Two Scenarios Are Presented Regarding Medication Management

ANSWERS 1. D. Rise slowly when getting out of bed or chair. 2. C. Consult with healthcare provider about another treatment for this effect. 3. C. Rapid resolution of wheezing. D. Improved pulse oximetry values. 4. B. Give the medication as prescribed and continue to monitor the client. 5. A. Withhold the scheduled dose. 6. None 7. A. Apply the patch at least 4 hours prior to departure. 8. D. Take the medication with food. 9. A. Use contraception during intercourse. 10. B. Notify the healthcare provider. 11. A. Potassium level of 3.1 mEq/L. 12. A. Verify both prescriptions with the healthcare provider. 13. D. Dexamethasone. 14. B. Constipation. 15. B. Every 12 hours. 16. D. A young adult with inflammatory bowel disease. 17. B. Benzodiazepines. 18. D. Heart failure. 19. C. Epinephrine. 20. C. Heart failure. 21. D. Distribution. 22. A. Use a reliable form of birth control. 23. A. Oral. 24. C. Another type of nonsteroidal antiinflammatory drug may be indicated. 25. A. This medication is given to prevent blood clot formation. 26. B. Refrain for eating foods high in potassium. 27. D. Discontinue the IV fluids. 28. A. Nitroglycerin. 29. A. Increase fluid intake, especially cranberry juice. 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. 30. A. Expected duration of flushing. 31. B. Presence of hand tremors. 32. C. Administer only the Dilaudid every 4 hours PRN for pain. 33. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg. 34. D. Vomiting. 35. B. Do not get up quickly. Always rise slowly. 36. C. Pentobarbital sodium for sleep. 37. B. Wheezing, hypotension, and AV block. 38. C. "No, it is not an oral insulin and can be used only when some beta cell function is present." 39. C. Inspect the client's oral mucosa for ulcerations. 40. B. Tachycardia and chest pain. 41. C. Administer the dose with a snack. 42. B. Immediately before the next antibiotic dose is given. 43. A. Rash. 44. B. Cephalosporins. 45. D. "You can begin taking the levodopa/carbidopa this evening, but do not take any more levodopa." 46. D. Decreased muscle weakness. 47. B. Respiratory rate is 16 breaths/minute. 48. B. Assessment of the rate and depth of the client's respirations. 49. C. Notify the healthcare provider of the finding immediately. 50. C. Bismuth subsalicylate (Pepto Bismol). 51. B. Abdomen. 52. C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). 53. A. Administer both medications according to the prescription. 54. A. Serum glucose. 55. D. Blood pressure from 180/120 mmHg to 140/70 mmHg. 56. C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. 57. C. Risk for injury. 58. D. Notify the healthcare provider of the urinary output. 59. C. Apply continuous cardiac monitoring. 60. A. Every 6 hours. 61. C. Blood pressure. 62. A. Take medication, go for a 30 minute morning walk, then eat breakfast. 63. C. Decrease the IV infusion rate of the meperidine. 64. B. Prothrombin Time (PT). 65. B. Lessening of tremors. 66. D. It inhibits the synthesis of T3 and T4 by the thyroid gland. 67. B. Dizziness. 68. A. Client states chest pain is relieved. 69. B. Assess the serum potassium level. 70. B. Two or three soft stools per day. 71. C. It helps maintain a gastric pH of 3.5 or above. 1. The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? A. Take the medication at bedtime. B. Report presence of increased bruising. C. Check pulse before taking medication. D. Rise slowly when getting out of bed or chair. 2. A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the client? A. Discontinue the antibiotic because original symptoms have subsided. B. Continue taking medication until finished until the symptoms subside. C. Consult with healthcare provider about another treatment for this effect. D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions. 3. The nurse is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the nurse expect? A. Tachycardia. B. Increased blood pressure. C. Rapid resolution of wheezing. D. Improved pulse oximetry values. E. Reduce fever airway inflammation. 4. A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take? A. Lower the head of the bed and assess the client for orthostatic vital sign changes. B. Give the medication as prescribed and continue to monitor the client. C. Prepare to administer atropine sulfate IV push. D. Hold the prescribed dose and contact the healthcare provider. 5. 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. Which action should the nurse take first? A. Withhold the scheduled dose. B. Check the client's apical pulse. C. Notify the healthcare provider. D. Repeat the serum potassium level. 6. 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.) 1. Albuterol (Proventil) puffs. 2. Salmeterol (Serevent Diskus). 3. Prednisone (Deltasone) orally. 4. Gentamicin (Garamycin) IM. 7. 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 patch every other day while on the cruise. C. Place the patch on a hairless area at the base of the skull. D. Drink no more than 2 alcoholic drinks during the cruise. 8. 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 medication after the diarrhea resolves. D. Take the medication with food. 9. A female client with rheumatoid arthritis takes 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? A. Use contraception during intercourse. B. Ensure the Cytotec is taken on an empty stomach. C. Encourage oral fluid intake to prevent constipation. D. Take Cytotec 30 minutes prior to Motrin. 10. 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? A. Review the client's hemoglobin results. B. Notify the healthcare provider. C. Inquire about the reaction to sulfa. D. Record the client's vital signs. 11. A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately? A. Potassium level of 3.1 mEq/L. B. Sodium level of 132 mEq/L. C. Calcium level of 8.6 mg/dL. D. Magnesium level of 1.2 mEq/L. 12. The nurse is transcribing a new prescription for spironolactone (Aldactone) 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. Report the medication interactions to the nurse manager. C. Hold the ACE inhibitor and give the new prescription. D. Transcribe and send the prescription to the pharmacy. 13. The nurse admits a client with tumor-induced spinal cord compression. Which medication should the nurse anticipate to be prescribed to offer the best palliative treatment for this client? A. Morphine sulfate. B. Ibuprofen. C. Amitriptyline. D. Dexamethasone. 14. The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain. The nurse should include strategies to help prevent which common side effect associated with long-term use of opioids? A. Sedation. B. Constipation. C. Urinary retention. D. Respiratory depression. 15. A client is prescribed controlled-release oxycodone. Which dosing schedule is best for the nurse to teach the client? A. As needed. B. Every 12 hours. C. Every 24 hours. D. Every 4 to 6 hours. 16. 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 fracture. D. A young adult with inflammatory bowel disease. 17. Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A. Antacids. B. Benzodiazepines. C. Antihypertensives. D. Oral antidiabetics. 18. A client is prescribed 1 mcg/kg/min of dobutamine hydrochloride via IV infusion. Which client's condition would benefit the most from an administration of dobutamine hydrochloride? A. Shock. B. Asthma. C. Hypotension. D. Heart failure. 19. A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer? A. Dopamine. B. Ephedrine. C. Epinephrine. D. Diphenhydramine. 20. The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition? A. Glaucoma. B. Hypertension. C. Heart failure. D. Asthma. 21. An older client with a decreased percentage of lean body mass is admitted to the hospital. Which pharmacokinetic process is affected and should be considered in the client's dosing of medication? A. Absorption. B. Metabolism. C. Elimination. D. Distribution. 22. 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 planning pregnancy. D. Abstain from intercourse while on this drug. 23. A client being discharged home is prescribed an antibiotic with a dosage three times higher than it was administered when the client was in the hospital. Which route of administration should the nurse anticipate will be prescribed for the greatest first-pass effect? A. Oral. B. Sublingual. C. Intravenous. D. Subcutaneous. 24. 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? A. The frequency of the dosing is necessary to increase the effectiveness. B. Therapeutic blood levels of this drug are reached in 4 to 6 weeks. C. Another type of nonsteroidal antiinflammatory drug may be indicated. D. Systemic corticosteroids are the next drugs of choice for pain relief. 25. After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse the reason for the medication. Which is the best response for the nurse to provide the client? A. This medication is given to prevent blood clot formation. B. This medication enhances antibiotics to prevent infection. C. This medication dissolves clots that develop in the legs. D. This medication enhances the healing of wounds. 26. 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 potassium. C. Restrict fluid intake to 1000 ml per day. D. Increase intake of milk and milk products. 27. 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 antidote. C. Apply warm compresses. D. Discontinue the IV fluids. 28. A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload? A. Nitroglycerin. B. Propranolol (Inderal). C. Morphine. D. Captopril (Capoten). 29. Which instruction 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. 30. 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 measures for pruritus. 31. The nurse is planning discharge instructions for a client prescribed cyclosporine following a liver transplant. Which adverse reactions should the nurse instruct the client to report to the healthcare provider? A. Changes in urine color. B. Presence of hand tremors. C. Increasing body hirsutism. D. Nausea and vomiting. 32. A client is taking hydromorphone (Dilaudid) PO every 4 hours at home. Following surgery, Dilaudid IV every 4 hours PRN and butorphanol tartrate (Stadol) IV every 4 hours PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. Which intervention should the nurse implement? A. Alternate the two medications every 4 hours PRN for pain. B. Alternate the two medications every 2 hours PRN for pain. C. Administer only the Dilaudid every 4 hours PRN for pain. D. Administer only the Stadol every 4 hours PRN for pain. 33. Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan 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 from 150 to 90 beats/minute. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg. 34. 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? A. Heartburn. B. Headache. C. Constipation. D. Vomiting. 35. The nitrate isosorbide dinitrate 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 rise slowly. C. Take the medication with food only. D. Increase your intake of potassium-rich foods. 36. The nurse is reviewing admission prescriptions for a client with myxedema. The nurse should clarify with the healthcare provider which prescription for the client? A. Liothyronine to replace iodine. B. Furosemid for relief of fluid retention. C. Pentobarbital sodium for sleep. D. Nitroglycerin for angina pain. 37. The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately? A. Headache, hypertension, and blurred vision. B. Wheezing, hypotension, and AV block. C. Vomiting, dilated pupils, and papilledema. D. Tinnitus, muscle weakness, and tachypnea. 38. 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 distributed, metabolized, and excreted in the same manner as insulin." C. "No, it is not an oral insulin and can be used only when some beta cell function is present." D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." 39. 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 tingling of extremities. C. Inspect the client's oral mucosa for ulcerations. D. Monitor the client's urine pH for increased acidity. 40. A 43-year-old female client is prescribed thyroid replacement hormone following a thyroidectomy. Which adverse effects should the nurse instruct the client to report immediately to the healthcare provider? A. Tinnitus and dizziness. B. Tachycardia and chest pain. C. Dry skin and intolerance to cold. D. Weight gain and increased appetite. 41. A client prescribed albuterol tablets reports nausea every evening with the 9:00 p.m. dose. Which action should the nurse perform to alleviate this side effect? A. Change the time of the dose. B. Hold the 9 p.m. dose. C. Administer the dose with a snack. D. Offer an antiemetic with the dose. 42. A peak and trough level is prescribed for a client receiving antibiotic therapy. When should the nurse should obtain the trough level? A. Sixty minutes after the antibiotic dose is administered. B. Immediately before the next antibiotic dose is given. C. Upon completion of the prescribed antibiotic regime. D. An hour before the next antibiotic dose is given. 43. A client is prescribed 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. 44. While taking a medical 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. Sulfonamides. D. Tetracyclines. 45. A client receives a new prescription for sustained release levodopa/carbidopa PO BID for the treatment of Parkinson's disease. The client's previous prescription was levodopa PO TID. The client's last dose of levodopa was at 0800 hr. Which set of instructions should the nurse give to the client? A. "Take the first dose of levodopa/carbidopa today, as soon as your prescription is filled." B. "Since you already took your levodopa, wait until tomorrow to take the levodopa/carbidopa." C. "Take both drugs for the first week, then switch to taking only the levodopa/carbidopa." D. "You can begin taking the levodopa/carbidopa this evening, but do not take any more levodopa." 46. 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? A. Progressive difficulty with swallowing. B. Decreased respiratory effort. C. Improvement in generalized fatigue. D. Decreased muscle weakness. 47. The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? A. A client's statement that the chest pain is better. B. Respiratory rate is 16 breaths/minute. C. Seizure activity has stopped temporarily. D. Pupils are constricted bilaterally. 48. A client is prescribed morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per patient-controlled analgesia (PCA) pump for a total of 5 mg IV maximally per hour. Which nursing action has the highest priority before initiating the PCA pump? A. Assessment of the expiration date on the morphine syringe in the pump. B. Assessment of the rate and depth of the client's respirations. C. Assessment of the type of anesthesia used during the surgical procedure. D. Assessment of the client's subjective and objective signs of pain. 49. The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports hearing non-stop ringing in the ears. Which action should the nurse implement? A. Refer the client to an audiologist for evaluation of her hearing. B. Advise the client that this is a common side effect. C. Notify the healthcare provider of the finding immediately. D. Face the client directly and speak in a low, monotone voice. 50. 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 (Lomotil). 51. 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. 52. 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 60 mg and administer a PRN dose of acetaminophen (Tylenol). B. Administer the 40 mg of Imdur and then contact the healthcare provider. C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider. 53. An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30 mg IV every 6 hours. Which action should the nurse implement? A. Administer both medications according to the prescription. B. Hold the ketorolac to prevent an antagonistic effect. C. Hold the morphine to prevent an additive drug interaction. D. Contact the healthcare provider to clarify the prescription. 54. A client is receiving methylprednisolone 40 mg IV daily. The nurse should monitor which laboratory value closely? A. Serum glucose. B. Serum calcium. C. Red blood cells. D. Serum potassium. 55. A client is receiving clonidine 0.1 mg/24 hr via transdermal patch. Which assessment finding indicates the desired effect of the medication has been achieved? A. Absence of nausea and vomiting. B. Change in peripheral edema from +3 to +1. C. Denial of anginal pain and shortness of breath. D. Blood pressure from 180/120 mmHg to 140/70 mmHg. 56. 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? A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms. B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping. C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug. 57. 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. 58. 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 2 hours. Which intervention should the nurse initiate? A. Stop the infusion of dopamine. B. Change the normal saline to a keep open rate. C. Replace the urinary catheter. D. Notify the healthcare provider of the urinary output. 59. 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 cardiac monitoring. D. Request that family members leave the room. 60. A client with a dysrhythmia is prescribed procainamide (Pronestyl) in 4 divided doses over the next 24 hours. Which dosing schedule is best for the nurse to implement? A. Every 6 hours. B. QID. C. AC and bedtime. D. PC and bedtime. 61. The nurse administers a dose of metoprolol for a client. Which assessment is most important for the nurse to obtain? A. Temperature. B. Lung sounds. C. Blood pressure. D. Urinary output. 62. 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. Take medication, go for a 30 minute morning walk, then eat breakfast. B. Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk. C. Take medication with breakfast, then take a 30 minute morning walk. D. Go for a 30 minute morning walk, eat breakfast, then take medication. 63. A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the past four days has become increasingly restless and irritable, and begins to hallucinate. Which action should the nurse take first? A. Administer a PRN dose of the PO lithium. B. Administer naloxone IV push. C. Decrease the IV infusion rate of the meperidine. D. Increase the IV infusion rate of the meperidine. 64. A client being discharged is prescribed warfarin for the treatment following a pulmonary embolism. Which diagnostic test should the nurse instruct the client to receive once a month? A. Perfusion scan. B. Prothrombin Time (PT). C. Activated partial thromboplastin (aPTT). D. Serum Coumadin level (SCL). 65. A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved? A. Decreased blood pressure. B. Lessening of tremors. C. Increased salivation. D. Increased attention span. 66. A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse how the medication works. Which is the best response to give the client? A. It decreases the amount of thyroid-stimulating hormone circulating in the blood. B. It increases the amount of thyroid-stimulating hormone circulating in the blood. C. It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid. D. It inhibits the synthesis of T3 and T4 by the thyroid gland. 67. A client with heart failure is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructions should include reporting which problem to the healthcare provider? A. Weight loss. B. Dizziness. C. Muscle cramps. D. Dry mucous membranes. 68. 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 pulse decreases from 120 to 90. C. Client's systolic blood pressure decreases from 180 to 90. D. Client's SaO2 level increases from 92% to 96%. 69. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? A. Observe respiratory rate and depth. B. Assess the serum potassium level. C. Obtain the client's blood pressure. D. Monitor the serum glucose level. 70. In evaluating the effects of lactulose (Cephulac), which outcome would 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. 71. A client is prescribed aluminum hydroxide for peptic ulcer disease. Which statement by the client demonstrates an understanding of the action of the medication? A. It decreases the production of gastric secretions. B. It produces an adherent barrier over the ulcer. C. It helps maintain a gastric pH of 3.5 or above. D. It slows down the gastric motor activity.