Practice A Pharmacology With Answer & Rationale Part 1

Practice A Pharmacology With Answer & Rationale ATI Practice A Pharmacology 2 1. A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching? A. "I should apply a patch every 5 minutes if I develop chest pain." B. "I will take the patch off right after my evening meal." C. "I will leave the patch off at least 1 day each week." D. "I should discard the used patch by flushing it down the toilet." A. Nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses sublingual tablets should place one tablet under their tongue at the onset of angina pain and continue taking a tablet every 5 min for a total of three doses of nitroglycerin. The effects of a nitroglycerin patch will take 30 to 60 min to occur and are not useful to prevent an ongoing angina attack. B. Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects. C. Nitroglycerin is an antianginal medication that results in dilation of the coronary vessels. Clients should apply the patch daily to sustain prophylaxis. D. Medication remains in the transdermal patch after removing it from the body and must be discarded safely. The nurse should instruct the client to fold the patch ends together with the medication on the inside and place the discarded patch in a closed container so that children and pets cannot gain access to the medication. 2. A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? A. MSO4 5 mg subcut every 4 hr PRN severe pain B. Morphine 5 mg subcut every 4 hr PRN severe pain C. MSO4 5 mg SQ every 4 hr PRN severe pain D. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain A. The use of the abbreviation MSO4 is prohibited by The Joint Commission. The medication name of morphine must be spelled out to reduce the risk for error. B. The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription. C. The use of the abbreviations MSO4 and SQ are prohibited by The Joint Commission. The abbreviation SQ can be mistaken for SL and, therefore, this route should be written as subcut, subq, or subcutaneously. D. The trailing zero on 5.0 can be mistaken for 50 if the decimal point is missed. Therefore, the dosage should be written as 5 mg without a trailing zero. 3. A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? A. Tingling of fingers B. Constipation C. Weight gain D. Oliguria A. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide. B. Diarrhea is an adverse effect of acetazolamide due to gastrointestinal disturbances. C. Weight loss is an adverse effect of acetazolamide due to gastrointestinal disturbances causing reduced appetite. D. Polyuria, rather than oliguria, is an adverse effect of acetazolamide. 1 Practice A Pharmacology With Answer & Rationale 4. A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? A. Report the incident to the charge nurse. B. Notify the provider. C. Check the client's blood glucose. D. Fill out an incident report. A. The nurse should report the incident to the charge nurse to protect the client from injury. However, there is another action the nurse should take first. B. The nurse should notify the provider to protect the client from injury. However, there is another action the nurse should take first. C. The first action the nurse should take using the nursing process is to assess the client. The client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia. D. The nurse should fill out an incident report to document the incident. However, there is another action the nurse should take first. The incident report alerts the risk manager to the incident, who then determines the cause and a plan of action to reduce the risk of reoccurrence. 5. A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine? A. Constipation B. Drowsiness C. Facial flushing D. Itching A. Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine. B. Drowsiness is not an adverse effect of morphine that can be minimized by taking docusate sodium. C. Facial flushing is not an adverse effect of morphine that can be minimized by taking docusate sodium. D. Itching is not an adverse effect of morphine that can be minimized by taking docusate sodium. 6. A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings? A. Diastolic BP B. Systolic BP C. Heart rate D. Respiratory rate A. Digoxin increases cardiac output and reduces the heart rate. A diastolic BP of 86 mm Hg is not a cause for withholding the medication and contacting the provider. B. Digoxin increases cardiac output and reduces the heart rate. A systolic BP of 140 mm Hg is not a cause for withholding the medication and contacting the provider. C. Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity. D. Digoxin increases cardiac output and reduces heart rate. A respiratory rate of 20/min is not a cause for withholding the medication and contacting the provider. 2 Practice A Pharmacology With Answer & Rationale 7. A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? A. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified. B. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. C. 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath. D. IV fluid initiated at 0500. Lungs clear to auscultation. A. The RN should only chart factual information in pt's medical record without indicating the error that occurred. B. The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status. C. This documentation is not complete because it does not include the amount of fluid that was infused over the amount of time. D. This documentation is not complete because it does not include the amount of fluid that was infused over the amount of time. 8. A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? A. Decreases stomach acid secretion B. Neutralizes acids in the stomach C. Forms a protective barrier over ulcers D. Treats ulcers by eradicating H. pylori A. Peptic ulcer disease manifests as an erosion of the gastric or duodenal mucosa. The acid production in the stomach causes further irritation and pain. H2 receptor antagonists, such as famotidine, decrease stomach acid secretion. B. Acid production in the stomach causes further irritation and pain to a client who has a peptic ulcer. Antacids, such as aluminum hydroxide, neutralize acids in the stomach and prevent pepsin formation, a digestive enzyme that can further damage the eroded epithelium. C. Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin. D. A common cause of peptic ulcers is a bacterial infection with Helicobacter pylori. Treatment of the ulcer includes a combination of antibiotics, such as metronidazole, tetracycline, clarithromycin, or amoxicillin, to eradicate the H. pylori infection. 9. A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia? A. Tall, tented T-waves B. Presence of U-waves C. Widened QRS complex D. ST elevation A. The nurse should identify tall, tented T-waves as a manifestation of hyperkalemia. Flattened or inverted T-waves are a manifestation of hypokalemia. B. The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide. C. The nurse should identify a widened QRS complex as a manifestation of hyperkalemia. 3 Practice A Pharmacology With Answer & Rationale D. The nurse should identify ST elevation is an indication of ischemia. ST depression is a manifestation of hypokalemia. 10. A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? A. Constipation B. Tinnitus C. Hypoglycemia D. Joint pain A. Gentamicin, an aminoglycoside used to treat serious infections, can cause several gastrointestinal adverse effects, such as inflammation of the liver and spleen. However, it does not cause constipation. B. Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur. C. Gentamicin, an aminoglycoside used to treat serious infections, can cause alternations in the functions of the liver and spleen. However, pancreatic function, mainly insulin production, is not affected by this medication. D. Aminoglycosides, such as gentamicin, can result in neuromuscular adverse effects such as twitching or flaccid paralysis. However, joint pain is not an adverse effect of gentamicin. 11. A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? A. Administer the medication outside the 5 cm (2-in) radius of the umbilicus. B. Aspirate for blood return before injecting. C. Rub vigorously after the injection to promote absorption. D. Place a pressure dressing on the injection site to prevent bleeding. A. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus. B. The nurse should not aspirate by pulling back on the plunger of the heparin syringe to check for a blood return, because this will cause the injection site to bruise. C. The nurse should apply firm pressure to the injection site for 1 to 2 min after the administration of the heparin to prevent bruising. D. The nurse does not need to apply a dressing over the injection site if pressure is held for at least 1 min to prevent bleeding. 12. A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? A. "I have tendonitis, so I haven't been able to exercise." B. "I take a stool softener for chronic constipation." C. "I take medicine for my thyroid." D. "I am allergic to sulfa." A. The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture. B. Ciprofloxacin is not contraindicated for the client who takes a stool softener for chronic constipation. Diarrhea is an adverse effect of the medication. 4 Practice A Pharmacology With Answer & Rationale C. Ciprofloxacin does not affect thyroid function and is not contraindicated for the client who takes thyroid medication. D. Ciprofloxacin is a quinolone antibiotic. Therefore, the client who has a sulfa allergy can take this medication. 13. A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings? A. Potassium 5.0 mEq/ L B. aPTT 2 times the control C. Hemoglobin 15 g/dL D. Platelets 96,000/mm3 A. Although heparin can cause an increase in potassium levels, the client's potassium level is within the expected reference range of 3.5 to 5 mEq/L. B. This is a therapeutic aPTT level for a client receiving heparin and is not an indication to stop the heparin infusion. C. An Hgb of 15 g/dL is within the expected reference range of 14 to 18 g/dL for a male and 12 to 16 g/dL for a female and is not an indication to stop the heparin infusion. D. A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion. 14. A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? A. Turn the client to a side-lying position. B. Disconnect the client's oxytocin from the maintenance IV. C. Apply oxygen to the client by face mask. D. Increase the client's maintenance IV infusion rate. A. The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority action the nurse should take is to place the client in a lateral position. B. The nurse should discontinue the oxytocin to reduce uterine contractions. However, another action is the nurse's priority. C. The nurse should apply oxygen by face mask to provide supplemental oxygen to the fetus. However, another action is the nurse's priority. D. The nurse should increase the client's maintenance IV infusion rate to maintain adequate blood flow and promote placental perfusion. However, another action is the nurse's priority. 15. A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take? A. Document the refusal and inform the client's provider. B. File an incident report with the risk manager. C. Contact the pharmacist to pick up the medication. D. Give the client the medication to take at home and document that it was administered. A. The nurse has the responsibility to verify that the client understands the risks of refusing the medication so that an informed decision can be made. The nurse should then document the refusal in the client's medical record and notify the health care provider. B. The nurse does not need to complete an incident report if a client refuses to take a medication. An incident report is necessary for a medication error. 5 Practice A Pharmacology With Answer & Rationale C. The nurse should follow facility protocols for discarding the medication. It is not the role of the pharmacist to retrieve medications that a client refuses to take. D. The nurse should not give the client a scheduled medication to take at home and then document that it was administered, because this violates the ethical principle of accountability. 16. A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Tingling toes B. Sexual dysfunction C. Absence of dreams D. Pica A. Fluoxetine is an SSRI that can cause muscle twitching. However, distorted sensations in the extremities are not adverse effects of fluoxetine. B. Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant. C. Fluoxetine can cause CNS adverse effects including abnormal dreaming, sedation, delusions, hallucinations, and psychosis. However, an absence of dreams is not associated with fluoxetine. D. Fluoxetine can cause neurologic adverse effects such as agitation, euphoria, and sedation. However, an eating disorder such as pica is not associated with fluoxetine. 17. A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? A. Hold the client's other oral medications for 8 hr post administration. B. Inform the client that this medication can turn stool a light tan color. C. Keep the client's solution in the refrigerator for up to 72 hr. D. Monitor the client for constipation. A. The nurse should hold the client's other oral medications for 6 hr before and after administration of sodium polystyrene sulfonate. B. Sodium polystyrene sulfonate will not alter the color of the client's stool. C. Sodium polystyrene sulfonate solution is stable for 24 hr when refrigerated. D. The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction. 18. A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? A. 1000 B. 0900 C. 0830 D. 1200 A. The nurse should identify that administering an antibiotic 2 hr after the scheduled time is too late and requires filing an incident report. 6 Practice A Pharmacology With Answer & Rationale B. The nurse should identify that administering an antibiotic 1 hr after the scheduled time is too late and requires filing an incident report. C. The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report. D. The nurse should identify that administering an antibiotic 4 hr after the scheduled time is too late and requires filing an incident report. 19. A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? A. Muscle weakness B. Sedation C. Tinnitus D. Peripheral edema A. Metoclopramide is a central dopamine receptor antagonist that increases gastrointestinal motility and prevents nausea. Tardive dyskinesia is an adverse effect of metoclopramide. However, metoclopramide does not cause muscle weakness. B. Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation. C. Metoclopramide does not cause ringing in the ears. D. Metoclopramide does not cause peripheral edema 20. A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? A. The medication should be taken 1 hr prior to eating. B. It takes 48 hr for therapeutic effects to occur. C. Tablets should not be crushed or chewed. D. Decreased respirations might occur. A. The client should take hydrocodone and acetaminophen with food or milk to decrease gastric irritation. B. The nurse should instruct the client that they should experience the effects of hydrocodone with acetaminophen within 20 min of administration and that pain relief should last for 4 to 6 hr. C. The client should avoid crushing, chewing, or breaking the extended release or immediate release hydrocodone tablets to prevent an immediate increase in CNS effects. Hydrocodone with acetaminophen tablets can be crushed if needed. D. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression. 21. A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Cough B. Joint pain 7 Practice A Pharmacology With Answer & Rationale C. Alopecia D. Insomnia A. Bupropion, an atypical antidepressant, does not cause coughing. B. Bupropion can cause neurologic adverse effects such as bradykinesia. However, it does not cause joint pain. C. Bupropion can cause sensory adverse effects such as changes in vision & hearing. It does not cause alopecia. D. Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia. 22. A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? A. Dyspepsia B. Diarrhea C. Dizziness D. Dyspnea A. The nurse should report dyspepsia to the provider because dyspepsia can cause discomfort and irritation to the esophageal tissues. However, the nurse should report another finding first B. The nurse should report diarrhea to the provider because diarrhea can result in electrolyte and fluid imbalances. However, the nurse should report another finding first. C. The nurse should report dizziness to the provider because dizziness can place the client at an increased risk for falls. However, the nurse should report another finding first. D. When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil. 23. A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? A. "It is safe to take an enteric-coated aspirin." B. "Aspirin will increase the risk of bleeding." C. "Acetaminophen may be substituted for aspirin." D. "The INR lab work must be monitored more frequently if aspirin is taken." A. Although it is common for clients to consider an occasional aspirin harmless, salicylates inhibit platelet aggregation and increase the potential for hemorrhage. Therefore, the client should avoid taking enteric-coated aspirin. B. Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding. C. Acetaminophen, an analgesic, can potentiate the action of the anticoagulant warfarin when administered in high doses and is not a safe substitute for aspirin. D. The client should continue to follow the provider's prescription for monitoring the PT and INR levels to adjust warfarin dosages. However, the nurse should discourage the client from using aspirin products because these medications increase the antiplatelet action of the warfarin and can result in bleeding. 8 Practice A Pharmacology With Answer & Rationale 24. A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) Answer: 100 gtt/min Step 1: Unit of measurement the nurse should calculate? Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. Step 4: Solve for X. Step 5: Round if necessary. Step 6: Determine whether the amount to administer makes sense. If the prescription reads D5W 400 mL IV to infuse over 60 min with a drop factor of 15 gtt/mL, it makes sense to administer 100 gtt/min. The nurse should set the manual IV infusion to deliver D5W IV at 100 gtt/min. 25. A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? A. "I will have increased saliva production." B. "I will continue taking the medication until the rash disappears." C. "I will taper off the medication before discontinuing it." D. "I will report any urinary incontinence." A. The client should use gum or sip on water to prevent dry mouth, which is an adverse effect of cyclobenzaprine. B. The client should take cyclobenzaprine for treatment of muscle spasms. This medication does not affect skin rashes. C. The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia. D. The client should report any urinary retention because of the anticholinergic effects caused when taking cyclobenzaprine. 26. A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.) A. Dry mouth B. Tinnitus C. Blurred vision D. Bradycardia E. Dry eyes A. Oxybutynin is an anticholinergic agent that can cause dry mouth. B. Oxybutynin can cause several sensory adverse effects including increased intraocular pressure. The nurse should instruct the client to report eye pain, seeing colored halos around lights, and a decreased ability to perceive light changes. However, tinnitus is not an adverse effect associated with oxybutynin administration. C. Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure. D. Oxybutynin can cause several cardiovascular adverse effects such as a prolongation of the QT interval, palpitations, hypertension, and tachycardia. E. Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation. 9 Practice A Pharmacology With Answer & Rationale 27. A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? A. Obtain the client's blood pressure. B. Contact the client's provider. C. Inform the charge nurse. D. Complete an incident report. A. When using the nursing process, the first action the nurse should take to prevent injury to the client is to assess the client for adverse effects of atenolol, such as hypotension. B. The nurse should contact the provider, who can provide direction to the nurse to prevent injury to the client. However, there is another action the nurse should take first. C. The nurse should alert the charge nurse about the medication error. However, there is another action the nurse should take first. D. The nurse should complete an incident report, which is used as part of a facility's quality assurance program. However, there is another action the nurse should take first. 28. A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) A. Blood glucose levels will be monitored during therapy. B. Avoid contact with people who have known infections. C. Take the medication 1 hr before breakfast. D. Decrease dietary intake of foods containing potassium. E. Grapefruit juice can increase the effects of the medication. A. The nurse should monitor the client for hyperglycemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. B. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. C. The nurse should instruct the client to take the medication with food or milk to decrease gastrointestinal upset. D. The nurse should instruct the client to increase dietary intake of potassium-rich foods while taking this medication. Glucocorticoids, such as methylprednisolone, deplete potassium in the body, which manifests as hypokalemia. E. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body. 29. A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? A. Temperature of 39.7° C (103.5° F) B. Urinary retention C. Heart rate 56/min D. Muscle flaccidity A. The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension. B. The nurse should report incontinence as a manifestation of NMS. C. The nurse should report tachycardia as a manifestation of NMS. D. The nurse should report severe muscle rigidity as a manifestation of NMS 10