Pharma Final Exam PDF

PHARM FINAL EXAM Question 6 A client in her first trimester of pregnancy asks the nurse which medications to avoid during pregnancy. The nurse's response is based on the knowledge that during pregnancy: Most over-the-counter medications are safe for use. It is best to discontinue all...

PHARM FINAL EXAM Question 6 A client in her first trimester of pregnancy asks the nurse which medications to avoid during pregnancy. The nurse's response is based on the knowledge that during pregnancy: Most over-the-counter medications are safe for use. It is best to discontinue all drugs used to treat medical conditions. When possible, drug therapy is postponed until pregnancy and lactation. The decision of whether or not to take medication is the responsibility of the mother. Answer: When possible, drug therapy is postponed until pregnancy and lactation. Question 7 A pregnant client asks the nurse what factors determine whether a drug will cross the placenta. The nurse's response will be based on which of the following principles? Drugs with larger molecular weights pass rapidly through the placental membrane. The lower the lipid content, the more easily the drugs cross the placental membrane. Highly protein-bound drugs pass rapidly through the placental membrane. Highly lipid-soluble drugs cross the placental membrane more easily than drugs with low lipid solubility. Answer: Highly lipid-soluble drugs cross the placental membrane more easily than drugs with low lipid solubility. Question 8 You are a nurse working in a long-term care facility with predominantly older adult patients. You are aware that older adults are more susceptible to confusion, forgetfulness, and an increased risk for falls when taking which of the following medications? Diuretics Laxatives  Sedatives Anticoagulants Answer: Sedatives. Question 9 The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk as related to drug therapy? Hyperperistalsis of the GI tract Immature renal system Smaller circulatory capacity Regular temperature regulation Answer: Immature renal system. Question 10 An Aboriginal client states, "I will only take medications that are approved by the shaman." The nurse understands that this statement reflects the client's: Ethnicity Health-related bias Genetic polymorphism Cultural belief Answer: Cultural belief. Question 11 It is 0245H and you have just called the prescriber to report that your client is experiencing an acute episode of perioperative pain. How can the nurse avoid medication errors when receiving a telephone order from a prescriber? Repeat the order back verbally to ensure accuracy. Decline to accept the telephone order.  Wait until the morning to consult with the prescriber and offer non-pharmacological pain-relieving measures throughout the night. Call the pharmacy and double-check that the order is appropriate. Answer: Repeat the order back verbally to ensure accuracy. Question 12 Your patient is receiving multiple medications, including one drug specifically used to stimulate gastric peristalsis. What influence could this drug have on additional oral medications? Reduced excretion Enhanced distribution Increased absorption Decreased absorption Answer: Decreased absorption. Question 13 A nurse is caring for a client with hepatitis and resulting hepatic impairment. The nurse would expect the duration of action of most of the client's medications to: Be unaffected Increase Decrease Improve Answer: Increase. Question 14 Each of the following statements describes a phase of pharmacogenetics. Place the statements in order, indicating the first phase and last phase: 1. A drug binds to the plasma proteins, albumin, and circulates through the body.  2. Enzymes in the liver transform the drug into an inactive metabolite. 3. Drug metabolites are secreted through passive glomerular filtration into the renal tubules. 4. A drug moves from the intestinal lumen into the mesenteric bloodstream. Answer: 1. A drug moves from the intestinal lumen into the mesenteric bloodstream. 2. A drug binds to the plasma proteins, albumin, and circulates through the body. 3. Enzymes in the liver transform the drug into an inactive metabolite. 4. Drug metabolites are secreted through passive glomerular filtration into the renal tubules. Question 15 What evidence does the nurse collect to determine whether the average dose of a medication is effective for a client? (Select all that apply): Route of administration Laboratory values Dosage time Physical examination Vital signs Answer: Laboratory values, Physical examination, Vital signs. These provide objective evidence of the medication's therapeutic effect. Question 16 A patient with a feeding tube has been ordered risperidone 8 mg in two divided doses via the feeding tube. The medication is available in 1 mg/mL solution. How many milliliters will the nurse administer per dose? Answer: 4 mL per dose. Each dose is 4 mg, and the solution concentration is 1 mg/mL. Question 17 A nurse expects that a client experiencing extrapyramidal symptoms during therapy with benzodiazepines will be prescribed: Haloperidol Diazepam Benztropine Lorazepam Answer: Benztropine. Benztropine is used to treat extrapyramidal symptoms. Question 18 You are the nurse caring for a patient three days post-op from bowel surgery. They’re eating soft food, ambulating regularly, and using oxycodone plus acetaminophen for pain. What would you include in the nursing care plan? Increasing dietary fiber and fluids Assessing the need for a stool softener Weaning pain medication to prevent addiction Inserting a urinary catheter for urinary retention Monitoring vital signs for respiratory depression Answer: Increasing dietary fiber and fluids, Assessing the need for a stool softener. Opioids like oxycodone can cause constipation, so these interventions are essential. Question 19 During a patient’s recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply): Muscle rigidity Tachypnea Respiratory depression Tachycardia Decreased levels of CO2 in the blood Answer: Muscle rigidity, Tachypnea, Tachycardia. These are key indicators of malignant hyperthermia. Question 20 Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply): The drug is used as a first choice for the treatment of sleeplessness. The drug can be administered safely with other benzodiazepines for insomnia. The patient needs to be evaluated for drowsiness that may occur the next morning. These drugs are intended for long-term management of insomnia. The dose needs to be given about one hour before the patient’s bedtime. Answer: The patient needs to be evaluated for drowsiness that may occur the next morning, The dose needs to be given about one hour before the patient’s bedtime. Question 21 The nurse is discussing the therapeutic effects of bethanechol with a patient who is receiving this drug for urinary retention. The nurse understands that bethanechol: Changes the diameter of the urethral opening Increases the amount of urine made in the kidneys Improves blood flow to the kidneys Increases the contractions of the bladder and structures that promote urination Answer: Increases the contractions of the bladder and structures that promote urination. Question 22 Which of the following is an anticholinergic drug that decreases mucus secretions in the respiratory tract and dries mucous membranes of the mouth, nose, pharynx, and bronchi? Acetylcholinesterase inhibitors Bethanechol  Atropine Ipratropium Answer: Atropine. Question 23 A patient who has had an accidental overdose of tricyclic antidepressants is to receive physostigmine 1.5 mg stat. The medication is available in a 2 mL vial with a concentration of 1 mg/mL. How much medication will the nurse draw into the syringe for this dose? Answer: 1.5 mL. Question 24 The nurse is teaching a patient about the possible adverse effects of Donepezil for Alzheimer’s disease. Which of these are possible adverse effects? (Select all that apply): Dizziness Constipation Blurred vision Drowsiness GI upset Answer: Dizziness, Drowsiness, GI upset. Question 25 A client is receiving hydralazine for elevated blood pressure levels. The nurse care plan will include monitoring the client for which adverse effect? Atelectasis Observing skin pressure points for turgor or integrity Orthostatic hypotension Photosensitivity Answer: Orthostatic hypotension. Question 26 A client with chest pain is receiving sublingual nitroglycerin. The nurse’s care plan will include monitoring the client for what adverse effects? Elevated blood pressure Decreased blood pressure Vomiting and diarrhea Photosensitivity Answer: Decreased blood pressure. Question 27 Your patient has been admitted for angina. You understand angina occurs when: The supply of oxygen and nutrients in the blood is insufficient to meet the demands of the heart. Beta-2 adrenergic receptors are activated in the lungs, and bronchodilation occurs. There is a deviation from the normal rhythm of the heart. The RAAS is decreasing blood volume. Answer: The supply of oxygen and nutrients in the blood is insufficient to meet the demands of the heart. Question 28 A client newly diagnosed with heart failure following an acute MI has a prescription for enalapril. This drug is frequently used in early heart failure because of which clinical improvement? It has diuretic effects, decreasing peripheral edema and pulmonary congestion. It strengthens the force of myocardial contraction to improve cardiac output. It decreases peripheral vascular resistance, increasing cardiac output. It slows the heart rate, improving filling time and increasing cardiac output. Answer: It decreases peripheral vascular resistance, increasing cardiac output. Question 29 Your client is prescribed propranolol for the treatment of arterial dysrhythmias associated with heart failure. The nurse knows that this drug is used cautiously in clients with heart failure because of which effect? It may lead to bronchoconstriction. It causes sodium retention, worsening congestion. It is a negative inotropic drug and will decrease myocardial contractility and cardiac output. Its adverse effects include hypertension and worsening heart failure. Answer: It is a negative inotropic drug and will decrease myocardial contractility and cardiac output. Question 30 A client who is taking warfarin states, "I wake up every morning with arthritis pain, and I always take aspirin or ibuprofen." The nurse’s response would be based on which physiological concept? The combination of aspirin products with anticoagulants will worsen arthritis pain. Aspirin and ibuprofen will counteract the therapeutic effects of many anticoagulants. Anticoagulants will reduce the half-life of drugs, such as aspirin and ibuprofen. Many substances, such as aspirin and ibuprofen, will increase the risk of bleeding. Answer: Many substances, such as aspirin and ibuprofen, will increase the risk of bleeding. Question 31 The nurse is caring for a client receiving gemfibrozil (Lopid) for hyperlipidemia. The nurse would question the order with the prescriber if the client reported a history of which of the following? (Select all that apply): Diabetes Hypertension  Renal disease Gallbladder disease Angina Answer: Renal disease, Gallbladder disease. Question 32 The order reads: Give mannitol 0.05 g/kg IV now over two hours. The patient weighs 165 lbs, and you have a 100 mL vial of 20% mannitol. How many grams will the patient receive, and how many milliliters will you prepare for the infusion? Answer: Grams: 3.7 g. Milliliters: 18.8 mL. Question 33 A client with type 1 diabetes will use a combination insulin that includes NPH and regular insulin. The nurse explains the importance of knowing the peak times for both insulins. Why is this important information for the client to know? Additional insulin may be required during the peak periods to avoid hyperglycemia. The risk of hypoglycemia is greatest around the peak periods of insulin. You can skip taking a meal if it is not within the peak periods of insulin action. The client will be able to estimate the next dose of insulin based on peak times. Answer: The risk of hypoglycemia is greatest around the peak periods of insulin. Question 34 A client on replacement therapy with levothyroxine reports feeling nervous and is having occasional palpitations and tremors. The nurse recognizes that these symptoms may indicate which effect is occurring? The client now has normal thyroid function and the levothyroxine is no longer needed. The client is experiencing symptoms of hyperthyroidism, and the drug dosage may need to be decreased.  The client has developed diabetes and needs further evaluation. The client is still experiencing symptoms of hypothyroidism, and the dose may need to be increased. Answer: The client is experiencing symptoms of hyperthyroidism, and the drug dosage may need to be decreased. Question 35 Which of the following assessment findings would the nurse expect to observe in an adult client experiencing therapeutic effects from levothyroxine? (Select all that apply): Constipation and weight gain Decreased blood cholesterol levels Decreased lacrimation and saliva Pulse rate between 60 and 100 bpm Decreased reports of fatigue Answer: Decreased blood cholesterol levels, Pulse rate between 60 and 100 bpm, Decreased reports of fatigue. Question 36 A client with asthma asks which of the following prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse will instruct the client to use: Zafirlukast Beclomethasone Ipratropium Salbutamol Answer: Salbutamol. Question 37 The nurse should inform the client who is prescribed a nebulizer treatment with salbutamol (Ventolin) that a common adverse effect is: Temporary dyspnea A predisposition to infection An increased heart rate with palpitations Sedation Answer: An increased heart rate with palpitations. Question 38 Ondansetron (Zofran) has been ordered prior to chemotherapy for your patient receiving treatment for breast cancer. Prior to administering this drug, the nurse will review the client’s past medical history for which condition? Allergy to eggs or soy products History of chronic constipation Glaucoma Cardiac dysrhythmias Answer: Cardiac dysrhythmias. Ondansetron may prolong QT intervals and should be used cautiously in patients with cardiac issues. Question 39 The nurse is scheduling her client’s daily medication. When would be the most appropriate time for the client to receive proton pump inhibitors? Half an hour before a meal Once daily at 0800 Bedtime Two hours before or after a meal Answer: Half an hour before a meal. Question 40 A nurse is caring for a patient with gastroesophageal reflux disease (GERD). The nurse should question the order for which drug to treat this condition? Antibiotics Antacids H2 receptor antagonist Proton pump inhibitor Answer: Antibiotics. GERD is not caused by an infection and does not require antibiotics. Question 41 Which instruction should the nurse give a 21-year-old female patient being treated with ampicillin? An antibiotic taken concurrently with oral contraceptives causes toxicity. Use oral contraceptives as prescribed because antibiotics do not react with birth control pills. Stop taking the oral contraceptive because serious drug interactions can occur. The antibiotic may decrease the effectiveness of oral contraceptives. Answer: The antibiotic may decrease the effectiveness of oral contraceptives. Question 42 A client reports abnormal vaginal discharge after completing a prescription of cefotaxime. For which condition is the client most likely exhibiting symptoms? Superinfection Clostridium difficile Hypersensitivity reaction Antibiotic toxicity Answer: Superinfection. Question 43 You are caring for a patient who has reported a previous allergic reaction to penicillin. You know that this patient may also have a sensitivity to which other classification of antibiotics? Cephalosporins Sulfonamides Tetracyclines Macrolides Answer: Cephalosporins. There is potential cross-reactivity between penicillins and cephalosporins. Question 44 A patient is admitted with a fever of 39°C of unknown origin. Assessment reveals bilateral crackles and a productive cough. The prescriber has ordered sputum and blood cultures and the administration of ampicillin 500 mg IV stat and Q6H. What is the correct sequence for the nurse to follow to complete these orders? Blood and sputum cultures, then ampicillin dose Blood culture, ampicillin dose, sputum culture Sputum culture, ampicillin dose, blood culture Ampicillin dose, blood and sputum cultures Answer: Blood and sputum cultures, then ampicillin dose. Cultures must be obtained before antibiotics are administered to ensure accurate results. Question 45 Your patient is receiving gentamicin 1 mg/kg IV Q8H for the treatment of pneumonia. Which of the following assessment results may indicate a possible toxicity of this drug? Decreased blood urea nitrogen (BUN) and creatinine levels Skin rash and fever Tinnitus and hearing loss A peak serum drug level of 7 mcg/mL Answer: Tinnitus and hearing loss. Gentamicin can cause ototoxicity, a significant adverse effect. Question 46 You are caring for a patient who is receiving treatment for a viral infection. Which of the following would you expect to see as a therapeutic response? Elimination of the virus Resistance to future viral infections Delayed progression of HIV infection Eradication of a superinfection Answer: Delayed progression of HIV infection. Antiviral drugs often suppress replication rather than eradicate the virus. Question 47 Your patient has been prescribed the antifungal medication ketoconazole to treat an infection. What monitoring should the nurse ensure is included prior to beginning drug therapy? Neurological vital signs Snellen eye exam International normalized ratio (INR) Hepatic function studies Answer: Hepatic function studies. Ketoconazole can cause hepatotoxicity, so liver function tests are critical. Question 48 Harrison is a four-month-old infant brought to the clinic for a check-up. The mother states that the child has never been ill and is meeting milestones. Which factor would the nurse consider most significant in assessing the baby’s likelihood of receiving immunizations?  Maternal and paternal allergies or reactions related to vaccine administration Nurse’s knowledge of the recommended pediatric immunization schedule Mother’s preconceptions and reservations relating to vaccines Allergy to previously prescribed medications Answer: Mother’s preconceptions and reservations relating to vaccines. Question 49 The nurse determines that the client understands the teaching given for required care following a tetanus toxoid injection when the client states: "I will limit my fluid intake for the next 24 hours." "I will take acetaminophen (Tylenol) if my arm gets sore." "I will avoid crowds and people for the next seven days as I will be temporarily immunocompromised from the immunization." "I will keep my arm still for 24 hours for maximum absorption." Answer: "I will take acetaminophen (Tylenol) if my arm gets sore." Question 50 Which of the following are included in the roles and responsibilities of RPNs in medication administration? (Select all that apply): Monitoring for adverse effects Monitoring laboratory studies if applicable Providing health teaching regarding drug use Monitoring for therapeutic responses to drug treatment Completing the "eight rights" and three checks Answer: Monitoring for adverse effects, Monitoring laboratory studies if applicable, Providing health teaching regarding drug use, Monitoring for therapeutic responses to drug treatment, Completing the "eight rights" and three checks. Question 51 A client with hypothyroidism reports feeling cold, fatigued, and having dry skin despite taking levothyroxine regularly. The nurse suspects: The dosage of levothyroxine may need to be increased. The client is experiencing side effects of levothyroxine. The client has developed a resistance to the medication. The client should stop taking levothyroxine. Answer: The dosage of levothyroxine may need to be increased. These symptoms suggest undertreated hypothyroidism. Question 52 A client has been prescribed albuterol (salbutamol) for acute bronchospasm. The nurse explains that the medication works by: Increasing mucus production to clear the airways. Reducing inflammation in the respiratory tract. Relaxing bronchial smooth muscle to improve airflow. Suppressing the immune response to allergens. Answer: Relaxing bronchial smooth muscle to improve airflow. Question 53 A nurse is discussing the adverse effects of corticosteroid use with a client diagnosed with asthma. Which of the following should the nurse include? (Select all that apply): Weight gain Increased susceptibility to infection Hypoglycemia Osteoporosis Drowsiness Answer: Weight gain, Increased susceptibility to infection, Osteoporosis. Question 54 The nurse is caring for a patient with diabetes who has been prescribed a beta-blocker. The nurse should monitor for which complication? Hypoglycemia masked by beta-blocker effects Increased insulin sensitivity Weight loss due to increased metabolism Hyperglycemia due to decreased insulin production Answer: Hypoglycemia masked by beta-blocker effects. Beta-blockers can mask symptoms of hypoglycemia, such as tachycardia. Question 55 Which instruction should the nurse provide a client using nitroglycerin patches for angina? Apply the patch in the evening before bed. Rotate application sites to prevent skin irritation. Use patches continuously, replacing them every 12 hours. Avoid applying the patch to the chest area. Answer: Rotate application sites to prevent skin irritation. Question 56 A client receiving warfarin therapy is advised to limit intake of which of the following foods? Leafy green vegetables Dairy products High-protein meats Citrus fruits Answer: Leafy green vegetables. These are high in vitamin K, which can counteract the effects of warfarin. Question 57 A patient is prescribed digoxin. The nurse knows to monitor for signs of toxicity, including: Bradycardia, nausea, and visual disturbances Tachycardia, dry mouth, and diarrhea Hypertension, headache, and confusion Muscle cramps, weight gain, and fatigue Answer: Bradycardia, nausea, and visual disturbances. Signs of digoxin toxicity include gastrointestinal distress, bradycardia, and visual changes like yellow halos. Question 58 A client receiving heparin therapy reports blood in their urine. The nurse’s first action is to: Stop the infusion and notify the healthcare provider Reduce the dose and monitor the client Reassure the client that this is a common side effect Obtain a urine sample for testing Answer: Stop the infusion and notify the healthcare provider. Blood in the urine is a sign of bleeding, which may indicate heparin toxicity. Question 59 A patient has been prescribed furosemide for heart failure. Which laboratory values should the nurse monitor? (Select all that apply): Potassium levels Blood glucose levels Calcium levels Sodium levels White blood cell count Answer: Potassium levels, Sodium levels. Furosemide can cause hypokalemia and hyponatremia, making electrolyte monitoring essential. Question 60 A client with rheumatoid arthritis is prescribed methotrexate. Which teaching point is most important for the nurse to include? Avoid alcohol to prevent liver damage Monitor for signs of infection only when symptoms are severe Increase intake of green leafy vegetables Take methotrexate with antacids to reduce gastrointestinal discomfort Answer: Avoid alcohol to prevent liver damage. Methotrexate is hepatotoxic, so alcohol should be avoided. Question 61 A nurse is administering vancomycin IV to a client. What is the primary reason for administering the medication over a prolonged period? To minimize the risk of developing resistance To avoid causing phlebitis at the infusion site To reduce the risk of ototoxicity and nephrotoxicity To prevent "red man syndrome" Answer: To prevent "red man syndrome." Rapid infusion of vancomycin can cause flushing, hypotension, and a rash known as "red man syndrome." Question 62 A client reports taking aspirin daily for pain. The nurse should monitor for which adverse effects? (Select all that apply): Gastrointestinal bleeding Tinnitus Hypoglycemia Hepatotoxicity Prolonged bleeding time Answer: Gastrointestinal bleeding, Tinnitus, Prolonged bleeding time. Question 63 A client with type 2 diabetes is prescribed metformin. The nurse knows the client should be monitored for: Hepatotoxicity Lactic acidosis Hypokalemia Hyperglycemia Answer: Lactic acidosis. This rare but serious complication is associated with metformin, especially in clients with renal impairment. Question 64 A client is prescribed erythromycin. The nurse instructs the client to report which potential side effect immediately? Nausea and vomiting Hearing loss or ringing in the ears Diarrhea Muscle pain Answer: Hearing loss or ringing in the ears. Erythromycin can cause ototoxicity, which should be addressed immediately. Question 65 The nurse is administering levodopa/carbidopa to a client with Parkinson’s disease. Which client statement indicates a need for further teaching? "This medication should help reduce my tremors." "I should avoid high-protein meals when taking this medication." "I can stop taking this medication when my symptoms improve."  "I might experience nausea when starting this medication." Answer: "I can stop taking this medication when my symptoms improve." Levodopa/carbidopa requires consistent use to manage symptoms effectively. Question 66 A nurse is caring for a client taking atropine. Which of the following adverse effects should the nurse monitor for? (Select all that apply): Dry mouth Blurred vision Bradycardia Urinary retention Diarrhea Answer: Dry mouth, Blurred vision, Urinary retention. These are common anticholinergic effects of atropine. Question 67 A client with depression is prescribed fluoxetine. The nurse should monitor for which adverse effects? (Select all that apply): Weight gain Sexual dysfunction Insomnia Sedation Orthostatic hypotension Answer: Weight gain, Sexual dysfunction, Insomnia. Question 68 The nurse is teaching a client prescribed lithium for bipolar disorder. Which dietary instruction should the nurse include?  Avoid foods high in potassium Maintain consistent sodium intake Increase protein intake Reduce caffeine consumption Answer: Maintain consistent sodium intake. Fluctuations in sodium can affect lithium levels and increase the risk of toxicity. Question 69 A nurse is administering phenytoin to a client with epilepsy. The nurse should monitor for which adverse effects? (Select all that apply): Gingival hyperplasia Ataxia Rash Hepatotoxicity Hyperglycemia Answer: Gingival hyperplasia, Ataxia, Rash. Question 70 The nurse is caring for a client receiving spironolactone. Which finding should the nurse report immediately? Serum potassium level of 6.2 mEq/L Blood pressure of 110/70 mmHg Urine output of 100 mL/hour Serum sodium level of 138 mEq/L Answer: Serum potassium level of 6.2 mEq/L. Spironolactone is a potassium-sparing diuretic, and hyperkalemia is a serious adverse effect. Question 71 A client taking prednisone for an inflammatory condition asks the nurse about stopping the medication. The nurse's best response is:  "You can stop the medication when your symptoms improve." "You need to gradually taper off the medication as directed by your healthcare provider." "You will need to continue the medication for the rest of your life." "You can stop taking it if you experience any side effects." Answer: "You need to gradually taper off the medication as directed by your healthcare provider." Abruptly stopping prednisone can lead to adrenal insufficiency. Question 72 A client with a history of peptic ulcer disease is prescribed ibuprofen for pain. Which teaching point is most important for the nurse to include? Take the medication with food to minimize gastric irritation. Stop the medication if you experience constipation. This medication is safe for long-term use. Increase fluid intake to prevent dehydration. Answer: Take the medication with food to minimize gastric irritation. NSAIDs like ibuprofen can irritate the gastric lining. Question 73 A client taking warfarin reports a new prescription for trimethoprim-sulfamethoxazole. The nurse should: Advise the client to increase their dose of warfarin. Notify the healthcare provider immediately. Instruct the client to stop taking warfarin while on the antibiotic. Encourage the client to monitor for increased bruising. Answer: Notify the healthcare provider immediately. Trimethoprim-sulfamethoxazole can potentiate warfarin's anticoagulant effects, increasing the risk of bleeding. Question 74 The nurse is teaching a client about the therapeutic effects of loratadine. The client is receiving this medication for: Allergic rhinitis Chronic pain Migraine headaches Hypertension Answer: Allergic rhinitis. Question 75 A nurse is caring for a client receiving furosemide. Which finding should prompt the nurse to hold the dose and contact the healthcare provider? Blood pressure of 120/80 mmHg Potassium level of 3.1 mEq/L Heart rate of 80 beats per minute Sodium level of 140 mEq/L Answer: Potassium level of 3.1 mEq/L. Furosemide can cause hypokalemia, which requires intervention. Question 76 A client is prescribed zolpidem for insomnia. The nurse should include which teaching point? Take the medication with a full meal for best absorption. Avoid engaging in activities that require alertness after taking the medication. You may safely drink alcohol while taking this medication. Take this medication for long-term management of insomnia. Answer: Avoid engaging in activities that require alertness after taking the medication. Zolpidem can cause drowsiness and impair coordination. Question 77 The nurse is administering methyldopa to a client with hypertension. The nurse should monitor for which potential adverse effect? Hyperkalemia Sedation Tachycardia Constipation Answer: Sedation. Question 78 A client receiving ferrous sulfate for anemia should be instructed to: Take the medication with milk to improve absorption. Expect dark, tarry stools as a normal side effect. Take the medication on an empty stomach for best results. Discontinue the medication if stomach upset occurs. Answer: Expect dark, tarry stools as a normal side effect. Question 79 A nurse is reviewing the laboratory results of a client receiving clozapine for schizophrenia. The nurse should prioritize which result? Elevated liver enzymes Decreased white blood cell count Increased blood glucose level Low serum potassium Answer: Decreased white blood cell count. Clozapine can cause agranulocytosis, which is life-threatening. Question 80 A client receiving isoniazid for tuberculosis should be monitored for which adverse effect? Hepatotoxicity Renal impairment Constipation Visual disturbances Answer: Hepatotoxicity. Isoniazid can cause liver damage, so monitoring liver function is essential. Question 81 A nurse is caring for a client taking amiodarone for ventricular arrhythmias. Which adverse effect is most concerning? Cough and shortness of breath Constipation and dry mouth Fatigue and dizziness Blurred vision Answer: Cough and shortness of breath. Amiodarone can cause pulmonary toxicity, which is life-threatening. Question 82 The nurse is teaching a client about rifampin for tuberculosis. Which teaching point is most important to include? Expect urine and other body fluids to turn orange-red. Take the medication with food to prevent nausea. Avoid alcohol to prevent liver damage. Monitor for signs of peripheral neuropathy. Answer: Expect urine and other body fluids to turn orange-red. Question 83 A client with severe rheumatoid arthritis is prescribed etanercept. The nurse should monitor the client for which potential adverse effect? Infection Increased blood pressure Weight gain Hypoglycemia Answer: Infection. Etanercept suppresses the immune system, increasing the risk of infections. Question 84 A client prescribed propranolol for hypertension reports feeling dizzy when standing. The nurse explains this is likely due to: An allergic reaction to the medication. Orthostatic hypotension caused by the medication. Dehydration related to the medication. A need for a higher dose of the medication. Answer: Orthostatic hypotension caused by the medication. Question 85 A client prescribed atorvastatin reports muscle pain and weakness. The nurse’s first action is to: Reassure the client that muscle pain is a common side effect. Notify the healthcare provider immediately. Advise the client to increase fluid intake. Discontinue the medication immediately. Answer: Notify the healthcare provider immediately. Muscle pain may indicate rhabdomyolysis, a rare but serious side effect. Question 86 A client is prescribed metoprolol for hypertension. Which adverse effect should the nurse monitor for? Bradycardia Hyperglycemia Diarrhea Hypertension Answer: Bradycardia. Metoprolol, a beta-blocker, can reduce heart rate. Question 87 The nurse is administering naloxone to a client experiencing opioid overdose. Which priority assessment should the nurse perform? Monitoring respiratory rate Assessing for pain relief Monitoring heart rate Assessing for signs of withdrawal Answer: Monitoring respiratory rate. Naloxone is administered to reverse respiratory depression caused by opioids. Question 88 A client with a history of bipolar disorder is prescribed valproic acid. Which laboratory value is most important for the nurse to monitor? White blood cell count Liver function tests Serum potassium Blood glucose Answer: Liver function tests. Valproic acid can cause hepatotoxicity, so liver enzymes must be monitored. The nurse is scheduling her client’s daily medication. When would be the most appropriate time for the client to receive proton pump inhibitors (PPIs)? Half an hour before a meal Once daily at 0800 Bedtime Two hours before or after a meal Answer: Half an hour before a meal. Proton pump inhibitors are most effective when taken before meals as they inhibit gastric acid secretion, which is typically triggered by food intake. Question 89 A client receiving gentamicin reports hearing loss and dizziness. The nurse’s priority action is to: Discontinue the medication and notify the provider Reassure the client that these symptoms are temporary Administer the next dose and monitor closely Perform a hearing test after the full course of treatment Answer: Discontinue the medication and notify the provider. Hearing loss and dizziness indicate ototoxicity, a severe adverse effect of gentamicin.