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HESI 312
| Question | Answer |
|---|---|
| The nurse should expect the healthcare provider to prescribed what treatment regimen for a client with peptic ulcer caused by Helicobacter pylori ? (Select all that apply.) Select all that apply | Omeprazole (Prilosec). Clarithromycin (Biaxin). Metronidazole (Flagyl). |
| A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication. What information should the nurse use to answer the question?i | A small margin exists between safe and toxic plasma levels. |
| A client receives a new prescription for pentazocine (Talwin), a mixed opioid agonist-antagonist, after an opioid agonist is discontinued. What is the advantage for the client when the new prescription is implemented? | Respiratory depression is less. |
| A client who is diagnosed with methillicin-resistant Staphylococcus aureus receives a prescription for vancomycin (Vancocin). Which assessment should the nurse perform to identify a potential adverse effect? | Whisper test is the most appropriate assessment. It screens for hearing loss, a direct indicator of vancomycin-induced ototoxicity |
| A 38-year-old gravida 2 para 2 is diagnosed with bacterial vaginosis 9-months postpartum. A prescription is written for metronidazole (Flagyl). Which information is most important for the nurse to obtain from the client before initiating treatment? | Method of infant feeding. |
| The healthcare provider has prescribed digoxin for a client who has been taking furosemide (Lasix) for six months. What laboratory serum levels should the nurse review before administering the digoxin? | Potassium. |
| The nurse is providing medication teaching for a client who has recently received a prescription for clozapine (Clozaril). Which instruction should be included in this client's teaching plan? | Rise slowly from a lying position. medication can cause orthostatic hypotension, leading to dizziness, lightheadedness, or fainting when changing positions |
| A client receives a new prescription for nitroglycerin (Nitrostat) tablets. Which instruction should the nurse include in this client's teaching? | Place under the tongue as needed every 5 minutes up to 3 times. |
| A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain of a dark, swollen, and painful leg. What instructions should the nurse provide the client? | Proceed to the closest emergency room. concerning for a possible deep vein thrombosis (DVT) or another serious vascular event. Danazol is known to increase the risk of blood clots, including DVT |
| A client receives a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. What client history contraindicates its use? | Renal artery stenosis. risk of acute renal failure |
| A client who has Trichomonas vaginalis receives a prescription for metronidazole (Flagyl). Which instruction should the nurse provide during client education? | Avoid over-the-counter antitussives. |
| Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad spectrum antibiotic. The medication administration record indicates that the | Administer the initial dose of the aminoglycoside antibiotic as soon as possible. |
| Which findings should the nurse identify in an adult client with possible chronic salicylate intoxication? | Hyperventilation and central nervous system effects. |
| A 48-year-old client is experiencing a severe anaphylactic reaction to an injection of contrast media. What pharmacologic agent is of greatest use in this situation? | Epinephrine (Adrenalin). |
| Which common side effect should the nurse alert a female client about when medroxyprogesterone (Depo-Provera) is prescribed? | Headaches or visual changes. |
| A client with pneumonia receives a prescription for tetracycline (Sumycin). What precaution should the nurse include in this client's teaching? | Avoid diary products for 2 hours after taking the medication. Dairy products (milk, cheese, yogurt, etc.) and foods high in calcium or iron significantly decrease the absorption of tetracycline, making the antibiotic less effective |
| The nurse administers the initial dose of a fentanyl (Duragesic) transdermal patch to a client with chronic pain. When monitoring the client an hour later, which assessment is most important for the nurse to obtain? | Level of consciousness. |
| A client with chronic gouty arthritis takes allopurinol (Zyloprim) and experiences an acute attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose colchicine. What information should the nurse provide the client that best explai | Reduces inflammation at the affected site. |
| A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days. Which instruction is best for the nurse to provide to this client? | Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. |
| A pediatric client who has been diagnosed with partial seizures receives a prescription for topiramate (Topamax). What information should the nurse provide to the child's parents? | Do not crush the tablet prior to administration. |
| What teaching should the nurse provide a client who has received a new prescription for sildenafil (Viagra)? (Select all that apply.) | Take within 30 to 60 minutes of sexual stimulation. Report rebound priapism that occurs for 4 hours or more. Can cause facial flushing and headache. |
| A resident of a long-term care facility is taking lithium carbonate (Eskalith) to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers? | Report symptoms of hypothyroidism such as fatigue and constipation. med can cause thyroid dysfunction, including hypothyroidism, as a side effect with long-term use |
| A client at 30-weeks gestation is in preterm labor. The healthcare provider prescribes two 12-mg doses of betamethasone (Celestone) intramuscularly every 12 hours. The client asks the nurse why she is receiving the Celestone. What information should the n | Stimulates fetal surfactant production. This action accelerates fetal lung maturation, |
| A client is diagnosed with peptic ulcer disease and receives a prescription for esomeprazole (Nexium) 20 mg capsule daily. When providing this client with discharge teaching, the nurse should include which instruction? | Take at same time each day one hour before eating a meal. To maximizes drug absorption and effectiveness by allowing esomeprazole to be absorbed before food stimulates acid production |
| Miotic drug therapy for the treatment of glaucoma is based chiefly upon which physiologic action? | Enhancing aqueous humor outflow. |
| A client is taking sulfisoxazole (Gantrisin) for a urinary tract infection (UTI) and complains of nausea and gastric upset since starting the medication. Which additional adverse reaction should the nurse instruct the client to report? | Rash: Indicates possible hypersensitivity or severe skin reactions requiring immediate medical attention |
| A client is receiving fentanyl via an epidural infusion. Which side effect should the nurse anticipate in the first 24 hours of epidural analgesia? | Urinary retention. |
| A client with depression receives a prescription for amitriptyline (Elavil). Which instruction should the nurse include in the client's teaching? | avoid the consumption of alcohol. Alcohol can significantly increase the levels of amitriptyline in the bloodstream, leading to greater risk of side effects such as increased drowsiness, dizziness, and impaired psychomotor skills. |
| The healthcare provider prescribes oral antifungal therapy for a client with onychomycosis. What information should the nurse tell the client? | The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months. |
| A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily. During the initial treatment, what is the priority nursing action? | Observe the client for signs of hypersensitivity. |
| The healthcare provider discontinues prednisone, a glucocorticoid, for a client with chronic obstructive pulmonary disease. What instructions should the nurse give the client about the regimen to follow? | The dose must be tapered over the course of 7 to 10 days. |
| A school-aged child is taking methylphenidate hydrochloride (Ritalin, Biphentin) for the treatment of attention-deficit hyperactivity disorder (ADHD). The mother tells the nurse that she gives the medication at bedtime so it is "working" during school the | Administer at least six hours before bedtime. |
| Which route should the nurse clarify with the healthcare provider prior to administering a drug with a high first-pass effect? | The oral route is most associated with significant first-pass metabolism, as the drug is absorbed from the gut and passes through the liver via the portal circulation before reaching systemic circulation, resulting in reduced bioavailability of the active |
| The therapeutic effect of insulin in treating Type 1 diabetes mellitus is based on which physiologic action? | Facilitates transport of glucose into the cells. |
| A client who is recently diagnosised with myasthenia gravis receives a prescription for pyridostigmine (Mestinon), a cholinergic agent. Which information should the nurse instruct the client to implement when taking this medication? | Take the medication at least 30 minutes before eating meals. so that it has time to work and help with muscle strength needed for chewing and swallowing |
| A client is beginning therapy with montelukast (Singulair) PO 10 mg once a day in the evening. The client asks the nurse, "When should I begin to feel better?" How should the nurse respond? our. | with in 24 hours |
| An older client is taking warfarin sodium (Coumadin) PO 2.5 mg twice a day. Which laboratory value should the nurse identify as a therapeutic response of the medication? | INR of 2 to 3. |
| When assessing a client prior to the administration of digoxin (Lanoxin, APO-Digoxin), which data is most important for the nurse to consider? | Irregular apical pulse with a rate of 87. |
| The mother of a newborn asks the nurse why her infant needs the vitamin K (AquaMEPHYTON) injection. What information should the nurse provide? | bacteria that synthesize vitamin K are not present in the newborn's intestinal tract and that, as a result, infants are born with very low levels of vitamin K, which is essential for normal blood clotting |
| A client with chronic schizophrenia illness is admitted after taking risperidone (Risperdal) 10 mg/day for three months. The nurse implements a daily assessment using the Abnormal Involuntary Movement Scale (AIMS). What findings should the nurse report to | Tremors and muscle twitching. |
| The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea? Colchicine (Colchicine). Erythromycin (E-Mycin). Naproxen (Aleve, Naprosyn). Labetolol (Normodyne). | Colchicine (Colchicine). |
| A client with rheumatoid arthritis is receiving a prescription for minocycline (Minocin). Which side effect is most important for the nurse to instruct the client to report? | Abdominal pain and diarrhea are the most important side effects to report, as they may indicate serious gastrointestinal complications. |
| A client with chronic pancreatitis receives a new prescription for pancrelipase (Pancrease). Which instruction is most important for the nurse to include in this client's teaching? | |
| A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide (Norpace). After explaining the action of this antidysrhythmic agent, which complaint should the nurse instruct the client to report? | Daily weight gain of 2 pounds. could indicate fluid retention and the onset of heart failure, a known serious complication of disopyramide |
| The healthcare provider prescribes pyridostigmine bromide (Mestinon) tablets for a client with myasthenia gravis (MG). What instruction should the nurse provide this client? | take the medication 30 to 45 minutes before eating. This timing allows pyridostigmine to reach peak effectiveness when it is most needed for chewing and swallowing, which are often affected by myasthenia gravis |
| Which drug of choice is indicated for acute ventricular dysrhythmias associated with myocardial infarction? Diltiazem.VT dys Bretylium. Amiodarone. Adenosine. | Amiodarone. |
| What is the expected outcome of esomeprazole (Nexium) when prescribed for a client with gastroesophageal reflux disease (GERD)? | Promotion of rapid tissue healing. |
| A client who is receiving chemotherapy is prescribed ondansetron (Zofran). What side effect should the nurse include in the teaching plan? Headache. Dry mouth. Impaired taste. Blurred vision. | Headache. |
| A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse identify? | headache |
| A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse identify? | Creatinine 28 mg/dl. |
| A male client with meningitis is prescribed cefotaxime (Claforan) IV and asks the nurse why he cannot receive an oral drug, such as cefaclor (Ceclor) or cefadroxil (Duricef), that he has taken before for infections.How should the nurse respond when consid | Cefotaxime (Claforan) provides therapeutic CNS concentrations. |
| Which heparin concentration should the nurse use to convert an intravenous site to a heparin lock? 10 units/ml. 100 units/ml. 1000 units/ml. 10,000 units/ml. | 100 units/ml is standard for adults and most central lines |
| What action should the nurse implement to provide analgesic titration for a client in pain? | Monitor the effects of continuous intravenous infusion of narcotic analgesics. |
| A client receives a prescription for sulfamethoxazole-trimethoprim (Septra) for a urinary tract infection (UTI). What instruction should the nurse provide the client? | Avoid prolonged exposure to sunlight. |
| A female client receives a prescription for cefadroxil (Duricef) for a urinary tract infection. The client informs the nurse that she is currently taking oral contraceptives (OCP). What information is important for the nurse to share with the client? | Use an additional form of contraception until your menstrual cycle. |
| What pathophysiological action supports the expected outcome for a client with chronic cancer pain who is treated with imipramine (Tofranil), a tricyclic antidepressant? | Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses. |
Created by:
adricela55