Nursing Care for Clients with Various Conditions (PDF)

1\) A nurse is caring for a client with hyperparathyroidism and notes that the client\'s serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1\. Calcium chloride 2\. Calcium gluconate 3\. Calcitonin (Miacalcin) 4\. Large doses of vitamin D - ANSWER\--3. Calcitonin (Miacalcin) 2.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1\. Notifying the registered nurse 2\. Discontinuing the medication 3\. Informing the client that this is normal 4\. Applying a thinner film than prescribed to the burn site - ANSWER\--3. Informing the client that this is normal 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site - ANSWER\--1.Hyperventilation 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? Downloaded at Knoowy - Upload your own study documents and earn money 1\. Tinnitus 2\. Diarrhea 3\. Constipation 4\. Decreased respirations - ANSWER\--1. Tinnitus 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1\. Immediately before swimming 2\. 15 minutes before exposure to the sun 3\. Immediately before exposure to the sun 4\. At least 30 minutes before exposure to the sun - ANSWER\--4. At least 30 minutes before exposure to the sun 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1\. Milk 2\. Water 3\. Apple juice 4\. Orange juice - ANSWER\--4. Orange juice 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1\. Platelet count 2\. Triglyceride level 3\. Complete blood count 4\. White blood cell count - ANSWER\--2. Triglyceride level 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client\'s medication record and would contact the (HCP) if the client is taking which medication? 1\. Vitamin A 2\. Digoxin (Lanoxin) 3\. Furosemide (Lasix) 4\. Phenytoin (Dilantin) - ANSWER\--1. Vitamin A 10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for: 1\. Acne 2\. Eczema 3\. Hair loss 4\. Herpes simplex - ANSWER\--1. Acne 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partialthickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? 1\. \"The medication is an antibacterial.\" 2\. \"The medication will help heal the burn.\" 3\. \"The medication will permanently stain my skin.\" 4\. \"The medication should be applied directly to the wound.\" - ANSWER\--3. \"The medication will permanently stain my skin.\" 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas? 1\. Back Downloaded at Knoowy - Upload your own study documents and earn money 2\. Axilla 3\. Soles of the feet 4\. Palms of the hands - ANSWER\--2. Axilla 12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action? 1\. Notify the registered nurse. 2\. Administer pain medication to reduce the discomfort. 3\. Apply ice and maintain the infusion rate, as prescribed. 4\. Elevate the extremity of the IV site, and slow the infusion. - ANSWER\--1. Notify the registered nurse. 13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1\. Echocardiography 2\. Electrocardiography 3\. Cervical radiography 4\. Pulmonary function studies - ANSWER\--4. Pulmonary function studies 14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1\. Clotting time 2\. Uric acid level 3\. Potassium level 4\. Blood glucose level - ANSWER\--2. Uric acid level 16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client: 1\. To take aspirin (acetylsalicylic acid) as needed for headache 2\. Drink beverages containing alcohol in moderate amounts each evening 3\. Consult with health care providers (HCPs) before receiving immunizations 4\. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair - ANSWER\--3. Consult with health care providers (HCPs) before receiving immunizations 17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication? 1\. Diarrhea 2\. Hair loss 3\. Chest pain 4\. Numbness and tingling in the fingers and toes - ANSWER\--4. Numbness and tingling in the fingers and toes 18.) The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client\'s history? 1\. Pancreatitis 2\. Diabetes mellitus 3\. Myocardial infarction 4\. Chronic obstructive pulmonary disease - ANSWER\--1. Pancreatitis 15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication? 1\. Alopecia 2\. Chest pain 3\. Pulmonary fibrosis 4\. Orthostatic hypotension - ANSWER\--4. Orthostatic hypotension 19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to: 1\. Increase DNA and RNA synthesis. 2\. Promote the biosynthesis of nucleic acids. 3\. Increase estrogen concentration and estrogen response. 4\. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. \- ANSWER\--4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. 20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? Downloaded at Knoowy - Upload your own study documents and earn money 1\. Glucose level 2\. Calcium level 3\. Potassium level 4\. Prothrombin time - ANSWER\--2. Calcium level 21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1\. Tinnitus 2\. Ototoxicity 3\. Hyperkalemia 4\. Hypercalcemia 5\. Nephrotoxicity 6\. Hypomagnesemia - ANSWER\--1. Tinnitus 2\. Ototoxicity 5\. Nephrotoxicity 6\. Hypomagnesemia 22.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1\. Treat thyroid storm. 2\. Prevent cardiac irritability. 3\. Treat hypocalcemic tetany. 4\. Stimulate the release of parathyroid hormone. - ANSWER\--3. Treat hypocalcemic tetany.. 23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1\. Keep insulin vials refrigerated at all times. 2\. Rotate the insulin injection sites systematically. 3\. Increase the amount of insulin before unusual exercise. 4\. Monitor the urine acetone level to determine the insulin dosage. - ANSWER\--2. Rotate the insulin injection sites systematically.. 24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching? 1\. Withdraws the NPH insulin first Downloaded at Knoowy - Upload your own study documents and earn money 2\. Withdraws the regular insulin first 3\. Injects air into NPH insulin vial first 4\. Injects an amount of air equal to the desired dose of insulin into the vial - ANSWER\--1. Withdraws the NPH insulin first 25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to: 1\. Freeze the insulin. 2\. Refrigerate the insulin. 3\. Store the insulin in a dark, dry place. 4\. Keep the insulin at room temperature. - ANSWER\--2. Refrigerate the insulin. 26.) Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1\. Alcohol 2\. Organ meats 3\. Whole-grain cereals 4\. Carbonated beverages - ANSWER\--1. Alcohol 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client\'s medical record and would question the prescription if which of the following is noted in the client\'s history? 1\. Neuralgia 2\. Insomnia 3\. Use of nitroglycerin 4\. Use of multivitamins - ANSWER\--3. Use of nitroglycerin 28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention? 1\. The medication is administered within 60 minutes before the morning and evening meal. 2\. The medication is withheld and the HCP is called to question the prescription for the client. 3\. The client is monitored for gastrointestinal side effects after administration of the medication. 4\. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration. - ANSWER\--2. The medication is withheld and the HCP is called to question the prescription for the client. 29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is: 1\. 2 to 4 hours after administration 2\. 4 to 12 hours after administration 3\. 16 to 18 hours after administration 4\. 18 to 24 hours after administration - ANSWER\--2. 4 to 12 hours after administration 30.) A client with diabetes mellitus visits a health care clinic. The client\'s diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client\'s regimen, may have contributed to the hyperglycemia? 1\. Prednisone 2\. Phenelzine (Nardil) 3\. Atenolol (Tenormin) 4\. Allopurinol (Zyloprim) - ANSWER\--1. Prednisone 31.) A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? 1\. \"I can take aspirin or my antihistamine if I need it.\" Downloaded at Knoowy - Upload your own study documents and earn money 2\. \"I need to take the medication every day at the same time.\" 3\. \"I need to avoid coffee, tea, cola, and chocolate in my diet.\" 4\. \"If I gain more than 5 pounds a week, I will call my doctor.\" - ANSWER\--1. \"I can take aspirin or my antihistamine if I need it.\" 32.) Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response? 1\. Decreased urinary output 2\. Decreased blood pressure 3\. Decreased peripheral edema 4\. Decreased blood glucose level - ANSWER\--1. Decreased urinary output 33.) The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply. 1\. Diarrhea can occur secondary to the metformin. 2\. The repaglinide is not taken if a meal is skipped. 3\. The repaglinide is taken 30 minutes before eating. Downloaded at Knoowy - Upload your own study documents and earn money 4\. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 5\. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide. 6\. Muscle pain is an expected side effect of metformin and may be treated with acetaminophen (Tylenol). - ANSWER\--1. Diarrhea can occur secondary to the metformin. 2\. The repaglinide is not taken if a meal is skipped. 3\. The repaglinide is taken 30 minutes before eating. 4\. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 34.) A client with Crohn\'s disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment? 1\. Monitoring the leukocyte count for 2 days after the infusion 2\. Checking the frequency and consistency of bowel movements 3\. Checking serum liver enzyme levels before and after the infusion 4\. Carrying out a Hematest on gastric fluids after the infusion is completed - ANSWER\--2. Checking the frequency and consistency of bowel movements 35.) The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition? Downloaded at Knoowy - Upload your own study documents and earn money 1\. Constipation 2\. Abdominal pain 3\. An episode of diarrhea 4\. Hematest-positive nasogastric tube drainage - ANSWER\--3. An episode of diarrhea 36.) The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client? 1\. Paralytic ileus 2\. Incisional pain 3\. Urinary retention 4\. Nausea and vomiting - ANSWER\--4. Nausea and vomiting 37.) The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1\. Weight loss 2\. Relief of heartburn 3\. Reduction of steatorrhea 4\. Absence of abdominal pain - ANSWER\--3. Reduction of steatorrhea 38.) An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1\. Tremors 2\. Dizziness 3\. Confusion 4\. Hallucinations - ANSWER\--3. Confusion 39.) The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times? 1\. With meals and at bedtime 2\. Every 6 hours around the clock 3\. One hour after meals and at bedtime 4\. One hour before meals and at bedtime - ANSWER\--4. One hour before meals and at bedtime 40.) The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted? 1\. Resolved diarrhea 2\. Relief of epigastric pain 3\. Decreased platelet count 4\. Decreased white blood cell count - ANSWER\--2. Relief of epigastric pain 41.) The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom? 1\. Diarrhea 2\. Heartburn 3\. Flatulence 4\. Constipation - ANSWER\--2. Heartburn 42.) A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1\. \"My ulcer will heal because these medications will kill the bacteria.\" 2\. \"These medications are only taken when I have pain from my ulcer.\" 3\. \"The medications will kill the bacteria and stop the acid production.\" Downloaded at Knoowy - Upload your own study documents and earn money 4\. \"These medications will coat the ulcer and decrease the acid production in my stomach.\" - ANSWER\-- 3\. \"The medications will kill the bacteria and stop the acid production.\" 43.) A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply. 1\. Nizatidine (Axid) 2\. Ranitidine (Zantac) 3\. Famotidine (Pepcid) 4\. Cimetidine (Tagamet) 5\. Esomeprazole (Nexium) 6\. Lansoprazole (Prevacid) - ANSWER\--1. Nizatidine (Axid) 2\. Ranitidine (Zantac) 3\. Famotidine (Pepcid) 4\. Cimetidine (Tagamet) 44.) A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication? 1\. Ambu bag Downloaded at Knoowy - Upload your own study documents and earn money 2\. Intubation tray 3\. Nasogastric tube 4\. Suction equipment - ANSWER\--4. Suction equipment 45.) A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will: 1\. Watch for irritability as a side effect. 2\. Take the tablet with a full glass of water. 3\. Take an extra dose if the cough is accompanied by fever. 4\. Crush the sustained-release tablet if immediate relief is needed. - ANSWER\--2. Take the tablet with a full glass of water. 46.) A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for: 1\. Pupillary changes 2\. Scattered lung wheezes 3\. Sudden increase in pain Downloaded at Knoowy - Upload your own study documents and earn money 4\. Sudden episodes of diarrhea - ANSWER\--3. Sudden increase in pain 47.) A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: 1\. Hypercalcemia 2\. Peripheral neuritis 3\. Small blood vessel spasm 4\. Impaired peripheral circulation - ANSWER\--2. Peripheral neuritis 48.) A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to: 1\. Drink alcohol in small amounts only. 2\. Report yellow eyes or skin immediately. 3\. Increase intake of Swiss or aged cheeses. 4\. Avoid vitamin supplements during therapy. - ANSWER\--2. Report yellow eyes or skin immediately. 49.) A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication: 1\. Should always be taken with food or antacids 2\. Should be double-dosed if one dose is forgotten 3\. Causes orange discoloration of sweat, tears, urine, and feces 4\. May be discontinued independently if symptoms are gone in 3 months - ANSWER\--3. Causes orange discoloration of sweat, tears, urine, and feces 50.) A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report: 1\. Impaired sense of hearing 2\. Problems with visual acuity 3\. Gastrointestinal (GI) side effects 4\. Orange-red discoloration of body secretions - ANSWER\--2. Problems with visual acuity 51.) Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication? 1\. To take the medication before meals 2\. To return to the clinic weekly for serum drug-level testing 3\. It is not necessary to call the health care provider (HCP) if a skin rash occurs. 4\. It is not necessary to restrict alcohol intake with this medication. - ANSWER\--2. To return to the clinic weekly for serum drug-level testing **52.)**\ **Question:** A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed?\ **Answer Choices:** 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level\ **Answer:** 3. Liver enzyme levels **53.)**\ **Question:** Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of the medication? Select all that apply.\ **Answer Choices:** 1. Signs of hepatitis 2. Flu-like syndrome 3. Low neutrophil count 4. Vitamin B6 deficiency 5. Ocular pain or blurred vision 6. Tingling and numbness of the fingers\ **Answer:** 1. Signs of hepatitis 7. Flu-like syndrome 8. Low neutrophil count 9. Ocular pain or blurred vision **54.)**\ **Question:** A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?\ **Answer Choices:** 1. \"I will take my pills every day at the same time.\" 2. \"I will be certain to avoid alcohol consumption.\" 3. \"I have already called my family to pick up a Medic-Alert bracelet.\" 4. \"I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.\"\ **Answer:** 4. \"I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.\" **55.)**\ **Question:** A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?\ **Answer Choices:** 1. 3 to 5 ng/mL 2. 0.5 to 2 ng/mL 3. 1.2 to 2.8 ng/mL 4. 3.5 to 5.5 ng/mL\ **Answer:** 2. 0.5 to 2 ng/mL **56.)**\ **Question:** Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?\ **Answer Choices:** 1. Hematocrit level 2. Hemoglobin level 3. Prothrombin time (PT) 4. Activated partial thromboplastin time (aPTT)\ **Answer:** 4. Activated partial thromboplastin time (aPTT) **57.)**\ **Question:** A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?\ **Answer Choices:** 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication\ **Answer:** 2. The development of audible expiratory wheezes **58.)**\ **Question:** Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:\ **Answer Choices:** 1. Cut the dose in half. 2. Discontinue the medication. 3. Take the medication with food. 4. Contact the health care provider (HCP).\ **Answer:** 3. Take the medication with food. **59.)**\ **Question:** A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?\ **Answer Choices:** 1. Monitor for renal failure. 2. Monitor psychosocial status. 3. Monitor for signs of bleeding. 4. Have heparin sodium available.\ **Answer:** 3. Monitor for signs of bleeding. **60.)**\ **Question:** A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication?\ **Answer Choices:** 1. Hypouricemia, hyperkalemia 2. Increased risk of osteoporosis 3. Hypokalemia, hyperglycemia, sulfa allergy 4. Hyperkalemia, hypoglycemia, penicillin allergy\ **Answer:** 3. Hypokalemia, hyperglycemia, sulfa allergy **61.)**\ **Question:** A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?\ **Answer Choices:** 1. \"Constipation and bloating might be a problem.\" 2. \"I\'ll continue to watch my diet and reduce my fats.\" 3. \"Walking a mile each day will help the whole process.\" 4. \"I\'ll continue my nicotinic acid from the health food store.\"\ **Answer:** 4. \"I\'ll continue my nicotinic acid from the health food store.\" **62.)**\ **Question:** A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?\ **Answer Choices:** 1. \"It is not necessary to avoid the use of alcohol.\" 2. \"The medication should be taken with meals to decrease flushing.\" 3. \"Clay-colored stools are a common side effect and should not be of concern.\" 4. \"Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.\"\ **Answer:** 4. \"Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.\" **63.)**\ **Question:** A client with coronary artery disease complains of substernal chest pain. After checking the client\'s heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, \"My chest still hurts.\" Select the appropriate actions that the nurse should take. Select all that apply.\ **Answer Choices:** 1. Call a code blue. 2. Contact the registered nurse. 3. Contact the client\'s family. 4. Assess the client\'s pain level. 5. Check the client\'s blood pressure. 6. Administer a second nitroglycerin, 0.4 mg, sublingually.\ **Answer:** 2. Contact the registered nurse. 7. Assess the client\'s pain level. 8. Check the client\'s blood pressure. 9. Administer a second nitroglycerin, 0.4 mg, sublingually. **64.)**\ **Question:** Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client\'s record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?\ **Answer Choices:** 1. Discontinuation of warfarin sodium (Coumadin) 2. A decrease in the warfarin sodium (Coumadin) dosage 3. An increase in the warfarin sodium (Coumadin) dosage 4. A decrease in the usual dose of nalidixic acid (NegGram)\ **Answer:** 2. A decrease in the warfarin sodium (Coumadin) dosage **65.)**\ **Question:** A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be included in the list of instructions?\ **Answer Choices:** 1. Restrict fluid intake. 2. Maintain a high fluid intake. 3. If the urine turns dark brown, call the health care provider (HCP) immediately. 4. Decrease the dosage when symptoms are improving to prevent an allergic response.\ **Answer:** 2. Maintain a high fluid intake. **66.)**\ **Question:** Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy?\ **Answer Choices:** 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat\ **Answer:** 4. Sore throat 67.) Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client: 1\. To take the medication at bedtime 2\. To take the medication before meals 3\. To discontinue the medication if a headache occurs 4\. That a reddish orange discoloration of the urine may occur - ANSWER\--4. That a reddish orange discoloration of the urine may occur 68.) Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication? 1\. Gastric atony 2\. Urinary strictures 3\. Neurogenic atony 4\. Gastroesophageal reflux - ANSWER\--2. Urinary strictures 69.) A nurse who is administering bethanechol chloride (Urecholine) is monitoring for acute toxicity associated with the medication. The nurse checks the client for which sign of toxicity? 1\. Dry skin 2\. Dry mouth 3\. Bradycardia 4\. Signs of dehydration - ANSWER\--3. Bradycardia 70.) Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication? 1\. Pallor 2\. Drowsiness Downloaded at Knoowy - Upload your own study documents and earn money 3\. Bradycardia 4\. Restlessness - ANSWER\--4. Restlessness 71.) After kidney transplantation, cyclosporine (Sand immune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? 1\. Decreased creatinine level 2\. Decreased hemoglobin level 3\. Elevated blood urea nitrogen level 4\. Decreased white blood cell count - ANSWER\--3. Elevated blood urea nitrogen level 72.) Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client. The nurse reviews the client\'s medical record and should contact the health care provider (HCP) regarding which documented finding to verify the prescription? Refer to chart. 1\. Renal insufficiency 2\. Chest x-ray: normal 3\. Blood glucose, 102 mg/dL 4\. Folic acid (vitamin B6) 0.5 mg, orally daily - ANSWER\--1. Renal insufficiency 73.) A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists? 1\. Ataxia 2\. Mouth sores 3\. Hypotension 4\. Hypertension - ANSWER\--4. Hypertension 74.) A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs? 1\. Vitamin K 2\. Atropine sulfate 3\. Protamine sulfate 4\. Acetylcysteine (Mucomyst) - ANSWER\--2. Atropine sulfate 75.) A client with myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing Downloaded at Knoowy - Upload your own study documents and earn money severity of the disease (myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which of the following indicates that the client is in cholinergic crisis? 1\. No change in the condition 2\. Complaints of muscle spasms 3\. An improvement of the weakness 4\. A temporary worsening of the condition - ANSWER\--4. A temporary worsening of the condition 76.) Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson\'s disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? 1\. Pruritus 2\. Tachycardia 3\. Hypertension 4\. Impaired voluntary movements - ANSWER\--4. Impaired voluntary movements 77.) Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions? 1\. \"I will use a soft toothbrush to brush my teeth.\" 2\. \"It\'s all right to break the capsules to make it easier for me to swallow them.\" Downloaded at Knoowy - Upload your own study documents and earn money 3\. \"If I forget to take my medication, I can wait until the next dose and eliminate that dose.\" 4\. \"If my throat becomes sore, it\'s a normal effect of the medication and it\'s nothing to be concerned about.\" - ANSWER\--1. \"I will use a soft toothbrush to brush my teeth.\" 78.) A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range? 1\. 5 to 10 mcg/mL 2\. 10 to 20 mcg/mL 3\. 20 to 30 mcg/mL 4\. 30 to 40 mcg/mL - ANSWER\--2. 10 to 20 mcg/mL 79.) Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication: 1\. With 8 oz of milk 2\. In the morning after arising 3\. 60 minutes before breakfast 4\. At bedtime on an empty stomach - ANSWER\--1. With 8 oz of milk 80.) A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client? 1\. Pregnancy should be avoided while taking phenytoin (Dilantin). 2\. The client may stop taking the phenytoin (Dilantin) if it is causing severe gastrointestinal effects. 3\. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). 4\. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and birth control pills together. - ANSWER\--3. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). 81.) A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication? 1\. Sodium level, 140 mEq/L 2\. Uric acid level, 5.0 mg/dL 3\. White blood cell count, 3000 cells/mm3 4\. Blood urea nitrogen (BUN) level, 15 mg/dL - ANSWER\--3. White blood cell count, 3000 cells/mm3 82.) A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply. Downloaded at Knoowy - Upload your own study documents and earn money 1\. Diarrhea 2\. Tremors 3\. Drowsiness 4\. Hypotension 5\. Urinary frequency 6\. Increased respiratory rate - ANSWER\--2. Tremors 3\. Drowsiness 4\. Hypotension 83.) The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept (Enbrel), it is most important for the nurse to check: 1\. The injection site for itching and edema 2\. The white blood cell counts and platelet counts 3\. Whether the client is experiencing fatigue and joint pain 4\. A metallic taste in the mouth, with a loss of appetite - ANSWER\--2. The white blood cell counts and platelet counts 84.) Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse assists in planning care, knowing that the primary therapeutic effect of this medication is which of the following? 1\. Increased muscle tone Downloaded at Knoowy - Upload your own study documents and earn money 2\. Decreased muscle spasms 3\. Increased range of motion 4\. Decreased local pain and tenderness - ANSWER\--2. Decreased muscle spasms 85.) A nurse is monitoring a client receiving baclofen (Lioresal) for side effects related to the medication. Which of the following would indicate that the client is experiencing a side effect? 1\. Polyuria 2\. Diarrhea 3\. Drowsiness 4\. Muscular excitability - ANSWER\--3. Drowsiness 86.) A nurse is reinforcing discharge instructions to a client receiving baclofen (Lioresal). Which of the following would the nurse include in the instructions? 1\. Restrict fluid intake. 2\. Avoid the use of alcohol. 3\. Stop the medication if diarrhea occurs. 4\. Notify the health care provider if fatigue occurs. - ANSWER\--2. Avoid the use of alcohol. 87.) A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nurse should make which appropriate response to the client? 1\. \"You should never stop the medication.\" 2\. \"It is best that you taper the dose if you intend to stop the medication.\" 3\. \"It is okay to stop the medication if you think that you can tolerate the muscle spasms.\" 4\. \"Weakness and fatigue commonly occur and will diminish with continued medication use.\" - ANSWER\--4. \"Weakness and fatigue commonly occur and will diminish with continued medication use.\" 88.) Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds, knowing that the therapeutic action of this medication is which of the following? 1\. Depresses spinal reflexes 2\. Acts directly on the skeletal muscle to relieve spasticity 3\. Acts within the spinal cord to suppress hyperactive reflexes 4\. Acts on the central nervous system (CNS) to suppress spasms - ANSWER\--2. Acts directly on the skeletal muscle to relieve spasticity 89.) A nurse is reviewing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication? 1\. Creatinine 2\. Liver function tests 3\. Blood urea nitrogen 4\. Hematological function tests - ANSWER\--2. Liver function tests 90.) A nurse is reviewing the record of a client who has been prescribed baclofen (Lioresal). Which of the following disorders, if noted in the client\'s history, would alert the nurse to contact the health care provider? 1\. Seizure disorders 2\. Hyperthyroidism 3\. Diabetes mellitus 4\. Coronary artery disease - ANSWER\--1. Seizure disorders 91.) Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client\'s record. Which of the following disorders, if noted in the client\'s record, would indicate a need to contact the health care provider regarding the administration of this medication? 1\. Glaucoma 2\. Emphysema 3\. Hyperthyroidism 4\. Diabetes mellitus - ANSWER\--1. Glaucoma 92.) In monitoring a client\'s response to disease-modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses? Select all that apply. 1\. Symptom control during periods of emotional stress 2\. Normal white blood cell counts, platelet, and neutrophil counts 3\. Radiological findings that show nonprogression of joint degeneration 4\. An increased range of motion in the affected joints 3 months into therapy 5\. Inflammation and irritation at the injection site 3 days after injection is given 6\. A low-grade temperature upon rising in the morning that remains throughout the day - ANSWER\--1. Symptom control during periods of emotional stress 2\. Normal white blood cell counts, platelet, and neutrophil counts 3\. Radiological findings that show nonprogression of joint degeneration 4\. An increased range of motion in the affected joints 3 months into therapy 93.) The client who is human immunodeficiency virus seropositive has been taking stavudine (d4t, Zerit). The nurse monitors which of the following most closely while the client is taking this medication? 1\. Gait 2\. Appetite 3\. Level of consciousness 4\. Hemoglobin and hematocrit blood levels - ANSWER\--1. Gait 94.) The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, Azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication? 1\. Blood culture 2\. Blood glucose level 3\. Blood urea nitrogen 4\. Complete blood count - ANSWER\--4. Complete blood count 95.) The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that the client Downloaded at Knoowy - Upload your own study documents and earn money may have the medication discontinued by the health care provider if which of the following significantly elevated results is noted? 1\. Serum protein 2\. Blood glucose 3\. Serum amylase 4\. Serum creatinine - ANSWER\--3. Serum amylase 96.) The nurse is caring for a postrenal transplant client taking cyclosporine (Sandimmune, Gengraf, Neoral). The nurse notes an increase in one of the client\'s vital signs, and the client is complaining of a headache. What is the vital sign that is most likely increased? 1\. Pulse 2\. Respirations 3\. Blood pressure 4\. Pulse oximetry - ANSWER\--3. Blood pressure 97.) Amikacin (Amikin) is prescribed for a client with a bacterial infection. The client is instructed to contact the health care provider (HCP) immediately if which of the following occurs? 1\. Nausea 2\. Lethargy Downloaded at Knoowy - Upload your own study documents and earn money 3\. Hearing loss 4\. Muscle aches - ANSWER\--3. Hearing loss 98.) The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet. The nurse should check the latest results of which of the following laboratory studies while the client is taking this medication? 1\. CD4 cell count 2\. Serum albumin 3\. Serum creatinine 4\. Lymphocyte count - ANSWER\--3. Serum creatinine 99.) The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine isethionate (Pentam 300). The client develops a temperature of 101° F. The nurse does further monitoring of the client, knowing that this sign would most likely indicate: 1\. The dose of the medication is too low. 2\. The client is experiencing toxic effects of the medication. 3\. The client has developed inadequacy of thermoregulation. Downloaded at Knoowy - Upload your own study documents and earn money 4\. The result of another infection caused by leukopenic effects of the medication. - ANSWER\--4. The result of another infection caused by leukopenic effects of the medication. 100.) Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus seropositive. The nurse reinforces medication instructions and tells the client to: 1\. Avoid sun exposure. 2\. Eat low-calorie foods. 3\. Eat foods that are low in fat. 4\. Take the medication on an empty stomach. - ANSWER\--1. Avoid sun exposure. 101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse includes when administering this medication. Select all that apply. 1\. Restrict fluid intake. 2\. Instruct the client to avoid alcohol. 3\. Monitor hepatic and liver function studies. 4\. Administer the medication with an antacid. 5\. Instruct the client to avoid exposure to the sun. 6\. Administer the medication on an empty stomach. - ANSWER\--2. Instruct the client to avoid alcohol. 3\. Monitor hepatic and liver function studies. 5\. Instruct the client to avoid exposure to the sun. Downloaded at Knoowy - Upload your own study documents and earn money 102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should monitor for which adverse effects of the medication? Select all that apply. 1\. Rash 2\. Hepatotoxicity 3\. Hyperglycemia 4\. Peripheral neuropathy 5\. Reduced bone mineral density - ANSWER\--1. Rash 2\. Hepatotoxicity 103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to monitor for an adverse effect associated with the use of this medication? 1\. Platelet count 2\. Cholesterol level 3\. White blood cell count 4\. Blood urea nitrogen level - ANSWER\--3. White blood cell count 104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication? 1\. A history of hyperthyroidism 2\. A history of diabetes insipidus 3\. When the last full meal was consumed 4\. When the last alcoholic drink was consumed - ANSWER\--4. When the last alcoholic drink was consumed 105.) A nurse is collecting data from a client and the client\'s spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication? 1\. Dementia 2\. Schizophrenia 3\. Seizure disorder 4\. Obsessive-compulsive disorder - ANSWER\--1. Dementia 106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication? 1\. \"I should take the medication with my evening meal.\" 2\. \"I should take the medication at noon with an antacid.\" 3\. \"I should take the medication in the morning when I first arise.\" 4\. \"I should take the medication right before bedtime with a snack.\" - ANSWER\--3. \"I should take the medication in the morning when I first arise.\" 107.) A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan? 1\. Reports not going to work for this past week 2\. Complains of not being able to \"do anything\" anymore 3\. Arrives at the clinic neat and appropriate in appearance 4\. Reports sleeping 12 hours per night and 3 to 4 hours during the day - ANSWER\--3. Arrives at the clinic neat and appropriate in appearance 108.) A nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). What information would be important for the nurse to gather regarding the adverse effects related to the medication? 1\. Cardiovascular symptoms 2\. Gastrointestinal dysfunctions 3\. Problems with mouth dryness 4\. Problems with excessive sweating - ANSWER\--2. Gastrointestinal dysfunctions 109.) A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which of the following would indicate medication effectiveness? 1\. No rapid heartbeats or anxiety 2\. No paranoid thought processes 3\. No thought broadcasting or delusions 4\. No reports of alcohol withdrawal symptoms - ANSWER\--1. No rapid heartbeats or anxiety 110.) A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is checked as a part of the routine follow-up and the level is 3.0 mEq/L. The nurse knows that this level is: 1\. Toxic 2\. Normal 3\. Slightly above normal Downloaded at Knoowy - Upload your own study documents and earn money 4\. Excessively below normal - ANSWER\--1. Toxic 111.) A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now at risk for which of the following? 1\. Insomnia 2\. Weight gain 3\. Seizure activity 4\. Orthostatic hypotension - ANSWER\--3. Seizure activity 112.) A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply. 1\. Figs 2\. Yogurt 3\. Crackers 4\. Aged cheese 5 Tossed salad 6\. Oatmeal cookies - ANSWER\--1. Figs 2\. Yogurt 4\. Aged cheese 113.) A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following would be included in the plan of care for instructions? 1\. Maintain a high fluid intake. 2\. Discontinue the medication when feeling better. 3\. If the urine turns dark brown, call the health care provider immediately. 4\. Decrease the dosage when symptoms are improving to prevent an allergic response. - ANSWER\--1. Maintain a high fluid intake. 114.) A postoperative client requests medication for flatulence (gas pains). Which medication from the following PRN list should the nurse administer to this client? 1\. Ondansetron (Zofran) 2\. Simethicone (Mylicon) 3\. Acetaminophen (Tylenol) 4\. Magnesium hydroxide (milk of magnesia, MOM) - ANSWER\--2. Simethicone (Mylicon) 115.) A client received 20 units of NPH insulin subcutaneously at 8:00 AM. The nurse should check the client for a potential hypoglycemic reaction at what time? 1\. 5:00 PM 2\. 10:00 AM 3\. 11:00 AM 4\. 11:00 PM - ANSWER\--1. 5:00 PM 116.) A nurse administers a dose of scopolamine (Transderm-Scop) to a postoperative client. The nurse tells the client to expect which of the following side effects of this medication? 1\. Dry mouth 2\. Diaphoresis 3\. Excessive urination 4\. Pupillary constriction - ANSWER\--1. Dry mouth 117.) A nurse has given the client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client immediately reports: 1\. Impaired sense of hearing 2\. Distressing gastrointestinal side effects 3\. Orange-red discoloration of body secretions 4\. Difficulty discriminating the color red from green - ANSWER\--4. Difficulty discriminating the color red from green 118.) A nurse is caring for an older client with a diagnosis of myasthenia gravis and has reinforced selfcare instructions. Which statement by the client indicates that further teaching is necessary? 1\. \"I rest each afternoon after my walk.\" 2\. \"I cough and deep breathe many times during the day.\" 3\. \"If I get abdominal cramps and diarrhea, I should call my doctor.\" 4\. \"I can change the time of my medication on the mornings that I feel strong.\" - ANSWER\--4. \"I can change the time of my medication on the mornings that I feel strong.\" 119.) A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol (Tenormin) for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which of the following is the most reliable indicator of hypoglycemia? 1\. Sweating 2\. Tachycardia 3\. Nervousness 4\. Low blood glucose level - ANSWER\--4. Low blood glucose level 120.) A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache? 1\. Naprosyn (Aleve) 2\. Ibuprofen (Advil) 3\. Acetaminophen (Tylenol) 4\. Acetylsalicylic acid (aspirin) - ANSWER\--3. Acetaminophen (Tylenol) 121.) A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that: 1\. Both are weak potassium-losing diuretics. 2\. The combination of these medications prevents renal toxicity. 3\. Hydrochlorothiazide is an expensive medication, so using a combination of diuretics is cost-effective. 4\. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic. - ANSWER\--4. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic. 122.) A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by: 1\. Telling the client not to take the medication with food 2\. Suggesting that the client taper the dose until taste returns to normal 3\. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months 4\. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor - ANSWER\--3. Informing the client that impaired taste is 123.) A nurse is planning to administer amlodipine (Norvasc) to a client. The nurse plans to check which of the following before giving the medication? 1\. Respiratory rate 2\. Blood pressure and heart rate 3\. Heart rate and respiratory rate 4\. Level of consciousness and blood pressure - ANSWER\--2. Blood pressure and heart rate 124.) A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication? 1\. Diarrhea 2\. Weakness 3\. Headache 4\. Constipation - ANSWER\--4. Constipation 125.) A nurse is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the nurse to check before administering the medication? 1\. Heart rate 2\. Temperature 3\. Respirations 4\. Blood pressure - ANSWER\--1. Heart rate 126.) A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect Select all that apply. 1\. Nausea 2\. Tinnitus 3\. Hypotension 4\. Hypokalemia 5\. Photosensitivity 6\. Increased urinary frequency - ANSWER\--2. Tinnitus 3\. Hypotension 4\. Hypokalemia 127.) The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following? 1\. \"I can skip a dose once a week.\" 2\. \"I need to change my position slowly.\" 3\. \"I take the pill after breakfast each day.\" 4\. \"If I get a bad headache, I should call my doctor immediately.\" - ANSWER\--1. \"I can skip a dose once a week.\" 128.) A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions? 1\. \"I will never be able to drive a car.\" 2\. \"My anticonvulsant medication will clear up my skin.\" 3\. \"I can\'t drink alcohol while I am taking my medication.\" 4\. \"If I forget my morning medication, I can take two pills at bedtime.\" - ANSWER\--3. \"I can\'t drink alcohol while I am taking my medication.\" 129.) Megestrol acetate (Megace), an antineoplastic medication, is prescribed for the client with metastatic endometrial carcinoma. The nurse reviews the client\'s history and contacts the registered nurse if which diagnosis is documented in the client\'s history? 1\. Gout 2\. Asthma 3\. Thrombophlebitis 4\. Myocardial infarction - ANSWER\--3. Thrombophlebitis 130.) The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1\. Anemia 2\. Decreased platelets 3\. Increased uric acid level 4\. Decreased leukocyte count - ANSWER\--3. Increased uric acid level 131.) The nurse is reinforcing medication instructions to a client with breast cancer who is receiving cyclophosphamide (Neosar). The nurse tells the client to: 1\. Take the medication with food. 2\. Increase fluid intake to 2000 to 3000 mL daily. 3\. Decrease sodium intake while taking the medication. 4\. Increase potassium intake while taking the medication. - ANSWER\--2. Increase fluid intake to 2000 to 3000 mL daily. 132.) The client with non-Hodgkin\'s lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication? Downloaded at Knoowy - Upload your own study documents and earn money 1\. Fever 2\. Diarrhea 3\. Complaints of nausea and vomiting 4\. Crackles on auscultation of the lungs - ANSWER\--4. Crackles on auscultation of the lungs 133.) A nurse is monitoring a client receiving desmopressin acetate (DDAVP) for adverse effects to the medication. Which of the following indicates the presence of an adverse effect? 1\. Insomnia 2\. Drowsiness 3\. Weight loss 4\. Increased urination - ANSWER\--2. Drowsiness 134.) A nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the medication: 1\. With food 2\. At lunchtime 3\. On an empty stomach 4\. At bedtime with a snack - ANSWER--- On an empty stomach 135.) A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs? 1\. Fatigue 2\. Tremors 3\. Cold intolerance 4\. Excessively dry skin - ANSWER\--2. Tremors 136.) A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of: 1\. Myxedema 2\. Graves\' disease 3\. Addison\'s disease 4\. Cushing\'s syndrome - ANSWER\--2. Graves\' disease 137.) A nurse is reinforcing instructions for a client regarding intranasal desmopressin acetate (DDAVP). The nurse tells the client that which of the following is a side effect of the medication? 1\. Headache 2\. Vulval pain 3\. Runny nose 4\. Flushed skin - ANSWER\--3. Runny nose 138.) A daily dose of prednisone is prescribed for a client. A nurse reinforces instructions to the client regarding administration of the medication and instructs the client that the best time to take this medication is: 1\. At noon 2\. At bedtime 3\. Early morning 4\. Anytime, at the same time, each day - ANSWER\--3. Early morning 139.) Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone? 1\. An additional dose of prednisone daily 2\. A decreased amount of daily Humulin NPH insulin 3\. An increased amount of daily Humulin NPH insulin 4\. The addition of an oral hypoglycemic medication daily - ANSWER\--3. An increased amount of daily Humulin NPH insulin 140.) The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1\. Intestinal obstruction 2\. Peptic ulcer with melena 3\. Diverticulitis with perforation 4\. Vomiting following cancer chemotherapy - ANSWER\--4. Vomiting following cancer chemotherapy 141.) The nurse has reinforced instructions to a client who has been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions? 1\. \"I will continue taking vitamin supplements.\" 2\. \"This medication will help lower my cholesterol.\" 3\. \"This medication should only be taken with water.\" Downloaded at Knoowy - Upload your own study documents and earn money 4\. \"A high-fiber diet is important while taking this medication.\" - ANSWER\--3. \"This medication should only be taken with water.\" 142.) A health care provider has written a prescription for ranitidine (Zantac), once daily. The nurse should schedule the medication for which of the following times? 1\. At bedtime 2\. After lunch 3\. With supper 4\. Before breakfast - ANSWER\--1. At bedtime 143.) A client has just taken a dose of trimethobenzamide (Tigan). The nurse plans to monitor this client for relief of: 1\. Heartburn 2\. Constipation 3\. Abdominal pain 4\. Nausea and vomiting - ANSWER\--4. Nausea and vomiting 144.) A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? 1\. Abdominal pain 2\. Reduction in steatorrhea 3\. Hematest-negative stools 4\. Regular bowel movements - ANSWER\--4. Regular bowel movements **145.) A nurse has a prescription to give a client albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs), by metered-dose inhaler. The nurse administers the medication by giving the:** 1. Albuterol first and then the beclomethasone dipropionate 2. Beclomethasone dipropionate first and then the albuterol 3. Alternating a single puff of each, beginning with the albuterol 4. Alternating a single puff of each, beginning with the beclomethasone dipropionate **ANSWER: 1. Albuterol first and then the beclomethasone dipropionate** **146.) A client has begun therapy with theophylline (Theo-24). The nurse tells the client to limit the intake of which of the following while taking this medication?** 1. Oranges and pineapple 2. Coffee, cola, and chocolate 3. Oysters, lobster, and shrimp 4. Cottage cheese, cream cheese, and dairy creamers **ANSWER: 2. Coffee, cola, and chocolate** **147.) A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:** 1. Drink at least 2 L of fluid per day. 2. Take the daily dose at bedtime. 3. Avoid changing brands of the medication without health care provider (HCP) approval. 4. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP. **ANSWER: 2. Take the daily dose at bedtime.** **148.) A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?** 1. Diarrhea 2. Excitability 3. Drowsiness 4. Excess salivation **ANSWER: 3. Drowsiness** **149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider\'s office that a dose was taken this morning. The nurse determines that:** 1. The client should reschedule the appointment. 2. A lower dose of allergen will need to be injected. 3. A higher dose of allergen will need to be injected. 4. The client should have the skin test read a day later than usual. **ANSWER: 1. The client should reschedule the appointment.** **150.) A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?** 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesia 3. Double vision, loss of appetite, and nausea 4. Constipation, dry mouth, and sleep disorder **ANSWER: 3. Double vision, loss of appetite, and nausea** **151.) A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?** 1. Monitoring weight loss 2. Monitoring temperature 3. Monitoring blood pressure 4. Monitoring potassium level **ANSWER: 3. Monitoring blood pressure** **152.) Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?** 1. Protamine sulfate 2. Potassium chloride 3. Phytonadione (vitamin K) 4. Aminocaproic acid (Amicar) **ANSWER: 1. Protamine sulfate** **153.) A client diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which priority data collection finding to the registered nurse before initiating this therapy?** 1. Adventitious breath sounds 2. Temperature of 99.4° F orally 3. Blood pressure of 198/110 mm Hg 4. Respiratory rate of 28 breaths/min **ANSWER: 3. Blood pressure of 198/110 mm Hg** **154.) A nurse is reinforcing dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which food item would the nurse instruct the client to avoid?** 1. Red meats 2. Orange juice 3. Grapefruit juice 4. Green, leafy vegetables **ANSWER: 3. Grapefruit juice** **155.) Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?** 1. Administer following meals. 2. Take the medication with a magnesium-type antacid. 3. Open the capsule and mix with food for administration. 4. Contact the health care provider (HCP) if a sore throat occurs. **ANSWER: 4. Contact the health care provider (HCP) if a sore throat occurs.** **156.) A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?** 1. Blood glucose of 200 mg/dL 2. Potassium level of 3.8 mEq/L 3. Platelet count of 300,000 cells/mm3 4. White blood cell count of 6000 cells/mm3 **ANSWER: 1. Blood glucose of 200 mg/dL** **157.) A client receiving nitrofurantoin (Macrodantin) calls the health care provider\'s office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?** 1. Nausea 2. Diarrhea 3. Anorexia 4. Cough and chest pain **ANSWER: 4. Cough and chest pain** **158.) A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory result would indicate a therapeutic effect of the medication?** 1. Hematocrit of 32% 2. Platelet count of 400,000 cells/mm3 3. White blood cell count of 6000 cells/mm3 4. Blood urea nitrogen (BUN) level of 15 mg/dL **ANSWER: 1. Hematocrit of 32%** **159.) A nurse is caring for a client receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?** 1. Encourage fluid intake. 2. Monitor the client\'s temperature. 3. Maintain the client in a supine position. 4. Encourage the client to cough and deep breathe. **ANSWER: 4. Encourage the client to cough and deep breathe.** **160.) Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which of the following would the nurse monitor for as a side effect of this medication?** 1. Diarrhea 2. Bradycardia 3. Hypertension 4. Urinary retention **ANSWER: 4. Urinary retention** **161.) A nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client. Which of the following would the nurse include in the plan of care while the client is taking this medication?** 1. Restrict fluid intake. 2. Monitor bowel activity. 3. Monitor for hypertension. 4. Monitor peripheral pulses. **ANSWER: 2. Monitor bowel activity.** **162.) Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client\'s health history, knowing that this medication is contraindicated if which of the following disorders is present?** 1. Headaches 2. Liver disease 3. Hypothyroidism 4. Diabetes mellitus **ANSWER: 2. Liver disease** **163.) A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client\'s laboratory results and determines that which of the following indicates toxicity associated with the medication?** 1. Sodium of 140 mEq/L 2. Prothrombin time of 12 seconds 3. Platelet count of 400,000 cells/mm3 4. A direct bilirubin level of 2 mg/dL **ANSWER: 4. A direct bilirubin level of 2 mg/dL** **164.) A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?** 1. \"My urine may turn brown or green.\" 2. \"This medication is prescribed to help relieve my muscle spasms.\" 3. \"If my vision becomes blurred, I don\'t need to be concerned about it.\" 4. \"I need to call my doctor if I experience nasal congestion from this medication.\" **ANSWER: 3. \"If my vision becomes blurred, I don\'t need to be concerned about it.\"** **165.) The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept (Enbrel), it is most important for the nurse to assess:** 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. Whether the client is experiencing fatigue and joint pain 4. A metallic taste in the mouth and a loss of appetite **ANSWER: 2. The white blood cell counts and platelet counts** **166.) Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:** 1. Take the medication at bedtime. 2. Take the medication in the morning with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning. **ANSWER: 4. Take the medication with a full glass of water after rising in the morning.** **167.) A nurse prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The nurse plans to include which of the following in the instructions?** 1. Instruct the client to drink 3000 mL of fluid per day. 2. Instruct the client to take the medication on an empty stomach. 3. Inform the client that the effect of the medication will occur immediately. 4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response. **ANSWER: 1. Instruct the client to drink 3000 mL of fluid per day.** **168.) Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client\'s medical history in the health record, knowing that the medication would be contraindicated in which disorder?** 1. Myxedema 2. Renal failure 3. Hypothyroidism 4. Diabetes mellitus **ANSWER: 2. Renal failure** **169.) Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:** 1. 1 hour after each meal 2. Once daily, at the same time each day 3. 15 minutes before breakfast, lunch, and dinner 4. Before each meal, on the basis of the blood glucose level **ANSWER: 2. Once daily, at the same time each day** 1. **Listen to the client\'s lung sounds.** 2. **Check the client\'s blood pressure.** 3. **Check the recent electrolyte levels.** 4. **Assess the client for muscle weakness.\ ANSWER\--2. Check the client\'s blood pressure.** 1. **Potassium level** 2. **Creatinine level** 3. **Cholesterol level** 4. **Blood urea nitrogen\ ANSWER\--1. Potassium level** 1. **Grapes** 2. **Spinach** 3. **Watermelon** 4. **Cottage cheese\ ANSWER\--2. Spinach** 1. **\"Do you have any joint pain?\"** 2. **\"Are you having any diarrhea?\"** 3. **\"Do you have frequent headaches?\"** 4. **\"Are you experiencing heartburn?\"\ ANSWER\--1. \"Do you have any joint pain?\"** 1. **Lung sounds** 2. **Blood pressure** 3. **Blood ammonia level** 4. **Serum potassium level\ ANSWER\--3. Blood ammonia level** 1. **Pancreatitis** 2. **Pharyngitis** 3. **Tonic-clonic seizures** 4. **Human immunodeficiency virus (HIV) infection\ ANSWER\--4. Human immunodeficiency virus (HIV) infection** 1. **\"Has your appetite increased?\"** 2. **\"Are you experiencing any heartburn?\"** 3. **\"Do you have any problems with vision?\"** 4. **\"Do you experience any leg pain when walking?\"\ ANSWER\--2. \"Are you experiencing any heartburn?\"** 1. **The magnesium sulfate is effective.** 2. **The infusion rate needs to be increased.** 3. **The client is experiencing cerebral edema.** 4. **The client is experiencing magnesium toxicity.\ ANSWER\--4. The client is experiencing magnesium toxicity.** 1. **Temperature** 2. **Lochial flow** 3. **Urine output** 4. **Blood pressure\ ANSWER\--4. Blood pressure** 1. **\"I need to obtain a yearly influenza vaccine.\"** 2. **\"I need to have dental checkups every 3 months.\"** 3. **\"I need to self-monitor my blood pressure at home.\"** 4. **\"I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy.\"\ ANSWER\--1. \"I need to obtain a yearly influenza vaccine.\"** 1. **Count the radial and carotid pulses every morning.** 2. **Check the blood pressure every morning and evening.** 3. **Stop taking the medication if the pulse is higher than 100 beats per minute.** 4. **Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.\ ANSWER\--4. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.** 1. **Vitamin C** 2. **Vitamin D** 3. **Acetaminophen (Tylenol)** 4. **Acetylsalicylic acid (aspirin)\ ANSWER\--4. Acetylsalicylic acid (aspirin)** 1. **Temperature** 2. **Respirations** 3. **Blood pressure** 4. **Radial pulse rate\ ANSWER\--3. Blood pressure** 1. **\"I need to watch for signs of infection.\"** 2. **\"I need to discontinue the medication after 14 days of use.\"** 3. **\"I can take the medication with meals to minimize nausea.\"** 4. **\"I need to call the health care provider (HCP) if more than one dose is missed.\"\ ANSWER\--2. \"I need to discontinue the medication after 14 days of use.\"** 1. **Cyclobenzaprine (Flexeril)** 2. **Alendronate (Fosamax)** 3. **Allopurinol (Zyloprim)** 4. **Prednisone\ ANSWER\--4. Prednisone** 1. **Aloe** 2. **Kava** 3. **Ginger** 4. **Chamomile** 5. **Peppermint oil\ \*\*ANSWER\--4. Chamomile** 6. **Peppermint oil\*\*** 1. **Releases bicarbonate in exchange for primarily sodium ions** 2. **Releases sodium ions in exchange for primarily potassium ions** 3. **Releases potassium ions in exchange for primarily sodium ions** 4. **Releases sodium ions in exchange for primarily bicarbonate ions\ ANSWER\--2. Releases sodium ions in exchange for primarily potassium ions** 1. **Intramuscularly in the deltoid muscle** 2. **Subcutaneously in the gluteal muscle** 3. **Subcutaneously in the outer aspect of the upper arm** 4. **Intramuscularly in the anterolateral aspect of the thigh\ ANSWER\--3. Subcutaneously in the outer aspect of the upper arm** 1. **Prednisone** 2. **Sulfisoxazole** 3. **Furosemide (Lasix)** 4. **Intravenous immune globulin (IVIG)\ ANSWER\--2. Sulfisoxazole** 1. **Prevents hypercyanotic (blue or tet) spells** 2. **Maintains an adequate hormone level** 3. **Maintains the position of the great arteries** 4. **Provides adequate oxygen saturation and maintains cardiac output\ ANSWER\--4. Provides adequate oxygen saturation and maintains cardiac output** **190.)** A child is hospitalized with a diagnosis of lead poisoning. The nurse assisting in caring for the child would prepare to assist in administering which of the following medications? 1. Activated charcoal 2. Sodium bicarbonate 3. Syrup of ipecac syrup 4. **Dimercaprol (BAL in Oil)** - **ANSWER: Dimercaprol (BAL in Oil)** **191.)** A child is brought to the emergency department for treatment of an acute asthma attack. The nurse prepares to administer which of the following medications first? 1. Oral corticosteroids 2. A leukotriene modifier 3. **A β2 agonist** - **ANSWER: A β2 agonist** 4. A nonsteroidal anti-inflammatory **192.)** A nurse is collecting medication information from a client, and the client states that she is taking garlic as an herbal supplement. The nurse understands that the client is most likely treating which of the following conditions? 1. Eczema 2. Insomnia 3. Migraines 4. **Hyperlipidemia** - **ANSWER: Hyperlipidemia** **193.)** Sodium hypochlorite (Dakin\'s solution) is prescribed for a client with a leg wound containing purulent drainage. The nurse is assisting in developing a plan of care for the client and includes which of the following in the plan? 1. **Ensure that the solution is freshly prepared before use.** - **ANSWER: Ensure that the solution is freshly prepared before use.** 2. Soak a sterile dressing with solution and pack into the wound. 3. Allow the solution to remain in the wound following irrigation. 4. Apply the solution to the wound and on normal skin tissue surrounding the wound. **194.)** A nurse provides instructions to a client regarding the use of tretinoin (Retin-A). Which statement by the client indicates the need for further instructions? 1. \"Optimal results will be seen after 6 weeks.\" 2. **\"I should apply a very thin layer to my skin.\"** - **ANSWER: I should apply a very thin layer to my skin.** 3. \"I should wash my hands thoroughly after applying the medication.\" 4. \"I should cleanse my skin thoroughly before applying the medication.\" **195.)** A nurse is caring for a client who is taking metoprolol (Lopressor). The nurse measures the client\'s blood pressure (BP) and apical pulse (AP) immediately before administration. The client\'s BP is 122/78 mm/Hg and the AP is 58 beats/min. Based on this data, which of the following is the appropriate action? 1. **Withhold the medication.** - **ANSWER: Withhold the medication.** 2. Notify the registered nurse immediately. 3. Administer the medication as prescribed. 4. Administer half of the prescribed medication. **196.)** A client has been prescribed amikacin (Amikin). Which of the following priority baseline functions should be monitored? 1. Apical pulse 2. Liver function 3. Blood pressure 4. **Hearing acuity** - **ANSWER: Hearing acuity** **197.)** Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse provides instructions to the client regarding the use of this medication. Which statement by the client indicates an accurate understanding of the use of this medication? 1. **\"I will apply the ointment once a day and cover it with a sterile dressing.\"** - **ANSWER: I will apply the ointment once a day and cover it with a sterile dressing.** 2. \"I will apply the ointment twice a day and leave it open to the air.\" 3. \"I will apply the ointment once a day and leave it open to the air.\" 4. \"I will apply the ointment at bedtime and in the morning and cover it with a sterile dressing.\" **198.)** Coal tar has been prescribed for a client with a diagnosis of psoriasis, and the nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instructions? 1. \"The medication can cause phototoxicity.\" 2. \"The medication has an unpleasant odor.\" 3. \"The medication can stain the skin and hair.\" 4. **\"The medication can cause systemic effects.\"** - **ANSWER: The medication can cause systemic effects.** **199.)** A nurse is applying a topical glucocorticoid to a client with eczema. The nurse monitors for systemic absorption of the medication if the medication is being applied to which of the following body areas? 1. Back 2. **Axilla** - **ANSWER: Axilla** 3. Soles of the feet 4. Palms of the hands **200.)** A client is seen in the clinic for complaints of skin itchiness that has been persistent over the past several weeks. Following data collection, it has been determined that the client has scabies. Lindane is prescribed, and the nurse is asked to provide instructions to the client regarding the use of the medication. The nurse tells the client to: 1. Apply a thick layer of cream to the entire body. 2. Apply the cream as prescribed for 2 days in a row. 3. Apply to the entire body and scalp, excluding the face. 4. **Leave the cream on for 8 to 12 hours and then remove by washing.** - **ANSWER: Leave the cream on for 8 to 12 hours and then remove by washing.** **201.)** A nurse is preparing to administer eardrops to an infant. The nurse plans to: 1. Pull up and back on the ear and direct the solution onto the eardrum. 2. **Pull down and back on the ear and direct the solution toward the wall of the canal.** - **ANSWER: Pull down and back on the ear and direct the solution toward the wall of the canal.** 3. Pull down and back on the ear and direct the solution onto the eardrum. 4. Pull up and back on the ear lobe and direct the solution toward the wall of the canal. **202.)** A nurse is collecting data from a client about medications being taken, and the client tells the nurse that he is taking herbal supplements for the treatment of varicose veins. The nurse understands that the client is most likely taking which of the following? 1. **Bilberry** - **ANSWER: Bilberry** 2. Ginseng 3. Feverfew 4. Evening primrose **203.)** A nurse is preparing to give the postcraniotomy client medication for incisional pain. The family asks the nurse why the client is receiving codeine sulfate and not \"something stronger.\" In formulating a response, the nurse incorporates the understanding that codeine: 1. Is one of the strongest opioid analgesics available 2. Cannot lead to physical or psychological dependence 3. Does not cause gastrointestinal upset or constipation as do other opioids 4. **Does not alter respirations or mask neurological signs as do other opioids** - **ANSWER: Does not alter respirations or mask neurological signs as do other opioids** **204.)** A client receives a dose of edrophonium (Enlon). The client shows improvement in muscle strength for a period of time following the injection. The nurse interprets that this finding is compatible with: 1. Multiple sclerosis 2. **Myasthenia gravis** - **ANSWER: Myasthenia gravis** 3. Muscular dystrophy 4. Amyotrophic lateral sclerosis **205.)** A nurse is assisting in preparing to administer acetylcysteine (Mucomyst) to a client with an overdose of acetaminophen (Tylenol). The nurse prepares to administer the medication by: 1. Administering the medication subcutaneously in the deltoid muscle 2. Administering the medication by the intramuscular route in the gluteal muscle 3. Administering the medication by the intramuscular route, mixed in 10 mL of normal saline 4. **Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw** - **ANSWER: Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw** **206.)** A client is receiving baclofen (Lioresal) for muscle spasms caused by a spinal cord injury. The nurse monitors the client, knowing that which of the following is a side effect of this medication? 1. Muscle pain 2. Hypertension 3. **Slurred speech** - **ANSWER: Slurred speech** 4. Photosensitivity **207.)** A client is suspected of having myasthenia gravis, and the health care provider administers edrophonium (Enlon) to determine the diagnosis. After administration of this medication, which of the following would indicate the presence of myasthenia gravis? 1. Joint pain 2. A decrease in muscle strength 3. **An increase in muscle strength** - **ANSWER: An increase in muscle strength** 4. Feelings of faintness, dizziness, hypotension, and signs of flushing in the client 208.) A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium (Enlon). Which of the following would indicate that the client is experiencing a myasthenic crisis? 1. Increasing weakness 2. No change in the condition 3. An increase in muscle spasms 4. A temporary improvement in the condition - **ANSWER: 4. A temporary improvement in the condition** 209.) A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which of the following would indicate that the client is experiencing a side effect related to this medication? 1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation - **ANSWER: 2. Drowsiness** 210.) Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for discomfort resulting from spasticity. The nurse tells the client about the importance of follow-up and the need for which blood study? 1. Creatinine level 2. Sedimentation rate 3. Liver function studies 4. White blood cell count - **ANSWER: 3. Liver function studies** 211.) A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/ml. Which of the following symptoms would be expected as a result of this laboratory result? 1. Nystagmus 2. Tachycardia 3. Slurred speech 4. No symptoms, because this is a normal therapeutic level - **ANSWER: 3. Slurred speech** 212.) Mannitol (Osmitrol) is being administered to a client with increased intracranial pressure following a head injury. The nurse assisting in caring for the client knows that which of the following indicates the therapeutic action of this medication? 1. Prevents the filtration of sodium and water through the kidneys 2. Prevents the filtration of sodium and potassium through the kidneys 3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of Henle 4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water and solutes - **ANSWER: 4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water and solutes** 213.) A client is admitted to the hospital with complaints of back spasms. The client states, \"I have been taking two or three aspirin every 4 hours for the past week and it hasn\'t helped my back.\" Aspirin intoxication is suspected. Which of the following complaints would indicate aspirin intoxication? 1. Tinnitus 2. Constipation 3. Photosensitivity 4. Abdominal cramps - **ANSWER: 1. Tinnitus** 214.) A health care provider initiates carbidopa/levodopa (Sinemet) therapy for the client with Parkinson\'s disease. A few days after the client starts the medication, the client complains of nausea and vomiting. The nurse tells the client that: 1. Taking an antiemetic is the best measure to prevent the nausea. 2. Taking the medication with food will help to prevent the nausea. 3. This is an expected side effect of the medication and will decrease over time. 4. The nausea and vomiting will decrease when the dose of levodopa is stabilized. - **ANSWER: 2. Taking the medication with food will help to prevent the nausea.** 215.) A client with rheumatoid arthritis is taking acetylsalicylic acid (aspirin) on a daily basis. Which medication dose should the nurse expect the client to be taking? 1. 1 g daily 2. 4 g daily 3. 325 mg daily 4. 1000 mg daily - **ANSWER: 2. 4 g daily** 216.) A nurse is caring for a client with gout who is taking Colcrys (colchicine). The client has been instructed to restrict the diet to low-purine foods. Which of the following foods should the nurse instruct the client to avoid while taking this medication? 1. Spinach 2. Scallops 3. Potatoes 4. Ice cream - **ANSWER: 2. Scallops** 217.) A health care provider prescribes auranofin (Ridaura) for a client with rheumatoid arthritis. Which of the following would indicate to the nurse that the client is experiencing toxicity related to the medication? 1. Joint pain 2. Constipation 3. Ringing in the ears 4. Complaints of a metallic taste in the mouth - **ANSWER: 4. Complaints of a metallic taste in the mouth** 218.) A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction should the nurse provide to the client? 1. \"Crush the tablets and mix them with food.\" 2. \"Notify the health care provider for a medication change.\" 3. \"Open the tablet and mix the contents with food.\" 4. \"Swallow the tablets with large amounts of water or milk.\" - **ANSWER: 4. \"Swallow the tablets with large amounts of water or milk.\"** 219.) A health care provider instructs a client with rheumatoid arthritis to take ibuprofen (Motrin). The nurse reinforces the instructions, knowing that the normal adult dose for this client is which of the following? 1. 100 mg orally twice a day 2. 200 mg orally twice a day 3. 400 mg orally three times a day 4. 1000 mg orally four times a day - **ANSWER: 3. 400 mg orally three times a day** 220.) A adult client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). The nurse reviews the medication record, expecting that which dose should be prescribed? 1. 15 mg four times a day 2. 25 mg four times a day 3. 30 mg four times a day 4. 40 mg four times a day - **ANSWER: 1. 15 mg four times a day** 221.) A nurse is reviewing the health care provider\'s prescriptions for an adult client who has been admitted to the hospital following a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms; the health care provider has prescribed 350 mg to be administered four times a day. When preparing to give this medication, the nurse determines that this dosage is: 1. The normal adult dosage 2. A lower than normal dosage 3. A higher than normal dosage 4. A dosage requiring further clarification - **ANSWER: 1. The normal adult dosage** 222.) A nurse has administered a dose of diazepam (Valium) to a client. The nurse would take which important action before leaving the client\'s room? 1. Giving the client a bedpan 2. Drawing the shades or blinds closed 3. Turning down the volume on the television 4. Per agency policy, putting up the side rails on the bed - **ANSWER: 4. Per agency policy, putting up the side rails on the bed** 223.) A client with a psychotic disorder is being treated with haloperidol (Haldol). Which of the following would indicate the presence of a toxic effect of this medication? 1. Nausea 2. Hypotension 3. Blurred vision 4. Excessive salivation - **ANSWER: 4. Excessive salivation** 224.) Neuroleptic malignant syndrome is suspected in a client who is taking chlorpromazine. Which medication would the nurse prepare in anticipation of being prescribed to treat this adverse effect related to the use of chlorpromazine? 1. Protamine sulfate 2. Bromocriptine (Parlodel) 3. Phytonadione (vitamin K) 4. Enalapril maleate (Vasotec) - **ANSWER: 2. Bromocriptine (Parlodel)** 225.) A nursing student is assigned to care for a client with a diagnosis of schizophrenia. Haloperidol (Haldol) is prescribed for the client, and the nursing instructor asks the student to describe the action of the medication. Which statement by the nursing student indicates an understanding of the action of this medication? 1. It is a serotonin reuptake blocker. 2. It inhibits the breakdown of released acetylcholine. 3. It blocks the uptake of norepinephrine and serotonin. 4. It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain. - **ANSWER: 4. It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain.** 226.) A client receiving lithium carbonate (Lithobid) complains of loose, watery stools and difficulty walking. The nurse would expect the serum lithium level to be which of the following? 1. 0.7 mEq/L 2. 1.0 mEq/L 3. 1.2 mEq/L 4. 1.7 mEq/L - **ANSWER: 4. 1.7 mEq/L** 227.) When teaching a client who is being started on imipramine hydrochloride (Tofranil), the nurse would inform the client that the desired effects of the medication may: 1. Start during the first week of administration 2. Not occur for 2 to 3 weeks of administration 3. Start during the second week of administration 4. Not occur until after a month of administration - **ANSWER: 2. Not occur for 2 to 3 weeks of administration** 228.) A client receiving an anxiolytic medication complains that he feels very \"faint\" when he tries to get out of bed in the morning. The nurse recognizes this complaint as a symptom of: 1. Cardiac dysrhythmias 2. Postural hypotension 3. Psychosomatic symptoms 4. Respiratory insufficiency - **ANSWER: 2. Postural hypotension** 229.) A client who is taking lithium carbonate (Lithobid) is scheduled for surgery. The nurse informs the client that: 1. The medication will be discontinued a week before the surgery and resumed 1 week postoperatively. 2. The medication is to be taken until the day of surgery and resumed by injection immediately postoperatively. 3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed. 4. The medication will be discontinued several days before surgery and resumed by injection in the immediate postoperative period. - **ANSWER: 3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed.** **230.) A client is placed on chloral hydrate (Somnote) for short-term treatment. Which nursing action indicates an understanding of the major side effect of this medication?** 1. Monitoring neurological signs every 2 hours 2. Monitoring the blood pressure every 4 hours 3. Instructing the client to call for ambulation assistance 4. Lowering the bed and clearing a path to the bathroom at bedtime **Answer:** 3. Instructing the client to call for ambulation assistance **231.) A client admitted to the hospital gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication?** 1. Complaints of hunger 2. Complaints of insomnia 3. A pulse rate less than 60 beats per minute 4. Frequent handwashing with hot, soapy water **Answer:** 4. Frequent handwashing with hot, soapy water **232.) A client in the mental health unit is administered haloperidol (Haldol). The nurse would check which of the following to determine medication effectiveness?** 1. The client\'s vital signs 2. The client\'s nutritional intake 3. The physical safety of other unit clients 4. The client\'s orientation and delusional status **Answer:** 4. The client\'s orientation and delusional status **233.) Diphenhydramine hydrochloride (Benadryl) is used in the treatment of allergic rhinitis for a hospitalized client with a chronic psychotic disorder. The client asks the nurse why the medication is being discontinued before hospital discharge. The nurse responds, knowing that:** 1. Allergic symptoms are short in duration. 2. This medication promotes long-term extrapyramidal symptoms. 3. Addictive properties are enhanced in the presence of psychotropic medications. 4. Poor compliance causes this medication to fail to reach its therapeutic blood level. **Answer:** 3. Addictive properties are enhanced in the presence of psychotropic medications **234.) A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. At lunchtime, a tray is delivered to the client. Which food item on the tray will the nurse remove?** 1. Yogurt 2. Crackers 3. Tossed salad 4. Oatmeal coo

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