrhythmic. It should be taken around-the-clock, so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of hypotension (an adverse effect) occurring because |
| Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) 1. | Albuterol puffs. Salmeterol. Prednisone orally. Gentamicin IM. |
| The nurse is assessing the effectiveness of high-dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. Which action should the nurse implement? | Notify the healthcare provider of this finding immediately. Rationale Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be notified immediately, and the medication discontinued. |
| While taking a nursing history, the client states, "I am allergic to penicillin." Which related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? | Cephalosporins. ationale If a client has a history of being allergic to penicillin (PCN); there appears to be a cross-sensitivity between penicillins and 1st generation cephalosporins. According to research, there appears to be no cross-sensitivity betw |
| The healthcare provider prescribes digitalis for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digitalis? | Assess the serum potassium level. Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digitalis. The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will not infor |
| The healthcare provider prescribes naloxone for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? | Respiratory rate is 16 breaths/minute |
| Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? | Client states chest pain is relieved. Rationale Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain. |
| Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? | A young adult with inflammatory bowel disease. The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. |
| Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? | Blood pressure reduced from 160/90 to 130/80 mmHg. Rationale Valsartan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The desired effect is a decrease in blood pressure. |
| A client is receiving ampicillin sodium for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? | Rash. Rationale A rash is the most common adverse effect of all penicillins, indicating an allergy to the medication which could result in anaphylactic shock, a medical emergency. |
| A client has a continuous IV infusion of dopamine and an IV of sodium chloride at 50 mL/hour. The nurse notes that the client's urinary output has been 20 mL/hour for the last two hours. Which intervention should the nurse initiate? | Notify the healthcare provider of the urinary output. Rationale The main effect of dopamine is adrenergic stimulation used to increase cardiac output, which should also result in increased urinary output. Urinary output of less than 20 mL/hour is oligur |
| The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximall | The rate and depth of the client's respirations. |
| A client is receiving methylprednisolone 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication? | Serum glucose. |
| Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? | Bismuth subsalicylate. Rationale Bismuth subsalicylate contains a subsalicylate that increases the potential for salicylate toxicity when used concurrently with aspirin (acetylsalicylic acid, another salicylate preparation). |
| Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine? | Apply continuous cardiac monitoring. Rationale Adenosine is an antiarrhythmic drug used to restore a normal sinus rhythm in clients with rapid supraventricular tachycardia. The client's heart rate should be monitored continuously for the onset of additi |
| Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside for chemotherapy? | Inspect the client's oral mucosa for ulcerations. Rationale Cytosine arabinoside affects the rapidly growing cells of the body, therefore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity. |
| The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance-related side effects. The nurse should prepare the client on which side effect that is most likely to persist during long-term use of opioids? | Constipation. |
| The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer to this client? | Epinephrine. |
| Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol? | Wheezing, hypotension, and AV block. Wheezing, hypotension, and AV block represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with bradycardia and results in potentially life-threatening decreases in cardi |
| A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. Which medication would be contraindicated for this client? | Phentobarbital sodium for sleep. Rationale Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates, and anesthetics. |
| A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? | Heart failure. |
| A client with heart failure (HF) is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril. The nurse's discharge instructions should include reporting which problem to the healthcare provider? | Dizziness. |
| After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During the administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? | This medication is a blood thinner given to prevent blood clot formation. |
| A client with Parkinson's disease is taking levodopa-carbidopa. Which observation by the nurse would indicate that the desired outcome of the medication is being achieved? | Lessening of tremors. Levodopa-carbidopa increases the amount of levodopa to the CNS (dopamine to the brain). Increased amounts of dopamine improve the symptoms of Parkinson's, such as involuntary movements, resting tremors, shuffling gait, etc. Decrease |
| A client receiving doxorubicin intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? | Discontinue the IV fluids. |
| Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? | Prothrombin Time (PT/INR). Rationale When used for a client with a pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3. |
| Dobutamine is an emergency drug most commonly prescribed for a client with which condition? | Heart failure. Rationale Dobutamine is a beta-1 adrenergic agonist that is indicated for short-term use in cardiac decompensation or heart failure related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures. |
| A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the clien | Consult with healthcare provider about another treatment for this effect. |
| In teaching a client who had a liver transplant about cyclosporine, the nurse should encourage the client to report which adverse response to the healthcare provider? | Presence of hand tremors. Neurological complications, such as hand tremors, occur in about 50% of clients taking cyclosporine and should be reported. Although this drug can be nephrotoxic, changes in urine color typically do not occur. Nausea is a common |
| A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? | Nitroglycerin |
| A client is taking hydromorphone PO every 4 hours at home. Following surgery, hydromorphone IV every 4 hours PRN and butorphanol tartrate IV every 4 hours PRN are prescribed for pain. The client received a dose of the hydromorphone IV four hours ago and i | Administer only the hydromorphone every 4 hours PRN for pain. Hydromorphone is an opioid agonist. Butorphanol tartrate is an opioid agonist-antagonist. Use of an agonist-antagonist for the client who has been receiving opioid agonists may result in abr |
| A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new prescription for sustained-release levodopa/carbidopa PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the tea | "You can begin taking the levodopa-carbidopa this evening, but do not take any more levodopa." |
| A client with coronary artery disease who is taking digoxin receives a new prescription for atorvastatin. Two weeks after initiation of the prescription, the nurse assesses the client. Which finding requires the most immediate intervention? | Vomiting. |
| Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? | Every 12 hours. |
| Which medications should the nurse caution the client about taking while receiving an opioid analgesic? | Benzodiazepines. |
| A client with heart failure is prescribed spironolactone. Which information is most important for the nurse to provide to the client about diet modifications? | Refrain from eating foods high in potassium. pironolactone, an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided, along with table salt substitutes which generally contain potassium chloride, which can |
| An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac 30 mg IV every 6 hours. Which action should the nurse implement? | Administer both medications according to the prescription. |
| A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory finding should the nurse identify that places this client at risk? | Hypokalemia. ationale Hypokalemia affects myocardial contractility and places this client at the greatest risk for dysrhythmias that may be unresponsive to drug therapy. |
| The nurse is transcribing a new prescription for spironolactone for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? | Verify both prescriptions with the healthcare provider. he concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and a potassium-sparing diuretic such as spironolactone, should be given with caution because the two drugs may interact to cau |
Created by:
tmdlayton