Questions and Answers
A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition?
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved?
A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications?
A client receiving Doxorubicin (Adriamycin) intravenously 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?
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Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
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A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction?
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Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)?
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A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs?
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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?
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Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)?
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The nurse is preparing the 0900 dose of losartan (Cozaar), 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. What action should the nurse take first?
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A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory findings should the nurse identify that places this client at risk?
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Which statement reflects the correct drug-specific teaching the nurse should provide to a client prescribed atorvastatin (Lipitor) who complains of muscle pain?
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What is the optimum time for the nurse to obtain the trough level for a client receiving antibiotic therapy?
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Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin?
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What action should the nurse implement for a client experiencing tinnitus after high dose aspirin therapy?
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Which prescription should the nurse prepare to administer to a client experiencing anaphylaxis?
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What is the best response for a client who reports that naproxen (Naproxen) does not seem effective for osteoarthritis after three weeks?
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What instruction is most important for a young adult female client prescribed a Category X drug?
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Which information should the nurse provide to a client receiving a scopolamine patch for motion sickness?
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What laboratory value should the nurse anticipate increasing in a client receiving methylprednisolone (Solu-Medrol)?
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Which assessment data would indicate that naloxone (Narcan) has been effective?
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What action should the nurse implement for a client requesting pain medication after receiving hydromorphone (Dilaudid) IV four hours ago?
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Which adverse effects associated with thyroid hormone toxicity should the nurse instruct a client to report promptly?
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Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression?
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What assessment is most important for a nurse to obtain from a client taking metoprolol (Lopressor SR)?
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What action is most important for the nurse to implement prior to administering celecoxib (Celebrex) to a client with a sulfa allergy?
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Arrange the administration order of the medications for a client with acute status asthmaticus.
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What finding requires immediate intervention for a client taking atorvastatin (Lipitor) after two weeks?
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What problem should a nurse instruct a client with congestive heart failure to report to the healthcare provider?
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What side effect should the nurse prepare a client for during long-term opioid use?
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What instruction should the nurse include for the client prescribed isosorbide dinitrate (Isordil)?
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Which adverse response to cyclosporine (Sandimmune) should the nurse encourage the client to report?
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Which method of medication administration provides the greatest first-pass effect?
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What action should the nurse implement when a client's dose of isosorbide dinitrate (Imdur) is increased, and the client reports a headache?
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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?
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A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?
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When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body?
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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?
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A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to:
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Which change in data indicates to the nurse the desired effect of the angiotensin II receptor antagonist has been achieved?
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Which instructions should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis?
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The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme inhibitor. Which action should the nurse implement?
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A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows that which medication should be contraindicated for this client?
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A client has a continuous IV infusion of dopamine and an IV of normal saline 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?
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A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription?
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Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
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Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin II receptor antagonist irbesartan (Avapro)?
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A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO Q3H. The nurse notes that the client has become increasingly restless, irritable, and confused, stating that there are bugs all over the walls. What action should the nurse take FIRST?
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The client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement?
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After abdominal surgery, a male client is prescribed low molecular weight heparin. During 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?
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Following heparin treatment for a PE, 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?
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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 (Sinemet 25/100 PO BID). The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client?
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While taking a nursing history, the client states, 'I am allergic to penicillin.' What related allergy to another type of anti-infective agent should the nurse ask the client about when taking nursing history?
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A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
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An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
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The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to administering the digoxin?
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An antacid (Maalox) is prescribed for a client with PUD. The nurse knows that the purpose of this medication is to:
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Which client should the nurse identify as being at the highest risk for complications during the use of an opioid analgesic?
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A client is being treated for osteoporosis with alendronate (Fosamax), 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?
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A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved?
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A female client with RA takes ibuprofen (Motrin) 600 mg PO 4xday. To prevent GI bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching?
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Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription?
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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/hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV max per hour. What assessment has the highest priority before initiating the PCA pump?
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A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What action should the nurse take to alleviate this side effect?
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In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as intended?
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A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent?
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Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition?
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Study Notes
Sublingual Nitroglycerin in Angina
- Client reports relief of chest pain after administration indicates the desired effect of nitroglycerin.
- Nitroglycerin decreases myocardial oxygen consumption, alleviating ischemia and chest pain.
Niacin for Hyperlipidemia
- Flushing on the face and neck is a common side effect of niacin lasting up to an hour.
- Educating clients about this flushing may enhance adherence to treatment.
Acetaminophen Overdose Assessment
- Pain in the right upper quadrant of the abdomen should be assessed due to the potential for liver damage from acetaminophen toxicity.
Medication for Myocardial Infarction
- Nitroglycerin is prescribed to decrease both preload and afterload, aiding in myocardial relaxation through peripheral vasodilation.
Hyperthyroidism Treatment with PTU
- Propylthiouracil (PTU) inhibits the synthesis of T3 and T4, effectively controlling hyperthyroidism.
Angiotensin II Receptor Antagonists
- A decrease in blood pressure indicates effectiveness of angiotensin II receptor antagonists.
Metronidazole Instructions for Trichomonas
- Key instructions include avoiding alcohol, ensuring treatment of all sexual partners, and increasing fluid intake.
Spironolactone with ACE Inhibitors
- Caution is necessary when using spironolactone with ACE inhibitors due to the risk of elevated serum potassium levels.
Myxedema and Medication Contraindications
- Persons with myxedema should avoid barbiturates as they are hypersensitive and may require careful monitoring of other medications.
Urinary Output Monitoring with IV Infusions
- Continuous low urinary output during dopamine infusion necessitates notifying the healthcare provider.
Allergy Assessment with Cephalexin
- Assess for penicillin allergy due to cross-reactivity with cephalosporins like cephalexin.
Opioid Analgesic Interactions
- Concurrent use of benzodiazepines with opioids increases the risk of respiratory depression.
Injury Risk with Antihypertensives
- Clients on angiotensin II receptor antagonists like irbesartan are at higher risk for injury due to potential hypotension.
Meperidine Toxicity Monitoring
- Clients on continuous meperidine infusion with increasing confusion may require a reduction of infusion rate to prevent toxicity.
Procainamide Dosing Schedule
- Administer procainamide every 6 hours (q6h) for effective management of dysrhythmia.
Low Molecular Weight Heparin Purpose
- Administered to prevent blood clot formation post-abdominal surgery.
Warfarin Monitoring
- Regular monitoring of Prothrombin time (PT/INR) is essential for clients treated with warfarin for conditions like pulmonary embolism.
Levodopa and Carbidopa Switch
- Clients should transition directly to sustained release Sinemet without taking levodopa concurrently.
Cross-Allergy with Antibiotics
- Assess for cephalosporin allergy in clients allergic to penicillin due to cross-sensitivity.
Glipizide as Oral Insulin
- Glipizide is not insulin; it requires some beta cell function to be effective in lowering blood glucose.
Concurrent Administration of Morphine and Ketorolac
- Morphine and ketorolac can be given together for additive analgesic effects without detrimental interactions.
Digitalis Toxicity Monitoring
- Serum potassium levels should be assessed prior to administering digoxin to prevent potential toxicity.
Antacid Purpose in PUD
- Antacids maintain a gastric pH of 3.5 or above to protect the gastric lining and promote healing.
Highest Risk for Opioid Complications
- Young adults with inflammatory bowel disease are particularly vulnerable to complications from opioid use.
Alendronate Administration
- Administer alendronate in the morning, followed by a 30-minute walk, before eating to promote optimal absorption.
Clonidine Effectiveness
- A significant reduction in blood pressure indicates that clonidine (Catapres) is achieving its desired effect.
Cytotec and Pregnancy Precautions
- Misoprostol is classified as pregnancy category X; women should use contraception during treatment.
Controlled-Release Oxycodone Schedule
- Typical dosing for controlled-release oxycodone is every 12 hours (Q12H).
PCA Pump Assessment
- Respiratory assessment takes precedence before initiating PCA pump due to the risk of respiratory depression.
Albuterol Administration Timing
- Administering albuterol with a snack may alleviate associated nausea while maintaining therapeutic effectiveness.
Lactulose Effectiveness
- Two to three soft stools per day indicate that lactulose is achieving its intended effect in reducing blood ammonia levels.
Edrophonium Chloride for Myasthenia Gravis
- Edrophonium chloride temporarily alleviates muscle weakness as part of diagnosing myasthenia gravis.
Dobutamine Use in Heart Failure
- Dobutamine is primarily used in short-term management of heart failure due to its beta-1 adrenergic agonist action.
Atorvastatin Side Effect Awareness
- Muscle pain and weakness while on atorvastatin may indicate serious side effects and should prompt an immediate healthcare provider evaluation.
Trough Level Timing for Antibiotics
- Obtain trough levels immediately before the next dose of the antibiotic is due to accurately assess drug clearance.### Antibiotic Trough Levels
- Trough levels are ideally drawn just before the next antibiotic dose.
- This timing ensures the blood concentration is at its lowest.
Antidiarrheal Agents and Aspirin
- Bismuth subsalicylate (Pepto Bismol) should be used cautiously in clients on high-dose aspirin due to the risk of salicylate toxicity.
Aspirin Therapy Side Effects
- Tinnitus (ringing in the ears) can indicate salicylate toxicity.
- Immediate notification of the healthcare provider is necessary if tinnitus occurs.
Treatment for Anaphylaxis
- Epinephrine is the first-line treatment for anaphylaxis, stimulating beta receptors to increase cardiac output and relieve bronchospasm.
Duration for Naproxen Efficacy
- Naproxen may take 4 to 6 weeks to reach therapeutic levels, and individual responses can vary.
Category X Drug Cautions
- Clients prescribed category X drugs should use reliable birth control methods to prevent teratogenic risks.
Scopolamine Patch Application
- The patch should be applied at least 4 hours before departure to prevent motion sickness effectively.
Methylprednisolone Effects
- Methylprednisolone can cause hyperglycemia, leading to increased serum glucose levels.
Naloxone for Opiate Overdose
- A respiratory rate of 16 breaths/minute indicates effective reversal of respiratory depression from opioid overdose after naloxone administration.
Pain Management in Post-Surgical Clients
- Administer only Dilaudid as per PRN schedule to avoid withdrawal symptoms from alternating with Stadol.
Thyroid Hormone Toxicity Signs
- Tachycardia and chest pain are key signs of thyroid hormone toxicity that should be reported.
Palliative Treatment for Spinal Cord Compression
- Dexamethasone is used to manage symptoms related to tumor-induced spinal cord compression.
Monitoring Blood Pressure with Metoprolol
- Blood pressure monitoring is critical for clients taking metoprolol due to its antihypertensive properties.
Celecoxib Use in Allergic Patients
- Notify the healthcare provider if a client allergic to sulfa is prescribed celecoxib, as it contains a sulfur molecule.
Asthmatic Medication Administration Order
- Deliver medications in the following order: Albuterol, Gentamicin, Prednisone, then Salmeterol.
Digitalis Toxicity and Symptoms
- Vomiting is an early warning sign of digitalis toxicity, requiring immediate intervention.
Patient Education for ACE Inhibitors
- Clients should report dizziness while on captopril due to potential hypotension.
Persistent Opioid Side Effects
- Constipation is the most likely persistent side effect of long-term opioid use.
Discharge Teaching for Isosorbide Dinitrate
- Advise clients to rise slowly to prevent dizziness associated with orthostatic hypotension from nitrates.
Hand Tremors with Cyclosporine
- Hand tremors should be reported as they may indicate neurological complications linked to cyclosporine use.
First-Pass Effect in Drug Administration
- The first-pass effect is greatest with oral medications due to liver metabolism, affecting drug bioavailability.
Managing Headache from Isosorbide Dinitrate
- Administer both the prescribed dose of Imdur and acetaminophen for headache relief.
Beta-1 Agonist Indications
- Beta-1 agonists are most commonly prescribed for heart failure to improve cardiac output.
Desired Outcomes from Sinemet
- A decrease in tremors indicates effective treatment for Parkinson's disease with carbidopa-levodopa.
Potassium Management with Spironolactone
- Clients on spironolactone should avoid high potassium intake due to the risk of hyperkalemia.
Doxorubicin Administration Concerns
- Discontinue IV fluids immediately upon observing signs of infiltration to prevent further tissue damage.
Importance of Hydration with Antimetabolite Therapy
- Oral mucosa examination for ulcerations is crucial when administering cytosine arabinoside (Arc-C) due to toxicity risk.### Medication Administration Guidelines
- Flagyl Use: Take with food to minimize gastric distress; urine may turn red-brown but is not a cause for concern.
- Medication Adherence: Complete the full course of anti-infective medications to prevent resistant organisms, even if symptoms resolve.
Antiarrhythmic Drug Considerations
- Adenosine Monitoring: Continuous cardiac monitoring is crucial when administering adenosine for rapid supraventricular tachycardia to detect potential arrhythmias.
- Patient Communication: Inform clients about possible side effects like facial flushing, and prepare for emergency situations by possibly asking family to leave.
Penicillin Administration Alerts
- Rash Reporting: A rash while taking ampicillin may indicate a serious allergic reaction requiring immediate medical attention; other side effects like nausea or headache are generally manageable unless severe.
Pharmacokinetics in Older Adults
- Drug Distribution Factors: Older adults' decreased lean body mass impacts drug distribution, necessitating careful dose adjustments.
- Absorption and Metabolism: Aging affects gastric pH, emptying, hepatic blood flow, and overall metabolism, influencing drug efficacy and safety.
Beta-Adrenergic Blocker Side Effects
- Serious Risks: Key serious adverse effects of beta-blockers include wheezing, hypotension, and AV block, which can lead to critical respiratory and cardiac complications.
Managing Hyperkalemia in Heart Failure Patients
- Losartan Precautions: Withhold losartan if serum potassium is elevated (e.g., 5.9 mEq/L) to avoid cardiac dysrhythmias; notify the healthcare provider before further action.
Digoxin Patient Risk Factors
- Hypokalemia Concerns: Clients receiving digoxin for supraventricular tachycardia are at risk for dysrhythmias if hypokalemic, requiring careful monitoring of potassium levels to maintain cardiac stability.
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Description
Test your knowledge on medication classifications and nursing interventions. This quiz covers beta-1 agonists, chemotherapy drugs, and patient education related to pharmacological treatments. Perfect for nursing students and professionals looking to refresh their understanding of pharmacology.
