Pharm ATI Proctored Exam Guide

Pharm ATI PROCTORED A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse A. urinary health promotion should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects Saw palmetto is used primarily for manifestations related to prostatic conditions, such as benign prostatic hypertrophy (BPH). A. urinary health promotion Its effectiveness has not been scientifically proven, however. The B. immune system stimulation nurse should teach the client to check with the provider about C. decreased leg pain from arterial disease interactions between saw palmetto and other medications. D. prevention of nausea caused by motion sickness A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? a. Reye's syndrome a. Reye's syndrome b. Visual disturbances c. Diabetes mellitus d. Wilm's tumor A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? c. Promotes RBC production a. Reduces blood pressure b. Inhibits clotting of fistula c. Promotes RBC production d. Stimulates growth of neutrophils A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? d. Acetaminophen (anlagesics) a. Ibuprofen (NSAIDS) b. Naproxen (NSAIDS) c. Aspirin (NSAIDS) d. Acetaminophen (anlagesics) A nurse is caring for a client who has prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? a. Insomnia b. Hypotension c. Bleeding d. Constipation c. Bleeding A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as contraindication to ceftriaxone? a. Gentamicin b. Clindamycin c. Piperacillin d. Sulfamethoxazole-trimethroprim c. Piperacillin A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? b. Intestinal obstruction a. Hyperthyroidism b. Intestinal obstruction c. Glaucoma d. Low blood pressure 1 / 14 A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? a. Amantadine b. Bupropion (aytpical antidepressant) c. Phenelzine (MAOI) d. Hydroxyzine (Antihistamine) a. Amantadine A nurse is administering subQ epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? a. Hypotension b. Hyperthermia c. Hypoglycemia d. Tachycardia d. Tachycardia A nurse is providing teaching to a client who has UTI and new prescription for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? a. If the phenazopyridine upsets my stomach, I can take it with meals. b. The phenazopyridine will relieve my discomfort, but the cipro will get rid of the infections. d. I should notify my provider immediately if my urine turns an orange color. c. I need to drink2 liters of fluid per day while I am taking cipro. d. I should notify my provider immediately if my urine turns an orange color. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? a. Ecchymosis b. Decreased urine output c. Increased blood pressure d. Dizziness A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? d. Dizziness c. Levothyroxine a. Methimazole b. Somatropin c. Levothyroxine d. Propylthiouracil A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50mg po daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? d. Take the hydrochlorothiazide in the morning. a. Take the hydrochlorothiazide as needed for edema b. Check your weight once each week c. Take the hydrochlorothiazide on an empty stomach 2 / 14 d. Take the hydrochlorothiazide in the morning. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? a. Oxytocin b. Nifedipine c. Dinoprostone d. Misoprostol b. Nifedipine A nurse is providing teaching to a client who has cirrhosis and new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? d. Reduce ammonia levels a. Increases blood pressure b. Prevents esophageal bleeding c. Decreases heart rate d. Reduce ammonia levels A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? c. Electrocardiogram a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function test A nurse is providing teaching to a client who has gout and new prescription for allopurinol. The nurse should instruct client to discontinue taking the medications for which of the following adverse effects? a. Nausea b. Metallic taste c. Fever d. Drowsiness c. Fever A nurse is assessing a client who is receiving IV gentamicin 3 x daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication? a. Hypoglycemia b. Proteinuria c. Nasal congestion d. Visual disturbances b. Proteinuria A nurse is providing teaching to a newly nurse about caring for a client who has prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests? a. Platelet count b. Electrolyte levels c. Thyroid functions d. Liver function d. Liver function A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? a. Raynaud's phenomenon b. Migraine headaches c. Ulcerative colitis d. Anemia b. Migraine headaches A nurse is reviewing the lab values for a client who is receiving a continuous IV heparin infusion and has an aPTT (TR-60-80 sec) of 90 seconds. Which of the following actions should the nurse 3 / 14 prepare to take? a. Administer Vit K b. Reduce the infusion rate c. Give the client a low dose aspirin d. Request an INR b. Reduce the infusion rate A nurse is providing teaching to a client who had rheumatoid arthritis and a prescription for long term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? a. Stress fractures a. Stress fractures b. Orthostatic hypotension c. Gingival ulcerations d. Weight loss A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? a. Antiestrogenic b. Antimicrobial c. Androgenic d. Anti-inflammatory a. Antiestrogenic A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? d. Nephrotoxicity a. Hyperkalemia b. Hypertension c. Constipation d. Nephrotoxicity A nurse is administering subQ heparin to a client who is at risk for DVT. Which of the following should the nurse take? a. Administer the medication into the client's abdomen a. Administer the medication into the client's abdomen b. Inject the medication into a muscle c. Massage the site after administering the medication d. Use a 22 gauge needle to administer the medication A nurse is reviewing the lab results for a client who has prescription for filgastrim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication? b. Neutrophil count a. Erythrocyte count b. Neutrophil count c. Lymphocyte count d. Thrombocyte count A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? a. Jaundice a. Jaundice b. Constipation c. Oral candidiasis d. Sedation A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following lab 4 / 14 values should the nurse plan to monitor? Select all that apply. b. PTT a. BUN b. PTT c. Aspartate aminotransferase (AST) d. Urinalysis e. Alanine aminotransferase (ALT) c. Aspartate aminotransferase (AST) e. Alanine aminotransferase (ALT) A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? b. Superinfection a. Allergic response b. Superinfection c. Renal toxicity d. Hepatotoxicity A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? c. Muscle weakness a. Thrombophlebitis b. Hyperactive reflexes c. Muscle weakness d. Hypoglycemia A nurse on a medical unit is preparing to administer alendronate 40mg po for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority? a. Administer the medication to the client's before breakfast in the morning. b. Ambulate the client to a chair prior to administering the medication. b. Ambulate the client to a chair prior to administering the medication. c. Give the medication to the client with water rather than milk. d. Teach the client how to take the medication at home. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary TB. The client reports his urine is an orange color. Which of the following statements should the nurse make? a. Stop taking isoniazid for 3 days and the discoloration should go away. b. Rifampin can turn body fluids orange. b. Rifampin can turn body fluids orange. c. I'll make an appointment for you to see the provider this afternoon. d. Isoniazid can cause bladder distention. A nurse is caring for a client who had a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? a. Ecchymosis b. Jaundice c. Hypotension d. Hypokalemia c. Hypotension 5 / 14 A nurse is preparing a discharge teaching plan for a 6 year old client who has asthma and several prescription medication using metered dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? a. Add a spacer to each MDI. b. Instruct the child to inhale more rapidly than usual when using an MDI. a. Add a spacer to each MDI. c. Request that the provider change the child's medications from inhaled to oral formulation. d. Administer oxygen by facemask along with the MDI. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching? a. I will give my child a dose as soon as wheezing starts. a. I will give my child a dose as soon as wheezing starts. b. My child should rinse out his mouth after using the inhaler. c. My child should exhale completely before placing the inhaler in his mouth. d. If my child has difficulty breathing in the dose, a spacer can be used. A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching? a. Respiratory depression can occur 7 min after the morphine is administered. a. Respiratory depression can occur 7 min after the morphine is administered b. The morphine will peak in 10 min c. Withhold the morphine if the client has a respiratory rate of less than 16/min d. Administer the morphine over 2 min A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several prescription medications using metered dose inhalers [MDIs]. Which of the following interventions A. add spacer to each MDI should the nurse include in the plan? MDIs are difficult to use correctly and, even when properly used, A. add spacer to each MDI only a portion of the medication is delivered to the lungs. A spacer B. instruct the child to inhale more rapidly applied to an MDI can make up for lack of hand-lung coordination C. request that the provider change the child's medications from by increasing the amount of medication delivered to the lungs. inhaled to oral formulations D. administer oxygen by facemask along with the MDI A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal C. I will need to depress the side arms to activate the pump calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? The nurse should instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two A. I will administer a spray into each nostril daily white side arms toward the bottle six times. B. I should expect nasal bleeding for the first week C. I will need to depress the side arms to activate the pump 6 / 14 D. I should expect to take this medication for a short-term course of treatment A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the A. urine specific gravity 1.035 following findings should indicate to the nurse that the client is dehydrated? Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030 are expected findings in clients A. urine specific gravity 1.035 who are dehydrated. B. distended neck veins C. BUN 18 mg/dL D. bounding radial pulse A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin 25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number) 18 mL/hr A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain? Stop activity Place a tablet under the tongue Wait for 5 min Call 911 if the pain is not relieved Wait for 5 min Stop activity Call 911 if the pain is not relieved Place a tablet under the tongue A nurse is providing teaching to a client who is to start taking Hydrochlorothiazide for hypertension. The nurse instructs the client D. this medication can cause a loss of potassium to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion by the kidneys. The client should suppleA. this medication will not work unless I have enough potassium ment his diet with potassium-rich foods to avoid the occurrence of B. potassium will increase the therapeutic effect of my blood hypokalemia. Foods that are high in potassium include bananas, medication raisins, baked potatoes, pumpkins, and milk. C. potassium will lower my blood pressure D. this medication can cause a loss of potasium A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed Lorazepam, 1 mg three times per day, B. sedation to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess Lorazepam is a benzodiazepine with anti-anxiety and sedative the client? effects. Older adult clients, especially, are at risk for central nervous system depression even with low doses of benzodiazepines. A. low-grade fever Clients who are 50 years or older can have a more profound and B. sedation prolonged sedation than younger clients. C. diuresis D. tonic-clonic seizures A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is Digoxin 0.25 mg/1ml. How many ml should the nurse administer? A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? 0.8 mL B. I am likely to develop higher bp while taking this medication Half the clients who take cyclosporine develop a 10% to 15% inA. I will be able to stop taking this medication 6 months after my crease in blood pressure and might need to start antihypertensive surgery therapy. B. I am likely to develop higher bp while taking this medication C. I am likely to lose my hair while taking this medication D. I am taking this medication to boost my immune system 7 / 14 A nurse is caring for a client who is in preterm labor and has a new prescription for Nifedipine. The client states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the client that Nifedipine works for clients who are pregnant by which of the following mechanisms? B. it inhibits uterine contractions by blocking entry calcium into uterine cells A. it decreases the incidence of bacterial vaginosis, thus preventing uterine contractions Nifedipine, a calcium channel blocker, causes uterine relaxation by B. it inhibits uterine contraction by blocking entry of calcium into blocking the flow of calcium to the myometrial cells of the uterus. uterine cells C. it decreases the activity within the CNS, which regulates all smooth muscles D. it stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions A nurse is administering Adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during ad- C. dyspnea ministration of Adenosine? Dyspnea can occur during administration of adenosine due to A. seizures bronchoconstriction. Since adenosine has a very short half-life of B. cinchonism about 10 seconds, this effect should be short-lived. C. dyspnea D. transient pallor of the face A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to D. dry mouth expect? Hydroxyzine has anticholinergic properties. Dry mouth is a comA. diarrhea mon adverse effect of this medication. The nurse should instruct B. anxiety the client to take sips of water or suck hard candies to minimize C. nausea and vomiting this effect. D. dry mouth A nurse is planning discharge teaching for a client who has Major Depressive Disorder and a new prescription for Phenelzine. Which A. broiled beef steak of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine? Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. A. broiled beef steak Beef steak and other meats that are fresh do not interact with B. macaroni and cheese phenelzine and are safe to consume. C. pepperoni pizza D. smoked samon A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it C. tinnitus occurs? Loop diuretics, such as furosemide, can cause ototoxicity. The A. nasal congestion client should be taught to notify the provider if tinnitus, a full feeling B. tremors in the ears, or hearing loss occurs. C. tinnitus D. frontal headache A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should D. aspirate to check for IV patency before administering the the nurse take? diphenhydramine A. choose an IV port for IV bolus injection for the diphenhydramine it is important to confirm IV patency prior to administering an as near as possible to the client's hanging IV bag IV bolus. Some medications cause severe tissue damage when B. flush the IV tubing with 2 mL of 0.9% sodium chloride before inadvertently administered into tissue rather than into a vein. and after administering diphenhydramine C. allow IV infusion to keep running while administering the diphenhydramine via IV bolus 8 / 14 D. aspirate to check the IV patency before administering the diphenhydramine D. check the client's apical pulse A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refused to eat breakfast. Which of the following actions should the nurse take first? A. encourage the client to eat the toast on the breakfast tray B. administer the antiemetic C. inform the client's provider D. check the client's apical pulse Nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias, often caused by a slow pulse rate, are possible findings in digoxin toxicity. Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider about a change in the client's status, she must first collect adequate data from the client. Assessing will provide the nurse with knowledge to make an appropriate decision. A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for Isoniazid. The nurse should B. aspartate aminotransferase teach the client that which of the following laboratory values should be monitored while taking Isoniazid? Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes, such as AST, during therapy with isoniazid. In A. thyroid stimulating hormone level addition, the nurse should instruct the client to notify the provider B. asperate aminotransferase of jaundice, nausea, dark-colored urine or other findings indicating C. potassium hepatitis. D. sodium A nurse is preparing a discharge teaching plan for a client who is to being long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? C. schedule the medication on alternate days to decrease adverse effects A. stop taking the medication if a rash occurs B. take the medication of an empty stomach to enhance absorp- Some of the adverse effects caused by long-term glucocorticoid tion therapy, such as suppression of the adrenal gland, can be avoided C. schedule the medication on alternate days to decrease adverse by using alternate-day therapy. effects D. treat shortness of breath with an extra dose of the medication C. chlordiazepoxide A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first? A. acamprosate B. naltrexone C. chlordiazepoxide D. disulfiram Chlordiazepoxide, a long-acting oral benzodiazepine, is a first-line medication to use for a client who is experiencing manifestations of acute alcohol withdrawal. For clients who are nauseated or vomiting, another benzodiazepine, such as lorazepam, can be administered via IV. The nurse should apply the acute versus chronic priority-setting framework when caring for this client. Using this framework, acute needs (manifestations of acute alcohol withdrawal) are typically the priority need because they pose more of a threat to the client. Because chronic needs usually develop over a period of time, the client has more of an opportunity to adapt to the alteration in health. C. assess the client's apical pulse A nurse is caring for a client and realizes after administering the Caring for this client requires application of the nursing process 0900 medications that she administered digoxin 0.25 mg PO to priority-setting framework. The nurse can use the nursing process the client instead of the prescribed digoxin 0.125 mg PO. Which to plan client care and prioritize nursing actions. Each step of of the following actions should the nurse take first? the nursing process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, A. notify the provider implement a nursing intervention, or notify a provider about a B. contact the nursing supervisor change in the client's status, she must first collect adequate data C. assess the client's apical pulse from the client. Assessing will provide the nurse with knowledge to D. complete an incident report make an appropriate decision. Therefore, the first action the nurse should take is to assess the client. 9 / 14 A nurse is planning to administer Diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of Diltiazem. A. hypotension B. tachycardia C. decreased level of consciousness D. history of diuretic use A. hypotension Diltiazem can be a treatment option for essential hypertension. This medication will lower blood pressure and is contraindicated for a client who is hypotensive. The nurse should teach the client to self-monitor blood pressure and keep a record of the readings. A nurse is caring for a client who was brought to the emergency department by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to C. pinpoint pupils assess? Pinpoint pupils are an expected finding in opioid toxicity. Increased pupil size is seen in opioid withdrawal. A. temperature 39.2 C (102.6 F) B. respiratory rate 30/min C. pinpoint pupils D. severe abdominal cramping A nurse is preparing to administer Chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is Chlorothiazide oral suspension 250 mg/5ml. how many ml should the nurse administer per dose? 2.6 mL A nurse is preparing to administer dextrose 5& in 0.45% sodium chloride 400 ml IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many ml/hr? (round to the nearest whole number) 50 mL/hr A nurse is providing teaching to a client who has hypertension and a new prescription for oral Clonidine. Which of the following instructions should the nurse include in the teaching? A. discontinue the medication if a rash develops B. expect increased salivation during the first few weeks of therapy C. minimize fiber intake to prevent diarrhea D. avoid driving until the client's reaction to the medication is known D. avoid driving until the client's reaction to the medication is known Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client's response to the medication is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment. Over time, these effects are likely to decrease. A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water [D5W] to infuse over 15 minutes. The drop factor of the manual IV tubing is 10 gtt./ml. The nurse should set the manual IV infusion to deliver how many gtt./min? 33 gtt/min A nurse is assessing a client who has hypothyroidism and takes Levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute Levothyroxine overC. tremor dose? Tremor and anxiety are expected findings in acute levothyroxine A. bradycardia overdose. These findings are similar to those seen in hyperthyB. cold intolerance roidism. C. tremor D. hypothermia A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr. to a client who is dehydrated. The nurse should set the IV pump to deliver how many ml/hr.? 500 mL/hr A nurse is administering insulin glulisine 10 units subcutaneously B. 0745 at 0720 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which Insulin glulisine has a very short onset of action of 15 min. The of the following times? nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following administration of A. 0800 the insulin. B. 0745 10 / 14 C. 0900 D. 1030 A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription or Amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? B. I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease A. I will take amitriptyline in the morning because I'm likely to have trouble falling asleep if I take it in the evening Amitriptyline can cause orthostatic hypotension. The nurse should B. I will move slowly when I stand up because amitriptyline can instruct the client to take precautions to prevent injury due to falls cause my bp to decrease while taking amitriptyline. C. I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't interact with alcohol D. I will avoid foods high in fiber because amitriptyline can cause diarrhea A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg three times daily PO and gabapentin 1,800 mg three times daily PO to manage pain. The client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." Which of the following additions should the nurse anticipate to the client's medication regimen? A. oral meperidine B. parenteral naloxone C. parenteral diazepam D. oral oxycodone D. oral oxycodone The client's current pain regimen consists of a nonopioid analgesic, naproxen, and an adjuvant medication for neuropathic pain, gabapentin. According to the WHO analgesic ladder for cancer pain management, the next addition to the pain regimen is an opioid for moderate pain. Oxycodone is an oral opioid that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client's pain regimen. A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and a new prescription for Metformin. Which of the folB. myalgia lowing adverse effects of Metformin should the nurse instruct the client to watch for and report to the provider? Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occur while taking metformin A. weight gain due to blockage of lactic acid oxidation. The nurse should instruct B. myalgia the client to report these findings promptly to the provider. C. hypoglycemia D. severe constipation A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take? D. increase the dose of oxytocin to obtain uterine contractions that A. place oxytocin from a pre-filled syringe into the posterior fornix occur every 2 to 3 min of the vagina every 10 min until effective labor occurs B. check the client's bp and pulse every 15 min while induction of Effective uterine contractions should occur every 2 to 3 min. labor is occurring C. stop oxytocin for contractions that continue longer than 30 min D. increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea [IBS-D] and a new prescription for Alosetron. Which of the following interventions should the nurse C. the client must sign an agreement with the provider before include in the plan of care? beginning alosteron A. the client must sign an agreement with the provider before beginning alosetron B. the client must stop taking alosetron if diarrhea continues 1 week after beginning the medication C. the client should expect to have a slower heart rate while taking alosteron D. the client should use a barrier birth control method because alosteron interacts with oral contraceptives Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron. 11 / 14 A nurse is providing teaching to the parents of a school-age child who has asthma about medications for bronchospasm. Which of D. albuterol the following inhaled medications should the nurse instruct the parents to use to relieve and acute asthma attack? Albuterol is a short-acting beta2-adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One or A. salmeterol two puffs every 4 to 6 hr PRN is the usual prescribed dose for a B. cromolyn school-age child. If higher or more frequent doses are needed, the C. fluticasone provider should evaluate the client for worsening asthma. D. albuterol A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother take verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following A. verapamil is used to treat both high blood pressure and angina responses should the nurse make? Verapamil is a calcium channel blocker that is used for both hyA. verapamil is used to treat both high blood pressure and angina pertension and anginal pain because of its ability to dilate arteries B. you should talk to your provider to make sure the prescription and decrease afterload. is correct for you C. are you concerned that you might have high blood pressure D. your provider has prescribed verapamil so that you will not develop high blood pressure A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed Omeprazole. Which of the following statements should the nurse include in the teaching? C. you should take this medication before breakfast every day A. you will need to take this medication for the next 6 months B. taking this medication will decrease your risk for acquiring pneumonia C. you should take this medication before breakfast every day D. watch for serious adverse effects of tachycardia and heart palpations while taking this medication Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food. A nurse is preparing to administer codeine 30 mg PO every 4 hr. PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 ml. How many ml should the nurse plan to administer per does? 10 mL A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrex- B. platelets 78,000/mm3 ate via IV infusion. Which of the following laboratory values should the nurse report to the provider? The nurse should monitor the platelet count of a client who is taking methotrexate because the medication can cause thromboA. BUN 18 mg/dL cytopenia. This client's platelet count is very low and puts the client B. platelets 78,000/mm3 at risk for severe bleeding. The nurse should report this finding C. hemoglobin 14.2 g/dL promptly to the provider. C. aspartate aminotransferase 35 units/L A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler who weighs 33 lbs. available is ampicillin 125 mg/5ml oral solution. How many ml should the nurse administer per dose? 7.5 mL A nurse is preparing to administer iron dextran IV to a client. Which A. administer a small test dose before giving the full dose of the following actions should the nurse plan to take? A. administer a small test dose before giving the full dose B. infuse the medication over 30 sec C. monitor the client closely for hypertension after the infusion D. administer cyanocobalamin as an antidote if iron dextran toxicity occurs A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. It is recommended that a small test dose be administered over 5 min before giving the full dose. The client should be monitored carefully for an allergic reaction during and for a period of time following the test dose. A nurse is providing discharge teaching to a client who has heart failure and a prescription for Digoxin 0.125 mg PO daily and Furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching? 12 / 14 A. I know that blurred vision is something I will expect to happen while taking digoxin B. I will measure my urine output each day and document it in my diary C. I will skip a dose of my digoxin if my resting heart rate is below 72 bpm D. I will eat fruits and veggies that have high potassium content every day D. I will eat fruits and veggies that have high potassium content every day Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain the potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity. A nurse is planning to administer epoetin alfa to a client who has A. bp chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication? Epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. The nurse should monitor A. bp the client's blood pressure and notify the provider about increases. B. temp The client who receives epoetin alfa frequently requires concurC. blood glucose levels rent use of antihypertensive medication. D. total protein level A nurse is administering Ciprofloxacin and Phenazopyridine to a client who has a severe urinary tract infection [UTI]. The client asks why both medications are needed. Which of the following responses should the nurse make? D. ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain A. phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiB. combining phenazopyridine with ciprofloxacin hydrochloride otic and phenazopyridine is a bladder analgesic/anesthetic that shortens the course of therapy. relieves burning and pain in the bladder mucosa caused by bladC. the use of phenazopyridine allows for a lower dosage of der spasm and inflammation. ciprofloxacin hydrochloride D. ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? C. "I can develop lithium toxicity if I experience vomiting or diarrhea." A. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." Vomiting or diarrhea can cause electrolyte imbalances. If serum B. "I can develop lithium toxicity if I eat foods with lots of sodium." sodium decreases, lithium is retained by the kidneys and the risk C. "I can develop lithium toxicity if I experience vomiting or diar- for lithium toxicity increases. rhea." D. "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity." A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an A. "I might have difficulty recognizing when my blood sugar is low." understanding of the teaching? Metoprolol, a beta-adrenergic blocker, is used to treat hypertenA. "I might have difficulty recognizing when my blood sugar is low." sion. Because it decreases heart rate, this common manifestation B. "I will have less risk for developing an infection while I take this of hypoglycemia can be masked and hypoglycemia might become medication." more difficult to recognize. The client should be taught to recognize C. "I should be concerned about losing excess weight while I take hypoglycemia by other manifestations, such as hunger, nausea, this medication." and sweating. D. "I could have more problems with high blood sugars while taking this medication." A nurse is assessing a client who has oral Theophylline for relief B. tremors of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline? Theophylline is a xanthine derivative bronchodilator. An early manifestation of toxicity is CNS stimulation, often seen as tremors. A. constipation Seizures can occur if blood levels continue to rise. B. tremors 13 / 14 C. fatigue D. bradycardia A nurse is providing teaching to a client who has heart failure and is taking Spironolactone. Which of the following statements by the D. "I will watch for increased breast tissue growth while taking this client indicates an understanding of the teaching? medication." A. "I will increase my intake of citrus fruits, bananas, and potatoes." B. "I will use salt substitutes on my food." C. "I will drink as much water as I can while taking this medication." D. "I will watch for increased breast tissue growth while taking this medication." Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as gynecomastia, impotence in men and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur. A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following B. Carry a medic alert ID card. instructions should the nurse include in the teaching? A client who is taking warfarin is at increased risk for bleeding. A. Take ibuprofen as needed for headache or other minor pains. In the case of an emergency, it is important that any medical B. Carry a medic alert ID card. personnel are aware of the client's medication history. C. Report to the laboratory weekly to have blood drawn for aPTT. D. Increase intake of dark green vegetables. 14 / 14