question

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?

answer

Client states chest pain is relieved.

question

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 discharge?

answer

Prothrombin Time (PT/INR).

question

. 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?

answer

Penicillin

question

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?

answer

Nitroglycerin

question

Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription?

answer

Every 12 hours

question

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?

answer

Immediately before the next antibiotic dose is given

question

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?

answer

This medication is a blood thinner given to prevent blood clot formation

question

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?

answer

Lessening of tremors

question

A client is receiving metoprolol Lopressor SR. What assessment is most important for the nurse to obtain?

answer

Blood pressure

question

The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client?

answer

Epinephrine

question

A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition?

answer

Heart failure

question

Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside Arc-C for chemotherapy?

answer

Inspect the client's oral mucosa for ulcerations

question

Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression?

answer

Dexamethasone Decadron

question

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan Diovan has been achieved?

answer

Blood pressure reduced from 160/90 to 130/80

question

. Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis?

answer

Bismuth subsalicylate Pepto Bismol

question

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?

answer

Discontinue the IV fluids

question

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?

answer

Verify both prescriptions with the healthcare provider

question

The healthcare provider prescribes naloxone Narcan for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective?

answer

The client's respiratory rate is 16 breaths/minute

question

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?

answer

Notify the healthcare provider of this finding immediately

question

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 pain medication. What intervention should the nurse implement?

answer

Administer only the Dilaudid q4h PRN for pain

question

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 maximally per hour. What assessment has the highest priority before initiating the PCA pump?

answer

The rate and depth of the client's respirations

question

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?

answer

Notify the healthcare provider of the urinary output

question

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?

answer

Administer the dose with a snack

question

Which method of medication administration provides the client with the greatest first-pass effect?

answer

Oral

question

In evaluating the effects of lactulose Cephulac, which outcome should indicate that the drug is performing as intended?

answer

Two or three soft stools per day

question

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 orally. B) Gentamicin Garamycin IM. C) Albuterol Proventil puffs. D) Salmeterol Serevent Diskus.

answer

The best sequence of administration is C, D, A and B

question

An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process?

answer

Distribution

question

Which medications should the nurse caution the client about taking while receiving an opioid analgesic?

answer

Benzodiazepines

question

Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic?

answer

A young adult with inflammatory bowel disease

question

A client is being treated for hyperthyroidism with propylthiouracil PTU. The nurse knows that the action of this drug is to

answer

inhibit synthesis of T3 and T4 by the thyroid gland

question

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?

answer

Tachycardia and chest pain

question

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?

answer

Rash

question

33. 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?

answer

Presence of hand tremors

question

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 provider?

answer

Dizziness

question

. 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?

answer

Pentobarbital sodium, Nembutal Sodium for sleep

question

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?

answer

Take medication, go for a 30 minute morning walk, then eat breakfast

question

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?

answer

Do not get up quickly, Always rise slowly

question

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?

answer

Constipation

question

A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client?

answer

Use a reliable form of birth control

question

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?

answer

Cephalosporin's

question

Which instructions 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 abruptly discontinue the medication; taper use. C) Check blood pressure daily to detect hypertension. D) Avoid drinking alcohol while taking this medication. E) Use condoms until treatment is completed. F) Ensure that all sexual partners are treated at the same time.

answer

Correct selections are A, D, E, and F

question

Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine Adenocard?

answer

Apply continuous cardiac monitoring

question

Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol Inderal?

answer

Wheezing, hypotension, and AV block

question

An antacid Maalox is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to

answer

maintain a gastric pH of 3.5 or above

question

Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan Avapro?

answer

Risk for injury

question

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 dose?

answer

Notify the healthcare provider

question

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?

answer

Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect

question

A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new prescription for sustained release levodopa/carbidopa Sinemet 25/100 PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client?

answer

You can begin taking the Sinemet this evening, but do not take any more levodopa

question

. 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?

answer

Serum glucose

question

. A client with hyperlipidemia receives a prescription for niacin Niaspan. Which client teaching is most important for the nurse to provide?

answer

Expected duration of flushing

question

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?

answer

Abdomen

question

The nurse is preparing the 0900 dose of losartan Cozaar, an angiotensin II receptor blocker ARB, for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What action should the nurse take first?

answer

Withhold the scheduled dose

question

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?

answer

Assess the serum potassium level

question

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 intervention?

answer

Vomiting

question

. 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?

answer

Hyperkalemia

question

A client with giardiasis is taking metronidazole Flagyl 2 grams PO. Which information should the nurse include in the client's instruction?

answer

Take the medication with food

question

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?

answer

Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen Tylenol

question

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 teaching?

answer

Use contraception during intercourse

question

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?

answer

Blood pressure has changed from 180/120 to 140/70

question

A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride Tensilon. What is the expected outcome for this client following administration of this pharmacologic agent?

answer

Decreased muscle weakness

question

Dobutamine, Dobutrex is an emergency drug most commonly prescribed for a client with which condition?

answer

Heart failure

question

. A postoperative client has been receiving a continuous IV infusion of meperidine Demerol 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take first?

answer

Decrease the IV infusion rate of the meperidine, Demerol per protocol

question

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?

answer

Another type of nonsteroidal antiinflammatory drug may be indicated

question

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?

answer

Refrain for eating foods high in potassium

question

A client asks the nurse if glipizide Glucotrol is an oral insulin. Which response should the nurse provide?

answer

"Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin."

question

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?

answer

q6h

question

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?

answer

Apply the patch at least 4 hours prior to departure

question

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?

answer

Administer both medications according to the prescription

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