The nurse is transcribing a new prescription for spironolactone (Adactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement?
A. Verify both prescriptions with the healthcare provider.
B. R
Verify both prescriptions with the healthcare provider.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate
Vomiting
A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications?
A. Do not add salt to foods during preparation.
B. Refrain for eating foods high in
Refrain for eating foods high in potassium.
Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.)
A. Prednisone (Deltasone)
Albuterol (Proventil) puffs. Aminophylline (Truphyline) IV Prednisone (Deltasone) orally. Gentamicin (Garamycin) IM.
In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse should encourage the client to report which adverse response to the healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body
Presence of hand tremors.
When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body?
A. Flank.
B. Abdomen.
C. Chest.
D. Head.
Abdomen
A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs?
A. Rash.
B. Nausea.
C. Headache.
D. Dizziness.
Rash.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective?
A. T
Take medication, go for a 30 minute morning walk, then eat breakfast.
An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client?
A. Apply the patch at least 4 hours prior to departure.
B. Change the
Apply the patch at least 4 hours prior to departure.
A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting
Administer only the Dilaudid q4h PRN for pain.
Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved?
A. Dependent edema reduced from +3 to +1.
B. Serum HDL increased from 35 to 55 mg/dl.
C. Pulse rate reduced
Blood pressure reduced from 160/90 to 130/80.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
A. Administer both medications according to the prescription.
B. Hold the ketorolac to prevent an antagonis
Administer both medications according to the prescription.
Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A. Hydrate the client with IV fluids before and after infusion.
B. Assess the client for numbness and tinglin
Inspect the client's oral mucosa for ulcerations.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to
A. decrease production of gastric secretions.
B. produce an adherent barrier over the ulcer.
C. maintain a gastric pH of 3.
maintain a gastric pH of 3.5 or above.
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. Antacids.
B. Benzodiazepines.
C. Antihypertensives.
D. Oral antidiabetics.
Benzodiazepines.
he nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.
Epinephrine
Which method of medication administration provides the client with the greatest first-pass effect?
A. Oral.
B. Sublingual.
C. Intravenous.
D. Subcutaneous.
Oral
A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teachin
Use contraception during intercourse.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition?
A. Shock.
B. Asthma.
C. Hypotension.
D. Heart failure
Heart failure.
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this
Decreased muscle weakness.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved?
A. Client states chest pain is relieved.
B. Client's puls
Client states chest pain is relieved.
A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory findings should the nurse identify that places this client at risk?
A. Hypokalemia.
B. Hyponatremia.
C. Hypercalcemia.
D. Low uric acid levels
Hypokalemia
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always ris
Do not get up quickly. Always rise slowly.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to administering the digoxin?
A. Observe respiratory rate and depth.
B. Assess the serum potas
Assess the serum potassium level.
A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription?
A. Penicillins.
B. Aminogly
Penicillins
Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)?
A. Assess pupillary response to light.
B. Instruct the client that facial flushing may occur.
C. Apply continuous cardi
Apply continuous cardiac monitoring.
Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)?
A. Fluid volume deficit.
B. Risk for infection.
C. Risk for injury.
D. Impaired sleep patterns.
Risk for injury.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction?
A. Notify the clinic of any changes in the color of urine.
B. Avoid overexposure to the sun.
C. Stop the medicati
Take the medication with food.
The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? The client's
A. statement that the chest pain is better.
B. respiratory rate is 16 breaths/
respiratory rate is 16 breaths/minute.
A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What action should the nurse take to alleviate this side effect?
A. Change the time of the dose.
B. Hold the 9 p.m. dose.
C. Administer the dose with
Administer the dose with a snack.
A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took his levodopa at 0800. Which instruction should the nurse i
You can begin taking the Sinemet this evening, but do not take any more levodopa.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client?
Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect.
A client with congestive heart failure (CHF) is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should include reporting which problem to the healthcare
Dizziness.
A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level?
A. Sixty minutes after the antibiotic dose is administered.
B. Immediately before the next antibiotic dose
Immediately before the next antibiotic dose is given.
Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic?
A. An older client with Type 2 diabetes mellitus.
B. A client with chronic rheumatoid arthritis.
C. A client with a open compound frac
A young adult with inflammatory bowel disease.
A client is receiving metoprolol (Lopressor SR). What assessment is most important for the nurse to obtain?
A. Temperature.
B. Lung sounds.
C. Blood pressure.
D. Urinary output.
Blood pressure.
A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client?
A. Use a reliable form of birth control.
B. Avoid exposure to ultra violet light.
C. Refuse this medication if plannin
Use a reliable form of birth control.
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for the last two hours. Which intervention should the nurse initiate?
A. Stop the i
Notify the healthcare provider of the urinary output.
Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression?
A. Morphine Sulfate (Duromorph).
B. Ibuprofen (Advil).
C. Amitriptyline (Amitril).
D. Dexamethasone (Decadron).
Dexamethasone (Decadron).
The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids?
A. Sedati
Constipation
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement?
A. Hold the next scheduled dose of Imdur
Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide
Another type of nonsteroidal antiinflammatory drug may be indicated.
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved?
A. Decreased blood pressure.
B. Lessening of tremors.
C. Increased saliv
Lessening of tremors.
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement?
A. Assess for erythema.
B. Administer the antid
Discontinue the IV fluids.
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to
A. decrease the amount of thyroid-stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hor
inhibit synthesis of T3 and T4 by the thyroid gland.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximall
The rate and depth of the client's respirations.
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3
Blood pressure has changed from 180/120 to 140/70.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)?
A. Headache, hypertension, and blurred vision.
B. Wheezing, hypotension, and AV block.
C. Vomiting, dilated pupils, and papilledema.
D. Tinnitus, muscle
Wheezing, hypotension, and AV block.
Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis?
A. Loperamide (Imodium).
B. Probanthine (Propantheline).
C. Bismuth subsalicylate (Pepto Bismol).
D. Diphenoxylate hydrochloride with atropine (
Bismuth subsalicylate (Pepto Bismol).
A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and
Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide?
A. This
This medication is a blood thinner given to prevent blood clot formation.
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication?
A. Serum glucose.
B. Serum calcium.
C. Red blood cells.
D. Serum potassium.
Serum glucose.
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharg
Prothrombin Time (PT/INR).
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history?
A. Aminoglycosides.
B. Cephalosporins.
C.
Cephalosporins
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first do
Notify the healthcare provider.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?
A. Expected duration of flushing.
B. Symptoms of hyperglycemia.
C. Diets that minimize GI irritation.
D. Comfort m
Expected duration of flushing.
In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as intended?
A. An increase in urine output.
B. Two or three soft stools per day.
C. Watery, diarrhea stools.
D. Increased serum bilirubin.
Two or three soft stools per day.
Which instruction(s) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A. Increase fluid intake, especially cranberry juice.
B. Do not
Increase fluid intake, especially cranberry juice.
Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription?
A. As needed.
B. Every 12 hours.
C. Every 24 hours.
D. Every 4 to 6 hours.
Every 12 hours.
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload?
A. Nitroglycerin.
B. Propranolol (Inderal).
C. Morphine.
D. Captopril (Capoten).
Nitroglycerin
A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider?
A. Tinnitus a
Tachycardia and chest pain.
A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition?
A. Glaucoma.
B. Hypertension.
C. Heart failure.
D. Asthma.
Heart failure.
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin."
B. "Yes, it is an oral insulin and is distribute
No, it is not an oral insulin and can be used only when some beta cell function is present.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement?
A. q6h.
B. QID.
C. AC and bedtime.
D. PC and bedtime
q6h
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5
Withhold the scheduled dose.
n older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process?
A. Absorption.
B. Metabolism.
C. Elimination.
D. Distribution.
Distribution.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action should the nurse implement?
A. Refer the
Notify the healthcare provider of this finding immediately.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows that which medication should be contraindicated for this client?
A. Liothyronine (Cytomel) to replace iodine.
B. Furosemide (Lasix) for relief o
Pentobarbital sodium (Nembutal Sodium) for sleep.