Document 2.docx

SATA 1\. A nurse is administering morphine sulfate to a postoperative client. What are the appropriate nursing implications associated with this medication? (Select all that apply.) ⁃ Before administration, determine respiratory rate, blood pressure, pulse rate, and pain score. ⁃ Morphine should be given on a fixed schedule around the clock during the first 24 hours postoperatively. ⁃ The nurse will evaluate for urinary retention every 4 to 6 hours while on this Medication. 2\. Risk associated with estrogen progesterone therapy for women after menopause? Not on slide but my research. Risk of stroke, blood clots and heart attack Breast cancer, lung cancer 3\. A nurse is teaching a group of nursing students about administering medications to older adult clients. Which statement(s) by the nurse are correct? (Select all that apply.) ⁃ "Changes in gastrointestinal function in older adult clients can lead to an increase in serum drug levels." ⁃ "Many adverse drug reactions in older adult clients are related to altered renal function." ⁃ "Nonadherence for medications among older adult clients is often due to the cost of medications." SATA 1\. A nurse is administering morphine sulfate to a postoperative client. What are the appropriate nursing implications associated with this medication? (Select all that apply.) ⁃ Before administration, determine respiratory rate, blood pressure, pulse rate, and pain score. ⁃ Morphine should be given on a fixed schedule around the clock during the first 24 hours postoperatively. ⁃ The nurse will evaluate for urinary retention every 4 to 6 hours while on this Medication. 2\. Risk associated with estrogen progesterone therapy for women after menopause? Not on slide but my research. Risk of stroke, blood clots and heart attack Breast cancer, lung cancer 3\. A nurse is teaching a group of nursing students about administering medications to older adult clients. Which statement(s) by the nurse are correct? (Select all that apply.) ⁃ "Changes in gastrointestinal function in older adult clients can lead to an increase in serum drug levels." ⁃ "Many adverse drug reactions in older adult clients are related to altered renal function." ⁃ "Nonadherence for medications among older adult clients is often due to the cost of medications." 4\. A client is prescribed 100 mg of atenolol daily. The nurse will hold this medication in which of the following situations? (Select all that apply.) ⁃ Bradycardia ⁃ A blood pressure of 78/40 mmHg 5. Which are preventable causes of medication errors? (Select all that apply.) ⁃ Confusing drugs with similar packaging. ⁃ Giving a drug intravenously instead of intramuscularly. ⁃ Complicated drugs with names that look or sound alike. ⁃ Writing a prescription that is unreadable. 6\. Which variables can help determine the client's response to a drug? (Select all that apply.) ⁃ Liver disease ⁃ Age ⁃ Genetic factors ⁃ Gender 8\. The client is reporting severe chest pain radiating down the left arm and is nauseated and diaphoretic. The physician suspects the client is having a myocardial infarction (MI) and has ordered morphine sulfate for the pain. Which interventions should the nurse implement? (Select all that apply.) ⁃ Instruct the client not to get out of the bed without notifying the nurse. ⁃ Dilute the morphine sulfate to a 10 mL bolus with normal saline. ⁃ Administer the morphine sulfate slowly over 5 minutes. 11\. The client diagnosed with chronic kidney disease is prescribed erythropoietin. Which intervention should the nurse implement? (Select all that apply.) ⁃ Have the client take acetaminophen for pain. ⁃ Monitor the client's complete blood cell (CBC) count. ⁃ Teach the client to pace activities. ⁃ Monitor blood pressure while taking this medication. 13\. Meds that can safely be resume after pregnancy that were contradicting during pregnancy? I think this is the actual question\... my research The nurse is talking with a new mother about medications that can be safely resumed now that she is no longer pregnant. All the following medications are contraindicated during pregnancy, but which one may be ingested while breastfeeding without causing known infant harm? 1\. Lithium 2\. Methotrexate 3\. Ibuprofen 4\. Nicotine Answer is Ibuprofen 14\. How to suppress genital herpes during pregnancy? I think the actual question is\... my research A client who is pregnant has a history of recurrent genital herpes virus. The client asks the nurse what will be done to suppress an outbreak when she is near term. What is the nurse\'s response? A- \"Topical acyclovir must be used to control outbreaks\" B- \"Intravenous antiviral agents will be used if an outbreak occurs\" C- \"Antiviral medications are not safe during pregnancy\" D- \"Oral acyclovir may be used during pregnancy D- \"Oral acyclovir may be used during pregnancy 15\. A nurse is caring for a client and her newborn immediately after delivery. The client's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What is the nurse's most appropriate action? Monitor the infant's respiration and prepare to administer naloxone if needed. 16\. Pregnant mom stopped her asthma medication, what do you tell her? I think the actual question is\... my research A pregnant client stopped using a prescription medication she takes for asthma because she doesn\'t want to harm her baby. What will the nurse tell the client? 1\. Stopping medications for asthma doubles the chances of stillbirth 2\. Resume the medicines in her second trimester 3\. Avoid taking medications during her pregnancy 4\. Asthma medications will not affect the fetus. 19\. It has been determined that a client with vision disturbances has an elevated digoxin level. Which of these factors might contribute to digoxin toxicity? Failing to take potassium when taking digoxin and furosemide 20\. A client with tinnitus is suﬀering from aspirin toxicity. Which of these variables might be causing or contributing to the client's elevated salicylate level? The client has an elevated creatinine level. 22\. Older adults take cardiac meds w/O2 at 88- which action puts pt at risk for hypoxemia? (my research) People living with heart or lung diseases such as congestive heart failure, COPD or asthma, are at an increased risk for hypoxemia. Some contagious illnesses, like influenza, pneumonia and COVID-19, can also increase your risk of hypoxemia Classic causes of hypoxia include hypoventilation, ventilation-perfusion mismatch, the low oxygen content in the air, right to left shunting, or impaired diffusion. 25\. The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often because they are so eﬀective. What is the correct response by the nurse? Chronic steroid use can slow growth. 28\. What is required by the FDA to be on labels of herbal supplements? Supports immune system per Professor Weas And labeled as dietary supplements 29\. What is required by the FDS to be on labels of herbal supplements? name of supplement name+address of manufacturer list of ingredients serving size, amount, active ingredient 30\. A nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. To evaluate the risk of hemorrhage, the nurse will ask the client about antiplatelet and anticoagulant medications as well as which dietary supplement? Ginkgo biloba 31\. What herbal supplement taken with Warfarin increases risk for bleeding? Garlic 32\. Clients taking fluoxetine should be advised to avoid St John's Wort due to which of the following potentially severe adverse eﬀects? Serotonin Syndrome 33\. The nurse is obtaining a history from a client who discloses daily use of St. John's Wort in addition to prescription drugs. Which eﬀect of this dietary supplement would most concern the nurse? It accelerates the metabolism of some drugs. 34\. Which product did the FDA ban in the United States because of serious adverse effects of myocardial infarction stroke and death? (My research) Dietary supplements containing ephedrine alkaloids 35\. A client with no known drug allergies is receiving amoxicillin by mouth twice daily. Twenty minutes after being given a dose, the client complains of shortness of breath with a blood pressure of 100/58 mm Hg. What will the nurse do? Contact the provider and prepare to administer epinephrine as ordered 36\. The nurse is caring for a client who is receiving vancomycin. The nurse notes the client is experiencing flushing, rash, pruritus, and urticaria. The client's heart rate is 120 beats/min, and blood pressure is 92/57 mm Hg. What complication is the client experiencing? Red man syndrome 37\. A client is discharged from the hospital with a prescription for trimethoprim/ sulfamethoxazole. What must the nurse include in the discharge teaching? Drink eight to ten glasses of water each day 40\. The nurse reviewing allergies with a client before administering cephalosporins should also ask about allergies to which of the following medications? Penicillin 41\. She mentions priority for Ciprofloxacin? From the book. (my research) Ciprofloxacin can induce a variety of adverse effects, including GI reactions (nausea, vomiting, diarrhea, abdominal pain) and central nervous system (CNS) effects (dizziness, headache, restlessness, confusion). Candida infections of the pharynx and vagina may develop during treatment. Very rarely, seizures have occurred. In older adults, ciprofloxacin poses a significant risk of confusion, somnolence, psychosis, and visual disturbances. 42\. A client with an infection is being treated with vancomycin. The nurse providing care reviews the client's laboratory reports and notes that the client's blood urea nitrogen (BUN) and serum creatinine levels are newly elevated. What would be the appropriate nursing intervention? Consult the provider about the need for a less nephrotoxic medication. 43\. A client receiving cephalosporin has passed six distinct-smelling, unformed stools in the first 6 hours of the nurse's shift. What is the nurse's best action? Discontinue the cephalosporin and call the provider to recommend vancomycin or metronidazole. 44\. A client who is receiving a final dose of intravenous cephalosporin complains of pain and irritation at the infusion site. The nurse observes signs of redness at the intravenous insertion site and along the vein. What is the nurse's action? Immediately stop the infusion and select an alternate intravenous site. 45\. A client is taking oral itraconazole for a systemic fungal infection. The nurse reviews the medication record and notes that the client is also taking cimetidine for reflux disease. Which action should the nurse take? 1\. Administer the cimetidine at least two hours after the itraconazole. 2\. Don\'t give the cimetidine to a client receiving itraconazole. 3\. Administer the cimetidine with the itraconazole. 4\. Confer with the prescriber about a potentially hazardous interaction. My research found on a Quizlet 46\. The nurse is caring for a client receiving intravenous acyclovir. To prevent nephrotoxicity, what is the nurse\'s action? A- Provide a low- protein diet for one day before and two days after the acyclovir infusion B- increase the client\'s intake of food rich in vitamin C C- Monitor urinary output every 30 min D-Encourage PO fluid intake during the infusion and for 2 hours after the infusion My research found on Quizlet 47\. A client with bronchitis is taking trimethoprim/sulfamethoxazole 160/800 mg orally, twice daily. Before administering the third dose, the nurse observes the client has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats/min. The client looks ill and reports not feeling well. What is the nurse's response? Withhold the treatment and notify the provider of the symptoms. 48\. The nurse notices that an order for intravenous gentamicin for a newly admitted client is half of the normal dose usually ordered for an adult. Before calling the provider for confirmation of the order, the nurse reviews the client's history to check for which preexisting condition could have prompted the adjustment to the normal dose? Renal disease 49\. Both intravenous (IV) ampicillin/sulbactam and gentamicin are ordered for a patient. Which action should the nurse take when administering these medications? Administer the gentamicin first Found on Quizlet 52\. A client is admitted for pneumonia, and the provider orders ciprofloxacin. The client is also taking warfarin. The nurse will anticipate an order for which of these laboratory values? Prothrombin time (PT)/International normalized ratio (INR) 56\. A pregnant client asks the nurse whether she should continue to take her prescription for tetracycline to clear up her acne. Which response by the nurse is correct? "Tetracycline can be harmful to the baby's teeth and should be avoided." 57\. What assessment finding will alert the nurse to contact the provider when taking gentamicin? Tinnitus (ringing in ears) 58\. A client who has been taking gentamicin for 5 days reports a headache, dizziness, and a ringing in their ears. Which of the following actions will the nurse take? Suspect ototoxicity and notify the healthcare provider 59\. A client is discharged from the hospital with a prescription for trimethoprim/ sulfamethoxazole. What must the nurse include in the discharge teaching? Drink eight to ten glasses of water each day 60\. Before administering a cephalosporin to a client, it is most important for the nurse to assess that client for an allergy history to which of the following? Penicillins 61\. A client is receiving vancomycin. The nurse identifies what as the most common toxic eﬀect of vancomycin therapy? Renal toxicity 62\. A client is receiving vancomycin IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection. They ask the nurse, "Why can't I take this medication as a pill?" Which of the following is the correct response from the nurse? "It is more eﬀective when treating MRSA when delivered intravenously 63\. A client develops flushing, rash, and pruritus during an IV infusion of vancomycin. Which action should a nurse take first? Reduce the infusion rate 65\. Which instruction should a nurse include in the discharge teaching for a client who is to start taking tetracycline? "Use sunscreen and protective clothing when outdoors." 66\. The nurse is doing discharge teaching with the parent of an asthmatic child who will be going home on steroids. Which of these comments by the parent would indicate an accurate understanding of discharge teaching regarding these medications? My child may need to take a gastric acid suppressor while taking steroid 67\. A client who takes 325 mg of aspirin daily is scheduled for major surgery. Which of the following pre-surgical orders would the nurse expect to include in her teaching? Discontinue aspirin 7-10 days before surgery. 68\. A nurse is talking to a client who wants to stop taking glucocorticoids after taking them for 3 months. Which statement by the client indicates a good understanding of the teaching about withdrawal? "I should not try to taper oﬀ the medication without consulting my provider." 68\. A nurse is talking to a client who wants to stop taking glucocorticoids after taking them for 3 months. Which statement by the client indicates a good understanding of the teaching about withdrawal? "I should not try to taper oﬀ the medication without consulting my provider." 69\. A client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. With the client\'s steroid use history, for which complication will the nurse monitor in the recovery phase? 1\. Postoperative blood clots 2\. Bradycardia 3\. Impaired wound healing 4\. Pre-surgical dehydration Found on Quizlet/ Exact question she said 70\. A client will begin taking fexofenadine for hay fever. What education should be included regarding the use of this second-generation antihistamine? 1\. Citrus fruit juices can inactivate this class of medications. 2\. Fexofenadine has cholinergic side effects. It causes excessive salivation. 3\. Fexofenadine must be taken at bedtime. 4\. Fexofenadine must be taken apart from food Found on Quizlet/ Exact question she said 71\. A pregnant client asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the client? Antihistamines should be avoided in pregnancy unless necessary. 72\. The nurse will include which information when teaching a client about hydroxyzine? The client should avoid drinking alcohol while taking the 73\. A client on a morphine patient-controlled analgesia (PCA) pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals: pulse 84 beats/minute, respiratory rate 10 breaths/minute, blood pressure 90/50 mm Hg. What is the nurse's best action? Prepare to administer naloxone and provide respiratory support. 74\. Which of these situations would cause the nurse to hold a dose of morphine? Respiratory rate of 10 breaths per minute with an oxygen saturation level of 86%. 75\. The client has a severe anaphylactic reaction to insect bites. Which priority discharge intervention should the nurse discuss with the client? "Have an epinephrine auto-injector available at all times." 76\. A client is receiving morphine sulfate and promethazine (Phenergan). Which of the following is a priority assessment by the nurse? Client's level of consciousness 77\. A client develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer? Epinephrine 78\. A client has received a toxic dose of antihistamine. It is most important for the nurse to assess the patient for what? Seizure activity 79\. A client is scheduled to start taking aspirin for the treatment of rheumatoid arthritis (RA). The nurse anticipates the following medication will also most likely be prescribed to this client? Pantoprazole 80\. A client with cancer has been taking an opioid analgesic four times daily for chronic pain and reports needing increased doses for pain. Which of the following is a proper response? "Over time, people can develop a tolerance to opioids. We can discuss increasing your dose with the provider. 81\. A client who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes the client's cheeks appear full, and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory test? Serum electrolytes 82\. Which of these findings, from a client taking steroids, should the nurse report immediately? Temperature of 101.2 degrees Fahrenheit 83\. When teaching a client about potential adverse eﬀects of nonsteroidal anti- inflammatory (NSAID) therapy, the nurse will teach the patient to immediately notify the health care provider of what symptoms? Black tarry stools 84\. Morphine is prescribed for a client with pain. What should the nurse monitor for which potential side eﬀects of this medication? Urinary retention 89\. A client who has undergone renal transplantation reports taking ibuprofen as needed for arthritis pain. Which laboratory test is most important to determine the presence of an adverse eﬀect related to this medication in this client? Blood urea nitrogen (BUN 90\. What is an advantage of cyclooxygenase (COX)-2 inhibitors over other nonsteroidal anti-inflammatory drug (NSAID)? They are less likely to irritate the gastrointestinal mucosa 93\. Which agent is most likely to cause serious respiratory depression as a potential adverse reaction? Morphine 94\. A client asks the nurse about medications that can be given to alleviate severe, chronic pain of several months' duration. The patient has been taking oral oxycodone (OxyContin) and states that it is no longer eﬀective. The nurse will suggest discussing which of the following medications with the provider? Fentanyl transdermal patches 95\. A client newly diagnosed with cancer reports having pain that is an "8 out of 10" on the pain scale. Which type of pain management will most likely initially be used to treat pain in this client? Opioid analgesics 96\. A client is brought to the emergency department after stating they took a full bottle of extended-release acetaminophen tablets between 8 and 10 hours ago. The nurse will anticipate administering which of the following? Acetylcysteine 97\. The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? My research \... A 62-year-old patient with a history of stroke Anyone who children and teenagers recovering from chickenpox or flu-like symptoms have asthma or lung disease. have ever had a blood clotting problem. have liver or kidney problems. 98\. What is the mechanism of action of nonsteroidal anti-inflammatory drugs (NSAIDs)? Inhibiting prostaglandin production 99\. A patient taking levothyroxine for hypothyroidism, what will be a concern as a nurse? Notes from Pharm PowerPoint Mod 7. TAKE ON AN EMPTYSTOMACH FIRST THING INTHE MORNING. At least 30-60 min before breakfast Start with low dose then gradually increase dose 7-day half-life Takes about a month for steady state Treatment will be lifelong Levothyroxine Thyroid hormone replacement (Synthetic T4) Adverse Reactions: (Hyperthyroid in nature) Tachycardia, angina Heat intolerance, sweating Insomnia Tremors, nervousness Bone loss, risk for fractures. Warfarin will accelerate levothyroxine metabolism\...reduce warfarin dose. Supplements and GI meds may require an increased levothyroxine dose and should be spaced 4 hours apart. 100\. The nurse is caring for a pregnant client recently diagnosed with hypothyroidism. The client tells the nurse she does not want to take medications while she is pregnant. 1\. Neuropsychological deficits in the fetus can occur if the condition is not treated. 2\. No treatment is required if the client is experiencing symptoms. 3\. No danger to the fetus exists until the third trimester. 4\. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence 102\. The nurse educates the family members of a client newly diagnosed with diabetes mellitus about the importance of having glucagon on hand for emergency home use. The nurse determines that the teaching has been successful if the family indicates that the purpose of the medication is to treat which complication? Hypoglycemia from insulin overdose 103\. The nurse is educating a client about methimazole for the management of hyperthyroidism. The nurse determines that the teaching has been successful if the client states that they will report which of the following symptoms to their health care provider while taking this medication? Fever 104\. client with cystic fibrosis will be receiving insulin lispro this morning with their scheduled medications. Which of these actions by the nurse is most important? A. Ensure the client has taken their other medications first. B. Ensure the client has used the restroom. C. Ensure the client has their food readily available to eat. D. Administer the pancrelipase as ordered 106\. A person has adrenal insufficiency and is prescribed glucocorticoids, what instructions do you give them? In PowerPoint it states EDUCATION: SHOULD WEAR MEDICALALERT BRACELET WHEN DISCONTINUED, DOSE SHOULD BE TAPEREDTO ALLOW ADRENAL GLANDS TO RETURN TONORMAL FUNCTION. FAILURE TO DO SO CAN LEAD TOADRENAL INSUFFICIENCY (ADDISON'S) TAPERING THE DOSE IS DEPENDENT ON HOW LONG THEPATIENT HAS BEEN ON THERAPY ADRENAL SUPPRESSION CAN BE MINIMIZED THROUGHALTERNATE-DAY DOSING MAY NEED TO INCREASE DOSING IF TRAUMA ORSURGERY DUE TO EXTREME STRESS 107\. The nurse is caring for a female client who takes estrogen for birth control. Which of the following complications should the nurse monitor for this client? A. Dehydration B. Deep vein thrombosis C. Weight gain D. Tachycardia D. Jaundice 109\. The nurse is scheduled to administer lispro insulin Chris sliding scale before meals. The serum blood glucose reading before lunch is 152 mg / DL given the following sliding scale. How much insulin lispro should be given before lunch? If 151-200, give four units 110\. The diabetic client receives an injection of insulin glargine. What is the duration of insulin glargine? A. 15 minutes B. 2 to 4 hours C. 6 to 14 hours D. 18 to 24 hours 111\. Insulin lispro was given to a client at 0700 by a night nurse who needed to leave early. At 0730 the client is clammy and refusing breakfast, stating, "I don't feel well. I need to lie down." What is the nurse's action? A. Check the blood sugar and convince the client to drink juice if possible. B. Document the refusal and let the client sleep. C. Call the night nurse at home and tell her to come back and deal with the situation. D. Wait to offer breakfast until the client feels better 112\. Insulin glargine is prescribed for a hospitalized client who has diabetes. When will the nurse expect to administer this drug? A. Approximately 15 to 30 minutes before each meal B. With meals C. Once-daily at the same time every day D. After meals and at bedtime 113\. A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? A. The beta-blocker can cause insulin resistance. B. Using the two agents together increases the risk of ketoacidosis. C. Propranolol increases insulin requirements because of receptor blocking. D. The beta-blocker can mask the symptoms of hypoglycemia 114\. A 50-year-old postmenopausal client who has had a hysterectomy has moderate to severe hot flashes and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the side effects of estrogen therapy? A. An estrogen-progesterone product will increase side effects. B. An intravaginal preparation may be best. C. Side effects of estrogen therapy are uncommon among women of her age. D. Transdermal preparations of estrogen therapy have reduced side effects 118\. A client demonstrates the need for further education regarding metformin therapy when they make which of the following statements? A. "I can take this medication even if I am also taking insulin." B. "This medication can upset my stomach, so I should take it with food." C. "I should not take this medication on a day when I am having a diagnostic imaging study with contrast performed." D. "This medication should only be taken by individuals with Type 1 diabetes." 120\. A nurse who administers insulin in a long-term setting demonstrates the need for further teaching when they make which of the following statements? A. "Aspart insulin is given to brings glucose levels back to normal before meals." B. "Glargine insulin is often given a bedtime to reduce risk of insulin reactions." C. "Detemir insulin and glargine insulin should not be given to the same person." D. "Lispro and glargine insulin can be given together in the same syringe. 121\. A male client tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as "annoying." The client's provider examines him and notes that the prostate is moderately enlarged. The client is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order which of the following? A. Doxazosin B. Finasteride C. Silodosin D. A transurethral prostatectomy 125\. A nurse is reviewing protocols regarding the administration of subcutaneous glucagon versus intravenous 50% dextrose. If both of these medications are covered by standing orders, when should glucagon be administered? A. When a client's blood glucose is above 180 mg/dL B. When a pre-operative client has a glucose below 70 mg/dL C. When a stuporous client with no intravenous access is hypoglycemic D. When a client who has intravenous access is stuporous 126\. The nurse is working with a client who is taking doxazosin, an alpha-adrenergic blocker, for benign prostatic hypertrophy (BPH). Which one would be safe for the client to take with this medication? A. Sildenafil B. Alcohol C. Pseudoephedrine D. Cranberry juice 127\. A client who is experiencing postmenopausal symptoms is asking about the benefits of estrogen therapy. Which of these comments would indicate the need for further education? A. Estrogens can reduce the progression of bone loss, whiskers and wrinkles. B. Estrogens can reduce lipid levels, yet it increases the risk of stroke or heart attack. C. The risk for estrogen use-related clots or cancers goes down after menopause. D. People who smoke, or live with smokers, should not take estrogen replacements 129\. Which statement by a client indicates an understanding of self- care precautions when taking warfarin? A. "I should eat spinach to increase my iron count if my INR goes below two." B. "Herbal remedies are fine, but I shouldn't take aspirin without consulting my provider." C. "My warfarin dose may need to be readjusted when I take a course of antibiotics." D. "I should expect pink urine due to metabolic bi-products of the dye used in this medication." 131\. A client with a history of hypertension is going home with prescriptions for furosemide 40mg daily and potassium 10 mEq daily. Which of these comments by the client shows proper understanding of how the medication should be taken? A. "I will take my potassium whenever I feel my heart skipping beats." B. "I will take my potassium crushed in a tablespoon of applesauce just before bedtime." C. "I will not take my furosemide if my heart rate falls below 60." D. "I will take my potassium with my furosemide together, right after I eat breakfast. 133\. Which information does the nurse include when teaching a client about taking clopidogrel? A. Constipation may occur B. Normal dose is 25 mg each day C. Hypotension may occur D. Bleeding may increase when taken with aspirin 134\. A client with a new diagnosis of atrial fibrillation is receiving a continuous infusion of heparin. Which finding will the nurse report immediately? A. An activated partial thromboplastin time (aPTT) of 80 seconds. B. Evidence of dark, tarry stools. C. An international normalized ratio (INR) of 0.8. D. Concurrent use of acetaminophen for pain 135\. A client with a persistent cardiac arrhythmia will be going home with a prescription for amiodarone. What should the client be taught in preparation for discharge? A. "Expect a yellow discoloration to the skin. Use sun block if this occurs." B. "Report any blue tint to the skin. This would indicate venous insufficiency." C. "Expect a cough. This is a harmless, expected side effect." D. "Amiodarone can cause hyperthyroidism. Your physician may monitor your thyroid labs while taking this medication 136\. A client is taking warfarin 5 mg daily for atrial fibrillation. How does the nurse interpret the client\'s international normalized ratio (INR) result of 3.8? A. Within normal range B. Below recommended range C. At mid-recommended range D. Above recommended range 138\. What symptom does the nurse expect to occur when a client takes an initial dose of a nitrate? A. Headache B. Irregular pulse C. Stomach cramps D. Nausea 140\. The lab calls to inform the nurse that a client\'s partial thromboplastin time (PTT) level is 150 seconds. What antidote to heparin should the nurse have available? A. Protamine sulfate B. Atropine sulfate C. Pyridostigmine D. Vitamin K 142\. Which finding indicates the client is experiencing a positive outcome from treatment with filgrastim? A. Bone pain is eliminated. B. The neutrophil count increases. C. Cancer goes into remission. D. The red blood cell count increases. 143\. The nurse knows that enoxaparin has what kind of half-life as compared to heparin? A. A longer half-life than heparin B. A shorter half-life than heparin C. The same half-life as heparin D. A two times shorter half-life than heparin 144\. A client is changing from an injectable to an oral anticoagulant. Which anticoagulant does the nurse anticipate administering? A. Enoxaparin B. Fondaparinux C. Bivalirudin D. Warfarin 145\. The nurse is caring for a client with anemia related to chronic renal failure. Which agent might be used to treat anemia? A. Filgrastim B. Sargramostim C. Oprelvekin D. Epoetin alfa 148\. Which of the following does the nurse identify as a nitrate? A. Metoprolol B. Lisinopril C. Isosorbide D. Amlodipine 155\. A client is starting to take furosemide and asks the nurse, "When is the best time to take this medication?" What is the nurse's response? A. 2200 B. 1600 C. 0800 D. 1900 156\. What should the nurse include in a client's discharge teaching when going home with a prescription for digoxin 0.125 mg by mouth once daily? A. "Take the digoxin at bedtime." B. "Take your pulse prior to taking your medication." C. "Do not take digoxin if your heart rate exceeds 90 beats per minute." D. "Eat a diet high in bran, fiber, and calcium 157\. In which situation would the nurse hold digoxin? A. When the lab reports a digoxin level 1.2 ng/mL B. When the client is edematous C. When the client is pacing and very thirsty D. When the client complains of seeing yellow-green halo 158\. Which of these findings would cause the nurse to hold the administration of oral metoprolol 25 mg? A. Heart rate of 92 beats per minute B. Respiratory rate of 26 breaths per minute C. Blood pressure of 92/44 mmHg D. Oxygen saturation level of 94% on room air 160\. A client diagnosed with high blood pressure is prescribed lisinopril. Which statement made by the client indicates discharge teaching has been effective? A. \"I should get up slowly when getting out of bed." B. \"If I experience leg cramps, I should take an extra potassium supplement." C. \"If I forget to take a dose of medication, I should take two doses the next day." D. \"My diet does not matter; I am free to eat anything I want as long as I continue to take my medication as ordered 161\. A healthcare provider has ordered captopril for a client with hypertension. The client reports a history of swelling of the tongue and lips after taking enalapril in the past. Which action by the nurse is correct? A. Administer the captopril and monitor for adverse effects B. Hold the dose and notify the provider C. Request an order to administer fosinopril instead of captopril D. Reassure the client that this is not a serious side effect 162\. A nurse is teaching a client about her lisinopril. The client asks what the medication is for. What would be the correct response by the nurse? A. "It is a vasodilator diuretic. It reduces cardiac work and supports circulation." B. \"It increases the force of heart contraction to improve cardiac output." C. \"It causes fluid retention to increase cardiac output." D. \"It constricts the blood vessels to improve oxygen delivery 163\. A client with diastolic heart failure has been prescribed furosemide 40 mg intravenous (IV). Which assessment finding would indicate a therapeutic effect of this medication? A. A drop in systolic blood pressure of 10mmHg B. Regular heart tones C. Clear lung sounds D. A heart rate of 75 beats per minute 165\. A client is taking enalapril. The nurse understands that clients taking this type of medication for heart failure need to be monitored carefully for which of the following electrolyte abnormalities? A. Hypernatremia B. Hypermagnesemia C. Hyperkalemia D. Hypercalcemia 166\. The nurse is preparing to administer the following medications. Which medication should the nurse question administering? A. Hydralazine to the client with a blood pressure of 168/94. B. Prazosin to the client with a serum sodium level of 137 mEq/L. C. Diltiazem to the client with a glucose level of 280 mg/dL. D. Furosemide to the client with a serum potassium level of 3.1 MEq/L 167\. A client is having bursts of ventricular arrhythmias. Which medication should the nurse be prepared to give to resolve this concern? A. Atropine B. Adenosine C. Amiodarone D. Verapamil 168\. A client is taking metoprolol for treatment of hypertension. Which of the following interventions is most critical for the nurse to include in the plan of care? A. Instruct the client to take a second dose if angina occurs. B. Monitor intake and output closely. C. Administer the medication between meals. D. Hold the medication if the heart rate is less than 60 Beats/minute. 170\. A nurse is caring for a client who has a new prescription for verapamil for management of atrial fibrillation. The nurse should instruct the client to avoid grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? A. Tachycardia B. Dehydration C. Diarrhea D. Hypotension 171\. A client has 3+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6.1 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question? A. Bumetanide B. Furosemide C. Spironolactone D. Hydrochlorothiazide 172\. A client who sustained a severe head injury in a motor vehicle accident arrives in the emergency department by ambulance. The provider orders intravenous mannitol. The nurse understands the purpose of this medication is to achieve which of the following? A. Reduce intracranial pressure B. Decrease renal perfusion C. Decrease peripheral edema D. Increase extracellular fluid 173\. Which medication does the nurse identify as a cardiac glycoside? A. Atenolol B. Captopril C. Digoxin D. Furosemide 175\. An adolescent client is taking a leukotriene blocker. Which of these statements by the client requires the most immediate intervention? A. "I will take this medication to prevent asthma attacks." B. "I am still using my rescue inhaler twice a month." C. "This medication is messing with my sleep." D. "I want to die and know how to do it." 176\. The nurse is educating a client regarding the use of omeprazole. What statement by the client shows a proper understanding of how to take this medication? A. "I should chew the medication when my heartburn is bad, so it absorbs more rapidly." B. "I should plan to take this medication for the rest of my life." C. "I should take this medication on an empty stomach before I eat." D. "I should take this medication with an antacid to maximize its Effects. 178\. A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following should the nurse include in the response? A. The medication will loosen respiratory secretions. B. The medication is a cough suppressant. C. The medication will open the airways. D. The medication will reduce interstitial inflammation. 179\. Which of these symptoms might be attributed to the anticholinergic component of a combination of albuterol and ipratropium in an inhalation solution? A. Nervousness B. Tremors C. Hypertension D. Urine retention 181\. A client is receiving intravenous promethazine (Phenergan) 25 mg for postoperative nausea and vomiting. What is an important nursing action when giving this drug? A. Giving the dose as an IV push over 3 to 5 minutes B. Infusing the dose with microbore tubing and an infusion pump C. Observing the IV insertion site frequently for patency D. Telling the client to report dry mouth and sedation 182\. A nurse is observing a student nurse reinforcing teaching to a client on how to take sucralfate. Which statement made by the student would require intervention by the nurse? A. \"Take this in the morning 1 hour before breakfast." B. \"Take this with your other stomach medications." C. \"Take your heart medication 2 hours after sucralfate." D. \"You might experience constipation while taking this medication.\" 184\. An adolescent client is taking a leukotriene blocker. Which of these statements by the client requires the most immediate intervention? A. "I will take this medication to prevent asthma attacks." B. "I am still using my rescue inhaler twice a month." C. "This medication is messing with my sleep." D. "I want to die and know how to do it 187\. A nurse is teaching a client who has asthma the appropriate use of inhaled fluticasone. What advice should the nurse give to help the client avoid complications with the use of inhaled steroids? A. Check the pulse after taking the medication. B. Take the medication before eating. C. Rinse your mouth after inhaling the medicine. D. Limit your caffeine intake. 191\. A client going on a vacation cruise is prescribed a scopolamine transdermal patch for motion sickness. The nurse teaches the client to recognize which of the following side effects? A. Increased heart rate B. Dry mouth C. Irritability D. Urinary frequency 192\. Which side effects should the nurse explain to the male client who is prescribed cimetidine? A. The medication can cause indigestion and heartburn. B. The medication can cause impotence and gynecomastia. C. The medication can cause insomnia and hypervigilance. D. The medication can cause Zollinger-Ellison syndrome. 193\. Which statement is the scientific rationale for administering a proton-pump inhibitor (PPI) to a client diagnosed with gastroesophageal reflux disease (GERD)? A. PPI medications neutralize the gastric secretions B. PPI medications block H2 receptors on the parietal cells. C. PPI medications inhibit the enzyme that generates gastric acid. D. PPI medications form a protective barrier against acid and Pepsin. 197\. The nurse is administering morning medications. Which medication should the nurse question? A. Misoprostol to a 29-year-old pregnant female with a non- steroidal anti-inflammatory drug (NSAID)-produced ulcer. B. Omeprazole to a 68-year-old male with a duodenal ulcer. C. Furosemide to a 56-year-old male with a potassium level of 4.2 mEq/L. D. Acetaminophen to an 84-year-old female with a frontal Headache. 198\. A nurse is talking with a client who has peptic ulcer disease and is starting therapy with sucralfate. The nurse should include which instruction about the medication? A. Take it with an antacid. B. Take 1 hour before meals and at bedtime. C. Take it whenever indigestion occurs. D. Take it immediately after meals 203\. Which patient should receive dantrolene with caution? A. A 20-year-old woman with a spinal cord injury B.A 45-year-old man with a history of malignant hyperthermia C. A 55-year-old woman with cirrhosis of the liver D.An 8-year-old child with cerebral palsy 204\. A client is taking a first-generation antipsychotic (FGA) for schizophrenia. The nurse notes that the client has trouble speaking and chewing and observes slow, worm- like movements of the client's tongue. The nurse recognizes which adverse effect in this client? A. Acute dystonia B.Akathisia C. Tardive dyskinesia D.Focal seizure 207\. A client who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the client has a shuffling gait and mild tremors. The nurse will ask the client's provider about which course of action? A. Administering a direct dopamine antagonist B. Giving an anticholinergic medication C. Increasing the dose of the antipsychotic medication D. Switching to a second-generation antipsychotic 209\. The nurse should include which intervention in the care-plan of a client taking lithium? A. Advocate for diuretics if hypertension occurs. B. Offer ibuprofen as needed for medication-induced headaches. C. Report impaired coordination and tremors. D. Teach the client to expect skipped heartbeats. 210\. A nurse in a physician's office is reviewing client lab results and notes a phenytoin level was drawn. Which client lab result would the nurse report to the physician immediately due to concerns of phenytoin toxicity? A. 4 mcg/mL B.9 mcg/mL C. 17 mcg/mL D.26 mcg/mL 211\. The nurse is caring for a client with bipolar disorder (BPD) who is taking lithium (Lithobid). Which laboratory value is most essential for the nurse to communicate to the healthcare provider while the client is taking this medication? A. Sodium level of 126 mEq/L B. Prothrombin time of 11 seconds C. Blood urea nitrogen level of 25 mg/dL D. Potassium level of 4.9 mEq/L 212\. The nurse is assigned to care for several patients on the psychiatric floor of a healthcare facility. Which of the following clients requires the nurse's immediate attention? A. A client with bipolar disorder who takes valproic acid (Depakene) and is reporting nausea and vomiting B. A client with bipolar disorder who takes lithium and has a lithium level of 1.6 mEq/L 213\. The client admitted to the psychiatric unit diagnosed with schizophrenia is prescribed clozapine. Which laboratory data should the nurse evaluate? A. The client's clozapine therapeutic level. B.The client's white blood cell (WBC) count. C. The client's serum sodium level. D. The client's arterial blood gases (ABGs). 216\. Which skeletal muscle relaxant is also the drug of choice for treating malignant hyperthermia? A. Baclofen B. Dantrolene C. Diazepam D. Tizanidine 224\. The nurse is administering a medication with a narrow therapeutic index. Which does the nurse know to be true about this type of medication? A. Altered metabolism rates would have no impact on the individual B. Dose changes must be large to create the desired therapeutic effect C. Therapeutic failure occurs easily when dosages are decreased D. Dose changes must be monitored closely to prevent toxicity 225\. A client with decreased cardiac output would most likely have impairment of which of the following pharmacokinetic processes? A. Absorption B. Distribution C. Metabolism D. Excretion 227\. For which reason should the nurse follow safe medication administration, particularly when administering intravenous (IV) medications? A. The IV route can result in delayed absorption of the medication B.The IV route results in a delayed onset of action C. Control over the levels of drug in the body is unpredictable D. The IV route results in a rapid onset of action 230\. The nurse is preparing to administer a medication with a low therapeutic index. The nurse understands that a low therapeutic index is best described as which of the following? A. The average lethal dose of the medication is much higher than the therapeutic dose B. The dose required to produce a therapeutic response in 50% of patients is low C. The highest dose needed to produce a therapeutic effect is close to the lethal dose D. There is a low variability of responses to this medication 236\. The nurse is monitoring for adverse drug reactions of assigned clients. Which client is most at risk for the development of drug toxicity? A. A 30-year-old man admitted for altered mental status B.A 55-year-old woman with abnormal arterial blood gas values C. A 70-year-old woman with an elevated creatinine level D.A 25-year-old woman with a urinary tract infection 237\. The nurse is caring for four different clients. Which of these clients should the nurse assess first? A.The client who is receiving digoxin with a blood pressure of 110/85 mmHg.. B.The client who can have nothing by mouth for a scheduled surgery this morning and received an ordered dose of insulin glargine the night before. C.The client who has a history of rheumatoid arthritis complaining of 5/10 pain in the joints of his hands. D.The client who requires a chlorhexidine scrub prior to a double mastectomy this morning 238\. The nurse is providing instructions to a client who is beginning therapy with digoxin. What instruction will the nurse provide to the client to ensure safety? A. Take pulse daily B. Have electrolytes levels drawn monthly C. Monitor the blood pressure once a week D. Measure their weight each morning before

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