Medical Surgical Nursing Harmacology Practice

harmacology 1. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication hypotension rationale: ACE drug, used to lower BP, can cause hypotension and postural hypotension, especially during the first 3 hours of the initial dose 2. A nurse is reinforcing teaching with a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates a need for further teaching? " I should notify my provider immediately if my urine turns orange" rationale : phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. Medication can cause the client's urine to turn a reddish-orange color. coloration can stain clothing this finding does not need to be reported to the provider. 3. A nurse is caring for a client who has new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidasis is a manifestation of which of the following adverse effect ? Superinfection Rationale: superinfection can develop from the overgrowth of fungus due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a superinfection, such as soreness of the mouth and a swollen tongue. 4. 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? Antiestrogenic Rationale: Tamoxifen is an antiestrogen medication used to treat cancer of the breast in both pre-and postmenopausal women who are at an increased risk 5. 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? acetaminophen rationale: Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of GI bleeding. 6. 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 effect? muscle weakness Rationale: Cholorthiazide is a thiazide diuretic used to treat hypertension and CHF. It promotes excretion of water and sodium, and potassium, and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias. 7. 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? migraine headaches rationale: ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, causes vasoconstriction of dilated cerebral blood vessels. 8. A nurse is reinforcing teaching with a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? fever rationale: fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue the allopurinol and notify the provider if a fever or rash develops. 9. A nurse is reinforcing teaching with 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? take the hydrochlorothiazide in the morning rationale: the client should take hydrochlorothiazide in the morning to allow for diuresis during the day and prevent nocturia 10. A nurse is reinforcing teaching with a class 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? Reye's syndrome rationale: aspirin should not be given to children or adolescents who have a viral infection, such as chickenpox or influenza; due the risk of developing Reye's syndrome 11. A nurse is collecting data from a client who has taken methimazole for a thyroid disorder during the past month. Which of the following findings demonstrates an expected response to methimazole? decrease in body temperature rationale: methimazole inhibits thyroid production for a client who has hyperthyroidism. increase body temperature with warm, moist skin is a manifestation of hyperthyroidism, therefore a decreased body temperature is an expected response to the medication. Other findings demonstrating effectiveness of the medication include decreased pulse rate and decrease in metabolic rate, which allows the client to maintain a healthy body weight. 12. A nurse is reinforcing teaching with a parent of a child who has asthma and a new prescription for cromolyn metered dose inhaler. Which of the following statements by the parent indicates a need for further teaching? I will give my child a dose as soon as wheezing starts rationale: Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication. 13. A nurse is reinforcing teaching with 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? intestinal obstruction rationale: Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction perforation 14. A nurse is reinforcing teaching with a client who has 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? stress fractures 15. 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 effect? Dizziness 16. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostics tests should the nurse plan to obtain prior to administering the medication? electrocardiogram Rationale: amitriptyline can cause tachycardia and ECG changes. Older adult is at risk for cardiovascular effects of amitriptyline. therefore an ECG should be performed prior to the start of therapy to obtain a baseline of the clients cardiovascular status. 17. a nurse is caring for a client who has bronchitis and a prescripition for a mucolytic agent. which of the following findings should the nurse identify as an adverse effect of this type of medicaiton? bronchospasm 18. a client has been taking levothyroxine for 3 months. which of the following statements by the client indicates that a decrease in the dosage of levo might be needed? " I am having trouble getting to sleep at night " 19. a nurse is collecting data from a client who is taking vasopressin for diabetes. which of the following findings should the nurse identify as a manifestation of water intoxication associated with this medication ? headache 20. an addidson disease patient is placed on fludrocortisone. which of the following pieces of information should the nurse provide when explaining the purpose of this therapy? mineralocorticoids maintain electrolyte and fluid balance 21. a nurse is reinforcing discharge teaching with a 6 year old client who has asthma and several prescription medications using a metered dose inhaler . what instructions should the nurse include in the teaching ? add a spacer to each MDI 22. a nurse is caring for a client who has multiple medication allergies during which of the following steps of the nursing process should the nurse identify the clients allergies? data collection 23. a nurse is caring for a client who has psudomonas infection and a new prescription for ticarcillin-clavulanate. which of the following should the nurse collect befor administering this medication? baseline BUN and creatine 24. a nurse is teaching a client who is experiencing age related vaginal atrophy and has a prescription for estradiol cream. which of the following statements should the nurse include in the teaching ? this medication has fewer systemic effects than oral estrogen 25. a nurse is administering brimonidine eye drops to a client who has glaucoma. which of the following ocular effects should the nurse expect ? decreased intraocular pressure 26. which food is safe for a client to consume while taking phenelzine? broiled beef steak 27. a nurse is preparing to apply fentayl transdermal patch to a client who has chronic pain. which of the following actions should the nurse take? press the patch firmly for 30 seconds to ensure contact with the skin 28. adverse effect of ADHD medication amphetamine/dextroamphetamine mixture? palpitations 29. the nurse should instruct to discontinue taking allopurinol if which adverse effect comes about ? fever 30. a nurse is caring for a client who has developed MRSA in a surgical incision. which of the following medications should the nurse expect the provider to prescribe? vancomycin 31. a nurse is assisting with a clients laceration repair in which the provider will use both lidocaine and epinephrine. the nurse should inform the client that epinephrine will perform which of the following actions? delay systemic absorption of the anesthetic properties of lidocaine 32. what lab should you monitor with a client who has a new prescription for isoniazid for a positive TB skin test AST aspartate aminotransferase 33. how should a nurse calculate the medication dosage for a preschooler? weight 34. hydrochlorothiazide can be used for . . . diabetes insipidus and hyertension 35. a nurse is collecting data from a client who is recieving omeprazole to treat a gastric ulcer. which of the following findings should the nurse report to the provider immediately ? diarrhea 36. a nurse is reinforcing teaching with a client who has asthma and a new prescription for a short acting beta2 agonist (SABA) bronchodilator no data 37. a nurse is planning care for a client who is postoperative and schedule to ambulate. at which of the following times should the nurse plan to administer PO morphine to the client for peak analgesic effect during ambulation? 60 to 90 minutes prior to ambulation 38. a nurse is caring for a client who reports diarrhea and abdominal cramps. the client tells the nurse " i take a variety of vitamin supplements." the nurse should identify the clients manifestations as potential adverse effects of which of the following vitamin supplements? ascorbic acid 39. migraine headaches what meds to take? sumatriptan 40. a nurse is collecting data from a client who is taking duloxetine to treat diabetic neuropathy pain. for which of the following manifestations should the nurse monitor as a potential adverse effect to the medication ? dry mouth 41. a nurse is reinforcing teaching with a client who has cirrohiss and a new prescription for lactulose. the nurse should inform the client that lactulose has which of the following therapeutic effects? lactulose does not decrease heart rate 42. a nurse is collecting data from a client who is taking bethanechol for urinary retention. which of the following findings should the nurse identify as a contrainidication for taking this medication blood pressure 112/70 43. a nurse is planning care for a client who is reciving gentamincin IM and has a new prescription to obtain gentamicin peak and trough levels. at which of the following times should the nurse plan to obtain a blood sample to evaluate the gentamixin peak? 1 hour after administering the IM injection 44. a nurse is caring for a client who is experiencing acute pain and is receiving morphine. which of the following findings should indicate to the nurse the need to withhold the clients next dose of morphine the clients respiratory rate is 10 / min 45. a nurse is caring for a client who is due to receive general anesthesia. the client asks the nurse what is the difference betweeen analgesic and anesthesia. which of the following statements should the nurse make ? anesthesia can cause loss of consciousness 46. a nurse is reinforcing teaching with a client who has a prescription for chenodiol for the treatment of gallstones. which of the following client statements indicates an understanding of the teaching? liver function tests are required while taking this medication 47. a nurse is reinforcing teaching with a client who has chronic bronchitis about how to administer acetylcysteine using a handheld nebulizer which of the following client statements indicates an understanding of the teaching i should try to cough productively just before i begin the treatment 48. a nurse is reviewing the medical record of a client who is asking about taking a combination oral contraceptive. which of the following findings should the nurse identify as a contraindication to taking this form of contraceptive? history of thrombophlebitis 49. a nurse is reinforcing with a client who has type 2 diabetes mellitus about a prescription for insulin lispro. which of the following statements should the nurse include in the teaching? insulin lispro has an onset of about 15 minutes 50. a nurse is reinforcing teaching with a client who is starting patient controlled analgesia following a procedure. which of the following client statements indicates an understanding of the teaching? the method works by keeping my opioid levels steady 51. a nurse is caring for a client who is experiencing an acute asthma exacerbation. which of the following medications should the nurse identify as being contraindicated for this client? propranolol 52. a nurse is reinforcing teaching with a female client who has a new prescription for misoprostol to treat peptic ulcer disease. which of the following client statements should indicate to the nurse that the teaching was effective ? i should avoid becoming pregnant while taking this medication 53. a nurse is preparing to administer an initial dose of zileuton to a client for asthma prophylaxis. for which of the following manifestatinos should the nurse monitor as a potenital adverse reaction? hallucinations 54. a nurse is caring for a client who is pregnant and inquiring about alternative, non pharmacological therapies for nausea and vomiting of pregnancy. which of the following options should the nurse recommend? ginger is effective in the treatment of nausea vomiting 55. adverse effect of COPD med tiotropium? mouth dryness 56. a nurse is caring for a client with type 1 diabetes mellitus who has a prescription to administer regular insulin subq. which of the following insulin durations should the nurse identify for regular insulin? short duration, slow acting 57. a nurse is caring for a female adult client who is experiencing menopause and has a prescription for estrogen along with progestin. the nurse should identify that the provider has prescribed these medications for which of the following reasons? short term use to control urogenital atrophy 58. what medication should you expect the provider to prescribe for fibromyalgia pregabalin 59. a nurse is administering a medication to a client. the nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the clients cell membranes? lipid solubility 60. a nurse is preparing an in service sessios for medical surgical staff on infections and antibiotic use. which of the following antibiotics should the nurse identify as having the highest rate of sever allergic reactions? penicillins 61. a nurse is preparing to administer an IM injection for a client. which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route? the client is takin an anticoagulant 62. a nurse is collecting data from a client who has TB and a prescription for ethambutol. the nurse should inform the client that he is likely to develop which of the following alterations as an adverse effect of this medication loss of red/green color discrimination 63. a nurse is reviewing the medication history of a client who has mild intermittent asthma. the nurse should anticipate a prescription for which of the following inhalers for the client? albuterol sulfate 64. a nurse is reinforcing teaching with a client who is postmenopausal and has a prescripition for alendronate. which of the following statements should th nurse include in the teaching? take this medication on an empty stomach 65. a nurse is checking a client who is receiving an IV infusion of telavancin of streptococcus pyogenes. which of the following actions should the nurse perform. check the client for pruritus 66. a nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. which ofthe following actions should the nurse take? apply the ointment using a dose measuring applicator 67. a nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. which of the following findings should the nurse identify as a contraindication to the client receiving this medication? hep. B virus 68. a nurse is preparing to administer levothyroxine to a client who has hypothyroidism. the nurse should idenify which of the following lab results as supporting the administration of this medication. thyroid stimulating hormone 8 microunits/ml 69. a nurse is reinforcing teaching with a client about a new prescription for captopril to treat hypertension. which of the following client statements indicates an understanding of the teaching? i might feel dizzy at times while taking this medication 70. a nurse is caring fora n adolescent who has cystic fibrosis and has a prescription for high dose ibuprofen daily. the nurse should identify that which of the following is an expected outcome for the client receiving this medication slowed progression of pulmonary damage 71. a nurse is reinforcing teaching with the partner of a client who has moderate alzheimers disease about a new prescription for a rivastigmine transdermal patch. which of the following information should the nurse provide? the old patch should be removed before a new patch is applied 72. a nurse is collecting data from a client who has cystic fibrosis. which of the following peices of information indicates a therapeutic response to pancreatic enzyme replacement? the client is having 1-2 bowel movements per day 73. what labs should you test for a client wit alzheimers taking memantine ? creatinine clearance 35 mL/min 74. a nurse is assisting in teaching a group of nurses about the effects of a client receiving spinal anesthesia. which of the following pieces of information should the nurse include in the teaching? hypotension is an adverse effect of spinal anesthesia 75. a nurse is reinforcing teaching with the guardian with DTAP vaccine which of the following pieces of information should the nurse include in the teaching ? the first immunization for DTaP in the series is given at 2 months 76. a nurse is collecting data on a client who has developed hypertension which of the following medications should the nurse expect the provider to prescribe first hydrochlorothiazide 77. Losartan administration  ARBs  combo hydrochlorothiazide (Hyzaar)  May be taken with or without food  liver failure  angioedema  headache  dizziness  hypotension  insomnia 78. What administration considerations apply to spironolactone?  Available for oral use only  Give alone or combined with other antihypertensive drugs  Maximum effect may take up to 4 weeks  hyperkalemia 79. What administration considerations apply to aliskiren?  oral form only  High fat-meals decrease absorption  Give at a consistent time daily before eating  2 weeks before full effect is seen  hypotension  hyperkalemia  cough  angioedema 80. What administration considerations apply to nifedipine?  capsules  sustained release form is approved to treat hypertension; do not chew or crush  combo with beta blocker to prevent reflex tachy  headache, dizziness  peripheral edema  gingival hyperplasia 81. What administration considerations apply to doxazosin?  Give at bedtime – ortho hypo  reflex tachy  headache dizziness 82. What administration considerations apply to atenolol and metoprolol?  Atenolol and metoprolol are available for oral or IV use  Give IV initially and then orally for acute myocardial infarction  Give orally for hypertension  Atenolol is available in a tablet which may be crushed or swallowed  Metoprolol is available as an immediate-release tablet (Lopressor) or in a sustainedrelease dose (Toprol XL), which must not be crushed and must be swallowed whole  Absorption of metoprolol may be enhanced with food; take at consistent time each day  Atenolol is best taken before meals or at bedtime  bradycardia  heart failure  rebound excitation causing angina pain or MI 83. What administration considerations apply to reserpine?  oral use only  Administer with food or milk to prevent GI symptoms  severe depression  risk of suicide  bradycardia  ortho hyo  diarrhea, cramping 84. What administration considerations apply to clonidine?  orally or as transdermal to treat hypertension  Give oral dose at bedtime to prevent daytime sedation  start low and gradually increase to prevent severe hypotension  Apply transdermal patch to a dry, relatively hairless area of skin on the upper outer arm or anterior chest once every 7 days  Rotate transdermal sites and monitor skin for inflammation, irritation  Be sure to remove the old patch before applying a new patch  drowsiness, dizziness, dry mouth  rebound hypertensive 85. What administration considerations apply to carvedilol?  Available for oral use only  Give with food to minimize orthostatic hypotension      dizziness hypotension bradycardia postural hypotension exacerbation of asthma 86. What administration considerations apply to hydralazine?  oral, IM, or IV forms  Give oral dose with food to enhance effectiveness  Oral dosage begins low and is gradually increased  Administer IV form undiluted; do not add to other solutions         headache dizziness weakness , fatigue reflex tachy SLE symptoms can occur fluid retention edema hypertensive crisis & hf 87. What administration considerations apply to hydrochlorothiazide?  orally alone and in fixed-dose combination with multiple other drugs, such as potassium-sparing diuretics, ACE inhibitors, ARBs, beta blockers and other antihypertensive drugs  Chlorothiazide is available in IV form  Give with food to minimize GI effects  Give last dose of day by 3 p.m. to prevent nocturia and sleep loss    electrolyte imbalance hyperglycemia increased uric acid levels 88. What administration considerations apply to dobutamine?  Available for IV infusion only  Dose based on client’s weight and titrated based on continuous monitoring of vital signs, ECG, urine output, and (if available) cardiac output and pulmonary wedge pressures  Peak effect obtained about 10 minutes after infusion begins  Multiple infusion incompatibilities exist; use dedicated IV line for infusion  Correct any fluid volume deficits before administering dobutamine    tachycardia cardiac dysrhythmias angina pain 89. What administration considerations apply to milrinone? IV infusion only  Give a loading dose over 10 minutes and then administer a dose based on client’s weight by continuous infusion     hypokalemia cardiac dysrhythmias hypotension anginal chest pain 90. What administration considerations apply to atorvastatin?  Available orally only  For greatest effectiveness, take in the evening with or without food (take one statin, lovastatin [Mevacor], with food for better absorption 91. What administration considerations apply to gemfibrozil?  Usually taken twice daily, 30 minutes before breakfast and evening meals  Monitor periodic LDL, HDL, triglyceride, and total cholesterol levels for improvement  nausea, abdominal pain, diarrhea, gallstones, myopathy , liver toxicity 92. What administration considerations apply to quinidine and procainamide?  oral, IM and IV forms  IM administration is painful and has poor absorption  Oral dosing is preferred – Give oral dose 1 hr before or 2 hr after meals for best absorption; give with food if GI symptoms occur  Do not crush or chew extended-release tablets  If giving IV procainamide, wait 4 hr before administering an oral dose  For IV doses, use an IV pump and infuse at recommended rate and dilution  Multiple IV solution incompatibilities exist; avoid infusing with other drugs or solutions 93. What administration considerations apply to lidocaine?  Available for IV infusion (IV preferred for dysrhythmias; local administration for anesthesia only)  IM administration is for emergency use only  Add 2 g lidocaine to 250 or 500 mL D5W and infuse at 1 to 4 mg/minute (per prescription) using an IV pump  Assure that the correct lidocaine preparation is used for the specific type of therapy (e.g. labeled for IV use only)  Incompatible in solution or tubing with other drugs, such as some antibiotics, phenytoin 94. What administration considerations apply to flecainide and propafenone?  Available for oral use only  Begin with low dose and increase gradually no more frequently than every 4 days until maximum or desired dose has been reached     dizziness, dyspnea , visual distrubances worsening of heart failure edema widen qrs complex 95. What administration considerations apply to propranolol?  Available for oral or IV use  Use the IV route to treat life-threatening dysrhythmias  Take either with or without food at consistent times during the day to minimize adverse effects  Take client’s BP and pulse before administering propranolol; withhold drug and notify provider if BP is below 90 mm/Hg systolic or if pulse is slower than 60 beats/min  Give IV dose either directly by IV bolus over 1 minute or give an intermittent infusion over 15 to 20 minutes 96. What administration considerations apply to amiodarone?  Available for oral and IV use  Give oral amiodarone with or without food, but at consistent times during the day  Infuse IV dose through central line catheter to prevent thrombophlebitis of peripheral IV sites  Begin oral dosing with hospitalized client  Correct low potassium or magnesium levels before beginning therapy 97. What administration considerations apply to verapamil?  Available for oral or IV use  Give oral dose with food to prevent GI upset  IV form: give dose using recommended dilution over 2 to 3 minutes; monitor cardiac rhythm and vital signs continuously 98. adverse drug reactions associated with captopril?  Severe hypotension following first dose (most likely in clients taking diuretics, with high BP, or who have hyponatremia)  Dry, nonproductive cough due to increase in bradykinin  Rash and report of metallic taste in mouth  Angioedema (swelling of mouth, throat (due to inhibition of kinase II)  Hyperkalemia  Neutropenia (decrease in white blood cells with increased risk of infection) 99. a pcp is considering the various pharmacologic options for a patient who has gynecologic infection and a history of alcohol use disorder. which of the following medications can cause a reaction similar to disulfiram (antabuse) if the patient drink alcohol while taking it? cefotetan metronidazole 100. a health care professional is caring for a patient who is taking warfarin (coumadin) and is about to begin taking trimethoprim/sulf (bactrim) to treat a uti. the health care professional should question the drug regimen because taking these two drugs concurrently can increase the risk for what? bleeding 101. a primary care provider should prescribe a lower dose of aztreonam for a patient who has a respiratory tract infection and also has which of the following ? renal impairment 102. which of the following drugs should a provider prescribe for a patient who has streptococcal pharyngitis and is allergic to penicillin erythromycin 103. a health care professional is caring for a patient who is about to begin taking ketoconazole to treat a fungal infection. the health care professional should tell the patient to report which of the following adverse effects of the drug? gynecomastia 104. a hcp is caring for a patient who is taking cipro to treat a UTI and has rheumatoid arthritis, for which he takes prednisolone. recognizing the adverse effects of cipro, the health care professional should tell the patient to report which of the following? tendon pain 105. a hcp is caring for a patient who is about to begin taking metronidazole (flagyl) to treat an anaerobic intra abdominal bacterial infection. the hcp should recognize that cautious use of the drug is indicated if the patient also has which of the following ? seizure disorder 106. a hcp is caring for a patient who is about to begin taking chloroquine (aralen) to prevent malaria. when talking with the patient about taking the drug, the hcp should include which of the following instructions ? - wear sunglasses - avoid driving - take with food 107. a hcp is caring for a client who is about to take nitrofurantoin to treat UTI the hcp should tell the patient to report which of the following adverse effects of this drug? cough 108. a pcp is prescribing drug therapy for a patient whose sputum culture results indicate methicillin resistant staph. aureus. which of the following drugs should be administer? vancomycin 109. a health care professional is caring for a patient who is about to begin using nystatin to treat oral candida albicans that resulted from tetracycline therapy. which of the following instructions should the health care professional include about use the antifungal preparation? swish the suspension in the mouth before swallowing it 110. a hcp is caring for a patient who is about to begin taking isoniazid to treat TB the hcp should tell the patient to report which of the following adverse effects of the drug? - jaundice - numbness of the hands - dizziness 111. a hcp is prep. to administer amphotericin B IV to a patient who has systemic fungal infection . which of the following drugs should the hcp administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration? - acetaminophen - diphenhydramine 112. when administering erythromycin to a patient who has pneumoccoccal pneumonia, the HCP should monitor for which of the following adverse effects of the drug cardiac dysrhythmias 113. a patient taking tetracycline orally to treat chlamydia infection contacts hcp to report severe blood tinged diarrhea. the hcp should suspect which adverse effects? pseudomembranous enterocolitis 114. when administering IV cefotetan to a patient to treat bacterial meningitis, the hcp finds the IV insertion site warm and reddened. which of the following actions should the hcp take ? stop the cefotetan infusion 115. a patient who is taking amoxicillin to treat a respiratory infections contacts the hcp to report a rash and wheezing. which of the following instructions should the health care professional provide? call emergency services immediately 116. a hcp is caring for a patient who is about to begin taking keflex to treat bacterial meningitis. the health care professional should explain to the patient the need to monitor which of the following lab tests? creatinine 117. a patient who is taking imipenem to treat a bacterial infection contacts he health care professional to report an inability to eat because of mouth pain. recognizing the adverse effects of impenem, the hcp should expect what? suprainfection 118. a hcp is caring for a patient who is about to receive gentamicin to treat a systemic infection,. the HCP should question the use of the drug for a patient who is taking which of the following drugs? furosemide 119. a hcp is caring for a patient who takes oral contraceptive and is about to begin rifampin therapy to treat tb, the HCP should include which of the following instruction? use additional contraception 120. a patient is taking cipro to treat respiratory infection contacts the health care professional to report dyspepsia. the health care professional should recommend which of the following instructions take an antacid at least 2 hour after taking the drug 121. what labs to watch out for when taking acyclovir to treat herpes simplex infection? BUN 122. a hcp is caring for a patient who is about to begin gentamicin therapy to treat an infection. the hcp should monitor which of the following? urine output 123. a hcp is caring for a patient who is about to begin receiving acyclovir zovirax IV to treat a viral infection. the hcp should recognize that cautious use of the drug is essential if the patient also has which of the following dehydration 124. a hcp is talking to a client about giving the correct dose of acetaminophen to the patients infant. the hcp explains that infants can absorb certain drugs at different rates than adults. which of the following is a physiologic characteristic of infants that can alter drug absorption delayed gastric emptying 125. a nurse is monitoring a client who has type 2 DM and is recieving repaglinide which of the following laboratory tests should the nurse plan to review to obtain information about the long term therapeutic effect of this medication? glycosylated HbA1c 126. a nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin transdermal patch. which of the following instructions should the nurse include? place patch on a different site for each application 127. a nurse is collecting data from a client who is post op and taking morphine for pain, which of the following findings is the priority for the nurse to report to the proivder ? O2 Sat of 87% 128. a nurse is reinforcing teaching with a client who has a new prescription for propranolol. which of the following information should the nurse include in the teaching? if your pulse rate is less than 50 beats per minute, notify your provider 129. a nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. the nurse should include in the plan to monitor the client for which of the following adverse effects to this medication? agranulocytosis 130. a nurse is reinforcing teaching with a client who has a prescription for alendronate. which of the following client responses indicates to the nurse an understanding of the teaching? " I will take the medication with 8 ounces of water " 131. a nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. which of the following information from the clients medical record should the nurse report to the provider BEFORE the client begins receiving this medication? penicillin allergy 132. a nurse is monitoring a client who is receiving a transfusion of packed RBCs the clients temperature increases to 39.1 C (102.4 F) which of the following actions should the nurse take first? stop the transfusion 133. a nurse is reinforcing teaching about comfort measures with the parent of a 10 year old child who has a viral infections. the nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions. reye syndrome 134. a nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. which of the following instructions about self administering medication should the nurse include? discard any solutions that are cloudy 135. a nurse is assisting with the care of a client who has a methicillin risistant staph MRSA infection and is receiving vancomycin via IV infusion. which of the following changes in the clients condition shouldthe nurse identify as the priority finding to report to the provider ? hypotension 136. a nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. which of the following actions should the nurse take to counteract the adverse effects of this medication? inform the client to apply sunblock before going outside 137. a nurse is reinforcing teaching with a client about the adverse effects of simvastatin. which of the following adverse effects should the nurse instruct the client to notify the provider ? muscle pain 138. a nurse is reinforcing teaching with a client who has a new prescription for theophylline. A nurse should instruct the client that which of the following is an expected outcome of the medication? dilates bronchioles 139. a nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. the nurse should monitor for which of the following adverse effects of this medication? hyperkalemia 140. a nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. which of the following instructions should the nurse include in the teaching? restrict foods high in potassium rationale: potassium sparing drug. will cause hyperkalemia 141. a nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. which of the following findings indicates to the nurse that the medication is having a therapeutic effect? decreased muscle spasticity 142. a nurse is planning to administer metoprolo to a client who has HF and a HR of 48/min. which of the following actions should the nurse take? withhold the clients medication rationale: medication decreases HR , should be withheld with a HR less than 50/min 143. a nurse is collecting data from a client who is taking ferrous sulfate orally. which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect? increased tolerance to exercise 144. a nurse is planning to reinforce teaching about newborn immunizations with a client who is 24 hours postpartum. which of the following information should the nurse plan to include ? " your baby will receive the first hepatitis B vaccine before discharge" 145. a nurse is reinforcing teaching with a client who has a new prescription for regular insulin. which of the following statements by the client indicates an understanding of the teaching? "I should ensure that the insulin is clear prior to drawing it up" 146. a nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. which of the following instructions should the nurse include? swallow the medication whole 147. a nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. the niurse should identify that which of the following findings is a contraindication to receiving celecoxib? history of myocardial infarction 148. a nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypertension. which of the following conditions should the nurse include as a contraindication for this medication? bradycardia 149. a nurse is teaching a client who has a new prescription for allopurinol. which of the following instructions should the nurse include? avoid driving or activities that require mental alertness 150. a nurse is caring for a group of postoperative clients. the nurse should identify that morphine is contraindicated for which of the following clients? a client who had a cholecystectomy 151. a nurse is reviewing the drug list for a client who has a new prescription for allopurinol. the nurse should identify that which of the following drugs interacts with allopurinol? warfarin rationale: allo. increases the effectiveness of warfarin. a lower dosage of warfarin might be required. 152. a nurse is caring for a client who has a new prescription for butorphanol. the nurse should monitor the client for which of the following adverse drug reactions? Nausea Dizziness Headache 153. a nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. the nurse should instruct the client to report which of the following adverse drug reactions? weight gain rationale : aspirin can cause renal impairment which can result in the retention of salt and water 154. A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? Aspirin 155. A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? - Discontinue the dug gradually - Report illness or infection - increase intake of calcium and vitamin D -Monitor for signs of gastric bleeding 156. a nurse is teaching a client who has a new prescription for allopurinol. the nurse should instruct the client to report which of the following adverse drug reactions? Sore throat Vertigo Bruising Vision changes 157. A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? hypokalemia 158. A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? Seizure disorder 159. A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? chest pain 160. A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? Sulfonamide allergy 161. A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? Diaphoresis Nausea Diarrhea 162. A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? eat a small meal before taking the drug 163. A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? -Increase fiber and fluid intake -Take the drug with food -Avoid driving after taking the drug -Change positions gradually 164. A nurse is caring for a client who is opioid dependant and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of ab syndrome? Vomiting Abdominal cramps Hypertension 165. A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? Urinary retention Respiratory depression Sedation Orthostatic hypotension 166. A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? bone loss 167. A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? fever 168. A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? Increased respiratory rate Increased pain Ventricular arrhythmias Hypertension 169. A nurse is planning care for a client who has stared taking prednisone. Which of the following interventions should the nurse include? monitor the client's blood glucose 170. A nurse is planning care for a client who has stared taking prednisone. Which of the following interventions should the nurse include? To reduce fever To relieve mild pain 171. A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? Fever Tinnitus Diaphoresis Dizziness 172. A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? Ibuprofen will reduce the cardioprotective effects of low-dose aspirin 173. A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? Alcohol use disorder 174. a nurse is reinforcing teaching with 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? reyes syndrome 175. a nurse is reinforcing teaching with 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? arthralgia 176. a nurse is reinforcing teaching with a client who has a new prescription for hydrochlorothiazide 50 mg po daily to treat hypertension. which of the following instructions should the nurse include in the teaching? take the hydrochlorothiazide in the morning 177. a nurse is reinforcing teaching with a client who has a UTI and a new prescription for phenazopyridine and cipro. which of the following statements by the client indicates the need for further teaching I should notify my provider immediately if my urine turns orange 178. a nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. the nurse should instruct the newly licensed nurse to monitor which of the following lab tests? liver function 179. 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 manifestion of which of the following adverse effects? superinfection 180. a nurse is collecting data from a client who has taken methimazole for a thyroid disorder during the past month. which of the following findings demonstrates an expected respone to methimazole ? decrease in body temperature 181. a nurse is reinforcing teaching with a client who has cirrhosis and a new prescription for lactulose. the nurse should instruct the client that lactulose has which of the following therapeutic effects? reduces ammonia levels 182. a nurse is caring for a client who has a new prescription for ergotamine. the nurse should recognize that ergotamin is administered to treat which of the following conditions? migraine headaches 183. 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 effect? dizziness 184. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostics tests should the nurse plan to obtain prior to administering the medication? electrocardiogram 185. A nurse is reinforcing teaching with a parent of a child who has asthma and a new prescription for cromolyn metered dose inhaler. Which of the following statements by the parent indicates a need for further teaching? I will give my child a dose as soon as wheezing starts. 186. A nurse is reinforcing teaching with a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? FEVER 187. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? BLEEDING 188. A nurse is reinforcing teaching with 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? intestinal obstruction 189. a nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? hypotension 190. 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 effect? muscle weakness 191. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? administer the medication into the client's abdomen 192. 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? acetaminophen 193. A nurse is reinforcing teaching with a client who has 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? stress fracture 194. 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 reslessness and tremors. which of the following medications should the nurse anticipate administering to the client first? chlordiazepoxide 195. a nurse is reinforcing teaching with a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin salmon. which of the following statements by the client indicates an understanding of the teaching I will need to depress the side arms to initially activate the pump - six times 196. a nurse is reinforcing discharge teaching about lithium toxicity with a client who has a new prescription for lithium. which of the following statements by the client indicates an understanding of the teaching? I can develop lithium toxicity if I experience vomiting or diarrhea rationale: vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys and the risk for lithium toxicity increases 197. a nurse is administering insulin glulisine 10 units subq at 0730 to an adolescent client who has type 1 DM. the nurse should anticipate onset of action of the insulin at what time? 0745 rationale: very short onset of action of 15 minutes. ensure the client eats breakfast immediately following administration of the insulin 198. a nurse is reviewing the medical record of a client who is experiencing an acute migraine attack and has a new prescription for sumatriptan. which of the following findings indicates a contraindication to the administration of the medication? history of uncontrolled hypertension rationale: sumatriptan can cause coronary vasospasm. it is contraindicated for a client who has a history of myocardial infarction, heart disease, uncontrolled hypertension 199. a nurse is collecting data from a client who has hyperthyroidism and takes levothyroxine. which of the following findings should alert the nurse that the client is experiencing acute levothyroxine overdose? tremors 200. a nurse is reinforcing teaching with the parents of a school age child who has asthma about medications for bronchospams. which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack? albuterol 201. a nurse is caring for a client who has heart failure and is taking oral furosimide 40 mg daily. for which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs? tinnitus 202. a nurse is preparing to administer a transdermal contraceptive patch to a female client. which of the following actions should the nurse plan to take? apply the patch to an area of skin on the lower abdomen rationale: apply the patch to clean, dry area of the lower abdomen, butt, upper outer arm, or the front or back of the upper torso. the nurse should avoid breast tissue or skin that is red, cut or irritated 203. a nurse is administering oral hydroxyzine to a client. which of the following adverse effects should the nurse instruct the client to expect? Dry mouth rationale: anticholinergic property. dry mouth is most common adverse effect of this medication. the nurse should encourage the client to take sips of water or suck hard candies to minimize this effect 204. a nurse is caring for a client who has a positive tb skin test and a new prescription for isoniazide.for which of the following laboratory values should the nurse monitor? aspartate aminotransferase (AST) rationale: isoniazide can be toxic to the liver. monitor liver enzymes such as AST during therapy, instruct the client to notify the provider about jaundice, nausea, dark colored urine or other findings indicating hepatitis 205. A nurse is collecting data from a client who takes oral theophylline for relief of chronic bronchitis. the nurse should recognize that which of the following findings indicates toxicity to ttheophylline? tremors rationale: theophylline is a xanthine deravitive bronchodilator. Tremors is often an early manifestion of toxicity seizures can occur if blood levels continue to rise 206. a nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25mg PO to the client instead of prescribed dose of digozin 0.125 mg PO which of the following actions should the nurse take first? check the clients apical pulse 207. a nurse is reinforcing discharge teaching with a client who has major depressive disorder a new prescription for phenlezine. which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? broiled beef rationale: phenelzine is a MAOI antidepressant. This medication interacts with a variety of foods to produce hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume 208. a nurse is reinforcing teaching with a client who is to start taking hydrochlorothiazide for hypertension the nurse instructs the client to eat foods rich in potassium. which of the following statements by the client indicates an understanding of the teaching? This medication can cause a loss of potassium 209. a nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. which of the following data should the nurse plan to review prior to administration of this medication? blood pressure rationale: epo alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. the nurse should monitor the clients blood pressure and notify if it increases. the client who receives epo frequently requires concurrent use of antihypertensive medicatinos 210. a nurse is reinforcing discharge teaching with a client who has HF 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? I will eat fruits and vegetables that have high potassium content every day 211. a nurse is reinforcing discharge teaching with a client who has venous thrombosis and a prescription for warfarin. which of the following instructions should the nurse include in the teaching? carry a medic alert ID card a client who is taking warfarin is at increased risk for bleeding. 212. a nurse in an outpatient facility is collecting data from a client who has a prescription for furosemide 40 mg daily. the client reports that she has been taking extra doses to promote weight loss. which of the following findings should indicate to the nurse that the client is dehydrated? urine specific gravity 1.035 213. a nurse is reinforcing teaching with a client who has hypertension and a new prescription for oral clonidine. which of the following instructions should the nurse include avoid driving until the clients reaction to the medication is known 214. a nurse is reinforcing discharge teaching with a 6 year old client who has asthma and several prescription medication using a metered dose inhaler. which of the following instructons should the nurse include in the teaching? add a spacer to each MDI