Deck 7: Pharmacology
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Deck 7: Pharmacology
1
The nurse is caring for a client in labor. The nurse reviews the physician's prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for:
A) Pain relief
B) Increasing uterine contractions
C) Decreasing uterine contractions
D) Promoting fetal lung maturity
A) Pain relief
B) Increasing uterine contractions
C) Decreasing uterine contractions
D) Promoting fetal lung maturity
Pain relief
2
The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the client may complain of which of the following?
A) Increase in her pain level
B) Decrease in her pain level
C) Increase in the amount of itching from the opioid used in the epidural
D) Decrease in the amount of itching from the opioid used in the epidural
A) Increase in her pain level
B) Decrease in her pain level
C) Increase in the amount of itching from the opioid used in the epidural
D) Decrease in the amount of itching from the opioid used in the epidural
Increase in her pain level
3
A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which of the following?
A) Prevent spontaneous delivery.
B) Stop the uterine contractions.
C) Promote maturation of the fetal lungs.
D) Accelerate the growth rate of the fetus.
A) Prevent spontaneous delivery.
B) Stop the uterine contractions.
C) Promote maturation of the fetal lungs.
D) Accelerate the growth rate of the fetus.
Promote maturation of the fetal lungs.
4
A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of magnesium toxicity?
A) Proteinuria
B) Hyperactive deep tendon reflexes
C) Respiratory rate of 10 breaths/min
D) Serum magnesium level of 5 mEq/L
A) Proteinuria
B) Hyperactive deep tendon reflexes
C) Respiratory rate of 10 breaths/min
D) Serum magnesium level of 5 mEq/L
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5
A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation?
A) 4
B) 14
C) 24
D) 34
A) 4
B) 14
C) 24
D) 34
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6
The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a newborn. The nurse plans to explain to the parents that the purpose of the medication is to:
A) Help the newborn to see more clearly.
B) Guard against infection acquired during intrauterine life.
C) Ensure the sterility of the conjunctiva in the newborn.
D) Protect the newborn from contracting an eye infection during birth.
A) Help the newborn to see more clearly.
B) Guard against infection acquired during intrauterine life.
C) Ensure the sterility of the conjunctiva in the newborn.
D) Protect the newborn from contracting an eye infection during birth.
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7
The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the newborn. Before giving the medication, the nurse explains to the client that this medication will:
A) Prevent clotting abnormalities in the newborn.
B) Stimulate the liver to produce vitamin K.
C) Prevent vitamin deficiency of fat-soluble vitamins.
D) Supplement the infant, because breast milk and formula are low in vitamin K.
A) Prevent clotting abnormalities in the newborn.
B) Stimulate the liver to produce vitamin K.
C) Prevent vitamin deficiency of fat-soluble vitamins.
D) Supplement the infant, because breast milk and formula are low in vitamin K.
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8
The client who has developed atrial fibrillation is not responding to medication therapy and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nurse would tell the client to avoid which of the following foods while taking this medication?
A) Cherries
B) Potatoes
C) Broccoli
D) Spaghetti
A) Cherries
B) Potatoes
C) Broccoli
D) Spaghetti
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9
A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The nurse checks the medication to ensure that which medication is available as an antidote if needed?
A) Magnesium oxide
B) Vitamin K
C) Aluminum hydroxide
D) Calcium gluconate
A) Magnesium oxide
B) Vitamin K
C) Aluminum hydroxide
D) Calcium gluconate
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10
The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following delivery of an infant. The nurse determines that this medication had the intended effect after evaluating for which of the following findings?
A) Decreased pulse rate
B) Increased urine output
C) Improved uterine tone
D) Increased blood pressure
A) Decreased pulse rate
B) Increased urine output
C) Improved uterine tone
D) Increased blood pressure
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11
The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe:
A) Discontinuation of the medication
B) A decrease of the dosage of the medication
C) An increase of the dosage of the medication
D) Continuation of the presently prescribed dosage
A) Discontinuation of the medication
B) A decrease of the dosage of the medication
C) An increase of the dosage of the medication
D) Continuation of the presently prescribed dosage
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12
The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication?
A) "I shouldn't rub the medication into the skin."
B) "The medication is applied everywhere except the face."
C) "I need to wash the sites gently before I apply the medication."
D) "I need to apply the medication generously and allow it to absorb."
A) "I shouldn't rub the medication into the skin."
B) "The medication is applied everywhere except the face."
C) "I need to wash the sites gently before I apply the medication."
D) "I need to apply the medication generously and allow it to absorb."
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13
The nurse working in the ambulatory care center is providing medication instructions about methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). The nurse recommends that the mother give the medication to the child:
A) At bedtime
B) With the evening meal
C) Just before the noontime meal
D) In the morning, 2 hours before breakfast
A) At bedtime
B) With the evening meal
C) Just before the noontime meal
D) In the morning, 2 hours before breakfast
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14
A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication information to the mother would plan to emphasize which of the following most important instructions about giving this medication to the child?
A) Give the medication with milk.
B) Give the medication with ice cream.
C) Mix the medication in a Styrofoam cup.
D) Use a straw when giving the medication.
A) Give the medication with milk.
B) Give the medication with ice cream.
C) Mix the medication in a Styrofoam cup.
D) Use a straw when giving the medication.
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15
The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which of the following statements, if made by the parent, indicates an understanding of the administration of this medication?
A) "I should give the iron with food."
B) "I can mix the iron with cereal to give it."
C) "I should add the iron to the formula in the baby's bottle."
D) "I should use a medicine dropper and place the iron near the back of the throat."
A) "I should give the iron with food."
B) "I can mix the iron with cereal to give it."
C) "I should add the iron to the formula in the baby's bottle."
D) "I should use a medicine dropper and place the iron near the back of the throat."
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16
The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high doses of this medication can cause which side effect?
A) Alopecia
B) Hyperkalemia
C) Hypercalcemia
D) Thinning of the skin
A) Alopecia
B) Hyperkalemia
C) Hypercalcemia
D) Thinning of the skin
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17
Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which of the following should the nurse include in the instructions?
A) Apply twice a day, and leave it open to the air.
B) Apply once a day, and leave it open to the air.
C) Apply twice a day, and cover it with a sterile dressing.
D) Apply once a day, and cover it with a sterile dressing.
A) Apply twice a day, and leave it open to the air.
B) Apply once a day, and leave it open to the air.
C) Apply twice a day, and cover it with a sterile dressing.
D) Apply once a day, and cover it with a sterile dressing.
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18
A nurse is caring for a female client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium (Solaraze). The nurse teaches the client that this medication is from which class of medications?
A) Anti-infectives
B) Vitamin A lotions
C) Coal tar preparations
D) Nonsteroidal anti-inflammatory drugs (NSAIDs)
A) Anti-infectives
B) Vitamin A lotions
C) Coal tar preparations
D) Nonsteroidal anti-inflammatory drugs (NSAIDs)
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19
The client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse evaluates that the client understands the use of the medication if the client states that:
A) The medication will act as a local analgesic.
B) The medication acts by decreasing muscle spasms.
C) The medication will cause redness, flaking, and the skin to peel.
D) A heating pad should be put on the area after applying the medication.
A) The medication will act as a local analgesic.
B) The medication acts by decreasing muscle spasms.
C) The medication will cause redness, flaking, and the skin to peel.
D) A heating pad should be put on the area after applying the medication.
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20
The client with a burn injury is applying mafenide (Sulfamylon) to the wound. The client calls the physician's office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse instructs the client to:
A) Discontinue the medication.
B) Apply a thinner film than prescribed to the burn site.
C) Continue with the treatment, as this is expected.
D) Come to the office to see the physician immediately.
A) Discontinue the medication.
B) Apply a thinner film than prescribed to the burn site.
C) Continue with the treatment, as this is expected.
D) Come to the office to see the physician immediately.
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21
The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution?
A) Rinse off immediately following irrigation.
B) Pour onto sterile sponges, and pack in wound.
C) Let the solution run freely over normal skin tissue.
D) Use each bottle of solution for 2 weeks before replacing.
A) Rinse off immediately following irrigation.
B) Pour onto sterile sponges, and pack in wound.
C) Let the solution run freely over normal skin tissue.
D) Use each bottle of solution for 2 weeks before replacing.
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22
An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching?
A) "I will return to the clinic for blood tests."
B) "If my lips begin to burn, it is probably because of the medication."
C) "My eyes may become dry and burn as a result of the medication."
D) "I need to take my vitamin A supplement so that the treatment will work."
A) "I will return to the clinic for blood tests."
B) "If my lips begin to burn, it is probably because of the medication."
C) "My eyes may become dry and burn as a result of the medication."
D) "I need to take my vitamin A supplement so that the treatment will work."
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23
An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed?
A) Nighttime sedation
B) Decrease in urticaria
C) Absence of ecchymoses
D) Healing of burned tissue
A) Nighttime sedation
B) Decrease in urticaria
C) Absence of ecchymoses
D) Healing of burned tissue
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24
The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should plan to tell the client to report which of the following immediately?
A) Alopecia
B) Headache
C) Stomatitis and diarrhea
D) Changes in color vision
A) Alopecia
B) Headache
C) Stomatitis and diarrhea
D) Changes in color vision
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25
The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that the reason for therapy with leucovorin is to:
A) Preserve normal cells.
B) Promote protein synthesis.
C) Promote medication excretion.
D) Hasten the effect of the methotrexate.
A) Preserve normal cells.
B) Promote protein synthesis.
C) Promote medication excretion.
D) Hasten the effect of the methotrexate.
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26
The nurse understands that an indication for the use of asparaginase (Elspar) is:
A) Lung cancer
B) Breast cancer
C) Metastatic prostate cancer
D) Acute lymphocytic leukemia
A) Lung cancer
B) Breast cancer
C) Metastatic prostate cancer
D) Acute lymphocytic leukemia
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27
The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?
A) Rinse the mouth with diluted baking soda or saline.
B) Use lemon and glycerin swabs liberally on painful oral lesions.
C) Place the client on NPO status for 12 hours, then resume liquids.
D) Brush the teeth and use nonwaxed dental floss at least twice a day.
A) Rinse the mouth with diluted baking soda or saline.
B) Use lemon and glycerin swabs liberally on painful oral lesions.
C) Place the client on NPO status for 12 hours, then resume liquids.
D) Brush the teeth and use nonwaxed dental floss at least twice a day.
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28
The client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to:
A) Prevent the destruction of normal cells.
B) Increase the destruction of tumor cells.
C) Decrease the risk of the alopecia and stomatitis.
D) Increase the likelihood of erythrocyte and leukocyte recovery.
A) Prevent the destruction of normal cells.
B) Increase the destruction of tumor cells.
C) Decrease the risk of the alopecia and stomatitis.
D) Increase the likelihood of erythrocyte and leukocyte recovery.
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29
The nurse tells the client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to preven:
A) Nausea
B) Diarrhea
C) Muscle spasms
D) Hyperuricemia
A) Nausea
B) Diarrhea
C) Muscle spasms
D) Hyperuricemia
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30
The client with breast cancer has been given a prescription for cyclophosphamide (Cytoxan). The nurse determines that the client understands the proper use of the medication if the client states that he or she will:
A) Increase dietary intake of potassium.
B) Take the medication with large meals.
C) Decrease dietary intake of magnesium.
D) Increase fluid intake to 2 to 3 L/day.
A) Increase dietary intake of potassium.
B) Take the medication with large meals.
C) Decrease dietary intake of magnesium.
D) Increase fluid intake to 2 to 3 L/day.
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31
The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which of the following results were reported from the lab?
A) Clotting time, 12 seconds
B) Ammonia level, 28 mcg/dL
C) Platelet count, 50,000 cells/mm3
D) White blood cell count (WBC), 4500/mm3
A) Clotting time, 12 seconds
B) Ammonia level, 28 mcg/dL
C) Platelet count, 50,000 cells/mm3
D) White blood cell count (WBC), 4500/mm3
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32
The client with cancer is about to be started on mitomycin (Mutamycin). The nurse should suggest contacting the physician after noting that the client is also taking which of the following medications?
A) Furosemide (Lasix)
B) Ondansetron (Zofran)
C) Warfarin (Coumadin)
D) Allopurinol (Zyloprim)
A) Furosemide (Lasix)
B) Ondansetron (Zofran)
C) Warfarin (Coumadin)
D) Allopurinol (Zyloprim)
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33
A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which of the following adjustments in medication dosage will be made?
A) Decreased NPH insulin
B) Increased NPH insulin
C) Lower dose of dexamethasone (Decadron) than usual
D) Higher dose of dexamethasone (Decadron) than usual
A) Decreased NPH insulin
B) Increased NPH insulin
C) Lower dose of dexamethasone (Decadron) than usual
D) Higher dose of dexamethasone (Decadron) than usual
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34
The nurse monitors the blood glucose level of the client who received NPH insulin at 7 AM with an understanding that the client may experience a hypoglycemic reaction between:
A) 9 to 11 AM
B) 1 to 7 PM
C) 7 to 11 PM
D) Midnight to 6 AM
A) 9 to 11 AM
B) 1 to 7 PM
C) 7 to 11 PM
D) Midnight to 6 AM
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35
The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat:
A) Diabetic ketoacidosis
B) Hypoglycemia from insulin overdose
C) Hyperglycemia from insufficient insulin
D) Hyperglycemia occurring on "sick days"
A) Diabetic ketoacidosis
B) Hypoglycemia from insulin overdose
C) Hyperglycemia from insufficient insulin
D) Hyperglycemia occurring on "sick days"
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36
The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states that he will report which of the following symptoms to the physician?
A) Fever
B) Nervousness
C) Tiredness
D) Fatigue
A) Fever
B) Nervousness
C) Tiredness
D) Fatigue
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37
The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time?
A) With breakfast
B) At lunch time
C) Just before a meal
D) One hour after a meal
A) With breakfast
B) At lunch time
C) Just before a meal
D) One hour after a meal
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38
The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication:
A) In the early morning
B) In the middle of the day
C) An hour before bedtime
D) Anytime of the day
A) In the early morning
B) In the middle of the day
C) An hour before bedtime
D) Anytime of the day
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39
The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most frequent side effect of this medication?
A) Diarrhea
B) Dyspnea
C) Constipation
D) Bradycardia
A) Diarrhea
B) Dyspnea
C) Constipation
D) Bradycardia
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40
A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which of the following sign/ symptom that indicates an adverse effect of this medication?
A) Depression
B) Chest pain
C) Nagging cough
D) Joint stiffness
A) Depression
B) Chest pain
C) Nagging cough
D) Joint stiffness
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41
The client has a prescription for sucralfate (Carafate) four times daily. The nurse writes in the medication record to administer the medication at which of the following times?
A) With meals and at bedtime
B) Every 6 hours around the clock
C) One hour after meals and at bedtime
D) One hour before meals and at bedtime
A) With meals and at bedtime
B) Every 6 hours around the clock
C) One hour after meals and at bedtime
D) One hour before meals and at bedtime
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42
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has begun taking misoprostol (Cytotec). Evaluation of the effectiveness of the misoprostol in preventing a side effect of chronic NSAID use is determined by the nurse if the client reports which of the following?
A) "I have fewer muscle aches."
B) "My joint mobility has improved."
C) "I no longer have pain above my stomach."
D) "I am no longer experiencing constipation."
A) "I have fewer muscle aches."
B) "My joint mobility has improved."
C) "I no longer have pain above my stomach."
D) "I am no longer experiencing constipation."
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43
The client in the preoperative holding area has been given a dose of scopolamine. The nurse assesses the client for which of the following side effects of the medication?
A) Dry mouth
B) Diaphoresis
C) Excessive urination
D) Pupillary constriction
A) Dry mouth
B) Diaphoresis
C) Excessive urination
D) Pupillary constriction
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44
The client with gastroesophageal reflux disease (GERD) has a new prescription for pantoprazole (Protonix). Which of the following instructions should the nurse plan to provide to the client?
A) Chew the pill thoroughly.
B) Swallow the tablet whole.
C) Crush the pill if it is difficult to swallow.
D) Headache is expected to occur.
A) Chew the pill thoroughly.
B) Swallow the tablet whole.
C) Crush the pill if it is difficult to swallow.
D) Headache is expected to occur.
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45
The client is experiencing diarrhea. The nurse reviews the client's PRN medication prescription sheet and plans to administer which of the following medications for this problem?
A) Sennosides (Senokot)
B) Bisacodyl (Dulcolax Bowel Prep Kit)
C) Psyllium (Metamucil)
D) Loperamide (Imodium)
A) Sennosides (Senokot)
B) Bisacodyl (Dulcolax Bowel Prep Kit)
C) Psyllium (Metamucil)
D) Loperamide (Imodium)
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46
The client with recurrent constipation has been prescribed psyllium (Metamucil). Teaching provided by the nurse should include which of the following instructions?
A) Mix the psyllium powder with any cold beverage.
B) Mix the psyllium powder with 4 oz of a hot beverage.
C) Mix the psyllium powder with gelatin, applesauce, or pudding.
D) Mix the psyllium powder with 8 oz of water or juice followed by drinking an additional 8 oz of liquid.
A) Mix the psyllium powder with any cold beverage.
B) Mix the psyllium powder with 4 oz of a hot beverage.
C) Mix the psyllium powder with gelatin, applesauce, or pudding.
D) Mix the psyllium powder with 8 oz of water or juice followed by drinking an additional 8 oz of liquid.
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47
The nurse is reading the medication list for a postoperative client and notes that a PRN prescription for ondansetron (Zofran) was administered. Evaluation of the effectiveness of the medication is determined by the nurse if the client makes which of the following statements?
A) "My headache is gone."
B) "The dizziness has stopped."
C) "I no longer feel nauseous."
D) "The pain at my incision has decreased."
A) "My headache is gone."
B) "The dizziness has stopped."
C) "I no longer feel nauseous."
D) "The pain at my incision has decreased."
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48
An older client has been receiving cimetidine (Tagamet). The nurse should report to the physician that the client is experiencing a side effect of the medication if which of the following is noted during the assessment?
A) Tremors
B) Stiff joints
C) Confusion
D) Constipation
A) Tremors
B) Stiff joints
C) Confusion
D) Constipation
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49
The nurse monitors the client receiving the first dose of albuterol (Proventil HFA) for which of the following side effects of this medication?
A) Drowsiness
B) Tachycardia
C) Hyperglycemia
D) Hyperkalemia
A) Drowsiness
B) Tachycardia
C) Hyperglycemia
D) Hyperkalemia
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50
The client has a prescription to receive pirbuterol (Maxair) two puffs and beclomethasone two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by:
A) Administering the beclomethasone before the pirbuterol
B) Administering the pirbuterol before the beclomethasone
C) Alternating a single puff of each hourly, beginning with the beclomethasone
D) Alternating a single puff of each hourly, beginning with the pirbuterol
A) Administering the beclomethasone before the pirbuterol
B) Administering the pirbuterol before the beclomethasone
C) Alternating a single puff of each hourly, beginning with the beclomethasone
D) Alternating a single puff of each hourly, beginning with the pirbuterol
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51
The client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone (Azmacort) by inhalation. The nurse plans to monitor the client for which of the following signs and symptoms during the change?
A) Chills, fever, generalized rash
B) Vomiting and diarrhea, increased thirst
C) Blurred vision, headache, and insomnia
D) Anorexia, nausea, weakness, and fatigue
A) Chills, fever, generalized rash
B) Vomiting and diarrhea, increased thirst
C) Blurred vision, headache, and insomnia
D) Anorexia, nausea, weakness, and fatigue
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52
The client taking theophylline has a serum theophylline level of 15 mcg/mL. The nurse interprets that this result is the therapeutic range.
A) Below
B) Near the top of
C) In excess of
D) In the middle of
A) Below
B) Near the top of
C) In excess of
D) In the middle of
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53
The client is taking cetirizine (Zyrtec). The nurse teaches the client to expect which of the following side effects of this medication?
A) Diarrhea
B) Excitability
C) Drowsiness
D) Excess salivation
A) Diarrhea
B) Excitability
C) Drowsiness
D) Excess salivation
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54
The client is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. Which of the following outcomes would the nurse expect to see as a result of the administration of this medication?
A) Bronchodilation
B) Decreased coughing
C) Absence of wheezing
D) Thinning of respiratory secretions
A) Bronchodilation
B) Decreased coughing
C) Absence of wheezing
D) Thinning of respiratory secretions
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55
The physician prescribes cromolyn (Intal) for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will:
A) Suppress an allergic response.
B) Promote bronchodilation.
C) Decrease the risk of infection.
D) Eliminate the need for a rescue inhaler.
A) Suppress an allergic response.
B) Promote bronchodilation.
C) Decrease the risk of infection.
D) Eliminate the need for a rescue inhaler.
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56
The nurse teaching the client about the effects of diphenhydramine (Benadryl), an ingredient in the cough suppressant prescribed for the client, should plan to tell the client to do which of the following while taking this medication?
A) Take it on an empty stomach.
B) Avoid activities requiring mental alertness.
C) Use alcohol for additional effect in reducing cough.
D) Avoid chewing sugarless gum or using oral rinses mouth.
A) Take it on an empty stomach.
B) Avoid activities requiring mental alertness.
C) Use alcohol for additional effect in reducing cough.
D) Avoid chewing sugarless gum or using oral rinses mouth.
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57
The physician has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse teaches the client to monitor for:
A) Constipation
B) Painful coughing
C) Difficulty swallowing
D) Increased urination
A) Constipation
B) Painful coughing
C) Difficulty swallowing
D) Increased urination
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58
A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, diarrhea, and blurry vision. The nurse notes that the client's serum potassium (K) level is 3.0 ng/mL. Based on analysis of the data, what might the nurse anticipate assessing when reviewing the digoxin level results?
A) Digoxin level lower than 0.5 ng/mL
B) Digoxin level higher than 2 ng/mL
C) Digoxin level of 1.8 ng/mL
D) Digoxin level of 0 ng/mL because of diarrhea
A) Digoxin level lower than 0.5 ng/mL
B) Digoxin level higher than 2 ng/mL
C) Digoxin level of 1.8 ng/mL
D) Digoxin level of 0 ng/mL because of diarrhea
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59
The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse reminds the client that which of the following is an anticipated, although unpleasant, side effect of this medication?
A) Rapid pulse
B) Persistent dry cough
C) Increased blood pressure
D) Metallic taste in the mouth
A) Rapid pulse
B) Persistent dry cough
C) Increased blood pressure
D) Metallic taste in the mouth
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60
A client has recently begun medication therapy with propranolol (Inderal). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted?
A) Complaints of insomnia
B) Audible expiratory wheezes
C) Decrease in heart rate from 86 to 78 beats/min
D) Decrease in blood pressure from 162/90 to 136/84 mm Hg
A) Complaints of insomnia
B) Audible expiratory wheezes
C) Decrease in heart rate from 86 to 78 beats/min
D) Decrease in blood pressure from 162/90 to 136/84 mm Hg
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61
A client having a myocardial infarction is receiving alteplase (Activase) therapy. Which of the following actions should be carried out by the nurse to monitor for the most frequent adverse effect?
A) Monitor for bleeding.
B) Assess for allergic reaction.
C) Evaluate the client for muscle weakness.
D) Monitor for signs and symptoms of infection.
A) Monitor for bleeding.
B) Assess for allergic reaction.
C) Evaluate the client for muscle weakness.
D) Monitor for signs and symptoms of infection.
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62
A client is receiving scheduled doses of lovastatin (Mevacor). The nurse evaluates that the medication is having the intended effect if the nurse notes which of the following client data?
A) Weight loss
B) Increased pulse rate
C) Lowered blood pressure
D) Decreased cholesterol level
A) Weight loss
B) Increased pulse rate
C) Lowered blood pressure
D) Decreased cholesterol level
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63
A client taking verapamil (Calan) has been given information about side effects of this medication. The nurse determines that the client understands the information shared if the client states that he or she will watch for which of the following most common side effects of this medication?
A) Weight loss
B) Constipation
C) Nasal stuffiness
D) Abdominal cramping
A) Weight loss
B) Constipation
C) Nasal stuffiness
D) Abdominal cramping
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64
The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which of the following?
A) Iodine
B) Shellfish
C) Penicillin
D) Sulfa drugs
A) Iodine
B) Shellfish
C) Penicillin
D) Sulfa drugs
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65
The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse assesses for which of the following manifestations that could indicate digoxin toxicity?
A) Dyspnea, edema, and palpitations
B) Chest pain, hypotension, and paresthesias
C) Constipation, dry mouth, and sleep disorder
D) Double vision, loss of appetite, and nausea
A) Dyspnea, edema, and palpitations
B) Chest pain, hypotension, and paresthesias
C) Constipation, dry mouth, and sleep disorder
D) Double vision, loss of appetite, and nausea
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66
A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take which of the following actions next?
A) Administer another nitroglycerin tablet.
B) Administer 10 L of oxygen via nasal cannula.
C) Call for a 12-lead electrocardiogram (ECG) to be performed.
D) Wait an additional 5 minutes, then give a second nitroglycerin tablet.
A) Administer another nitroglycerin tablet.
B) Administer 10 L of oxygen via nasal cannula.
C) Call for a 12-lead electrocardiogram (ECG) to be performed.
D) Wait an additional 5 minutes, then give a second nitroglycerin tablet.
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67
The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND). The nurse reviews the client's medication record and determines that which of the following medications has been prescribed to treat the PND?
A) Bumetanide (Bumex)
B) Propranolol (Inderal)
C) Warfarin (Coumadin)
D) Acetylsalicylic acid (aspirin)
A) Bumetanide (Bumex)
B) Propranolol (Inderal)
C) Warfarin (Coumadin)
D) Acetylsalicylic acid (aspirin)
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68
The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which of the following laboratory studies to determine the therapeutic effect of heparin for the client?
A) Bleeding time
B) Thrombin time
C) Prothrombin time (PT)
D) Partial thromboplastin time (PTT)
A) Bleeding time
B) Thrombin time
C) Prothrombin time (PT)
D) Partial thromboplastin time (PTT)
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69
The ambulatory care nurse is providing instructions to a client with a urinary tract infection (UTI) being started on medication therapy with nitrofurantoin (Macrodantin), a urinary antiseptic agent. The nurse tells the client that:
A) It can cause urinary retention.
B) It will cause the urine to become clear.
C) If taken with meals, it will help decrease the risk for gastrointestinal (GI) upset.
D) The sun should be avoided because it is a sulfa-based medication.
A) It can cause urinary retention.
B) It will cause the urine to become clear.
C) If taken with meals, it will help decrease the risk for gastrointestinal (GI) upset.
D) The sun should be avoided because it is a sulfa-based medication.
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70
A client is beginning to take trimethoprim-sulfamethoxazole (Bactrim) for a recurrent urinary tract infection (UTI). The nurse would give the client which of the following instructions regarding this medication?
A) Discontinue medication when symptoms subside.
B) Expect rashes or skin changes as a result of therapy.
C) Take most doses early in the day when fluid intake is greatest.
D) Take each dose with 8 oz of water, and drink extra water each day.
A) Discontinue medication when symptoms subside.
B) Expect rashes or skin changes as a result of therapy.
C) Take most doses early in the day when fluid intake is greatest.
D) Take each dose with 8 oz of water, and drink extra water each day.
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71
A client with a urinary tract infection (UTI) has been prescribed to take ciprofloxacin (Cipro). The nurse notes that the client also has a prescription for theophylline written by a pulmonologist. The nurse should do which of the following?
A) Clarify the medication prescriptions.
B) Encourage intake of antacids.
C) Schedule the doses to be given together.
D) Schedule the doses to be given at the same time.
A) Clarify the medication prescriptions.
B) Encourage intake of antacids.
C) Schedule the doses to be given together.
D) Schedule the doses to be given at the same time.
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72
The client with a urinary tract infection (UTI) has dysuria and is given a prescription for phenazopyridine (Pyridium) for symptom relief. The nurse provides medication teaching with this client and tells the client to:
A) Take the medication at bedtime.
B) Take the medication before meals.
C) Notify the physician if headache occurs.
D) Expect the urine to become reddish-orange.
A) Take the medication at bedtime.
B) Take the medication before meals.
C) Notify the physician if headache occurs.
D) Expect the urine to become reddish-orange.
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73
The nurse is preparing a subcutaneous dose of bethanechol (Urecholine) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed?
A) Vitamin K
B) Mucomyst
C) Atropine sulfate
D) Protamine sulfate
A) Vitamin K
B) Mucomyst
C) Atropine sulfate
D) Protamine sulfate
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74
A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report the results of periodic laboratory results that indicate which of the following?
A) Decreased creatinine level
B) Decreased hemoglobin level
C) Elevated blood urea nitrogen (BUN) level
D) Decreased white blood cell (WBC) count
A) Decreased creatinine level
B) Decreased hemoglobin level
C) Elevated blood urea nitrogen (BUN) level
D) Decreased white blood cell (WBC) count
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75
A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which of the following is a nursing considerations associated with this medication?
A) Give with cyclosporine (Sandimmune).
B) Assess for hypoglycemia.
C) Give with grapefruit juice.
D) Assess platelet count for thrombocytopenia.
A) Give with cyclosporine (Sandimmune).
B) Assess for hypoglycemia.
C) Give with grapefruit juice.
D) Assess platelet count for thrombocytopenia.
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76
A client must begin medication therapy with mycophenolate mofetil (CellCept) to prevent organ rejection following renal transplantation. The nurse plans to provide which of the following teaching points to the client?
A) Take the dose following meals.
B) Notify the physician if a fever develops.
C) Open the capsule and mix with food before use.
D) Take the medication with an aluminum-based antacid.
A) Take the dose following meals.
B) Notify the physician if a fever develops.
C) Open the capsule and mix with food before use.
D) Take the medication with an aluminum-based antacid.
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77
The client in renal failure is receiving epoetin alfa (Epogen). The nurse would monitor this client for which adverse effect of this medication?
A) Depression
B) Bradycardia
C) Fever
D) Hypertension
A) Depression
B) Bradycardia
C) Fever
D) Hypertension
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78
The preoperative medication sheet identifies that cyclopentolate (Cyclogyl) is prescribed for a client prior to cataract surgery. The nurse understands that the action of the medication is to:
A) Lubricate the affected eye.
B) Dilate the pupil of the affected eye.
C) Promote miosis of the affected eye.
D) Constrict the pupil of the affected eye.
A) Lubricate the affected eye.
B) Dilate the pupil of the affected eye.
C) Promote miosis of the affected eye.
D) Constrict the pupil of the affected eye.
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79
The client being discharged to home with a prescription for eye drops to be given in the left eye has received instructions regarding self-administration of the drops. The nurse determines that the client needs further instruction if, on return demonstration, the client:
A) Lies supine, pulls up on the upper lid, and puts the drop in the upper lid
B) Lies supine, pulls down on the lower lid, and puts the drop in the lower lid
C) Tilts the head back, pulls down on the lower lid, and puts the drop in the lower lid
D) Lies with head to the right, puts the drop in the inner canthus, and slowly turns to the left while blinking
A) Lies supine, pulls up on the upper lid, and puts the drop in the upper lid
B) Lies supine, pulls down on the lower lid, and puts the drop in the lower lid
C) Tilts the head back, pulls down on the lower lid, and puts the drop in the lower lid
D) Lies with head to the right, puts the drop in the inner canthus, and slowly turns to the left while blinking
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80
The nurse teaching a mother how to administer ear drops to an infant tells the mother to pull the child's ear:
A) Up and back and direct the solution onto the eardrum
B) Down and back and direct the solution onto the eardrum
C) Up and back and direct the solution toward the wall of the canal
D) Down and back and direct the solution toward the wall of the canal
A) Up and back and direct the solution onto the eardrum
B) Down and back and direct the solution onto the eardrum
C) Up and back and direct the solution toward the wall of the canal
D) Down and back and direct the solution toward the wall of the canal
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