Pharmacology Final Review 2020 Part 4

67)A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction? a) Client report of low back pain i) Rationale: Manifestations of an acute hemolytic reaction include apprehension, tachypnea, hypotension, chest pain, and lower back pain. b) Client report of tinnitus i) Rationale: Tinnitus is a manifestation of ototoxicity and is an adverse effect of aminoglycoside antibiotics. c) A productive cough i) Rationale: A cough is a manifestation of circulatory overload. d) Distended neck veins i) Rationale: Distended neck veins are a manifestation of circulatory overload. 68) A nurse is caring for a client who is receiving a transfusion of packed red blood cells and suspects that the client is experiencing a hemolytic reaction. Which of the following interventions is the priority? a) Collect a urine specimen. b) Administer 0.9% sodium chloride through the IV line. c) Stop the transfusion. i) Rationale: The greatest risk to the client is injury due to further hemolysis; therefore, the priority action is to stop the transfusion. When suspecting a hemolytic reaction, the priority action by the nurse is to immediately stop the transfusion to prevent further hemolysis. d) Notify the blood bank. 69) A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take? a) Administer the medication at 100 mg/min. i) Rationale: The nurse should administer phenytoin IV slowly, not faster than 50 mg/min, to reduce the risk of hypotension. b) Administer a saline solution after injection. i) Rationale: The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation. c) Hold the injection if seizure activity is present. i) Rationale: The nurse should administer phenytoin to prevent and to abort seizure activity. d) Dilute the medication with dextrose 5% in water. i) Rationale: The nurse should dilute phenytoin in 0.9% sodium chloride solution to prevent precipitation of the medication. 70)A nurse is planning care for a client who has a detached retina and is preoperative for a surgical repair. The nurse should prepare to administer which of the following medications? a) Phenylephrine i) Mydriatic medications, such as phenylephrine, are used preoperatively to dilate pupils to facilitate intraocular surgery. b) Latanoprost c) Pilocarpine d) Timolol 71) A nurse is assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome? a) Elevated temperature i) Rationale: An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multi- organ system failure due to fat overload syndrome. b) Hypertension c) Peripheral edema d) Erythema at the insertion site 72)A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? a) Report of recent migraine headaches b) History of gastric ulcers i) Rationale: Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding. c) Current diagnosis of glaucoma d) Prior reports of amenorrhea 73)A nurse is teaching a client who has a new prescription for colesevelam to lower his low- density lipoprotein level. Which of the following instructions should the nurse include? a) "Take this medication 4 hr after other medications." i) Rationale: The client should take this medication 4 hours after other medications to increase absorption of the medication. b) "Reduce fluid intake." c) "Take this medication on an empty stomach.” d) "Chew tablets before swallowing." 74)A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? a) Systolic blood pressure is increased i) Rationale: When dopamine has a therapeutic effect, it causes vasoconstriction peripherally and increases systolic blood pressure. b) Cardiac output is reduced c) Apical heart rate is increased d) Urine output is reduced 75)A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? a) Discard the NPH solution if it appears cloudy. b) Shake the insulin vigorously before loading the syringe. c) Expect the NPH insulin to peak in 6 to 14 hr. d) Freeze unopened insulin vials. 76)A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching? a) "I should expect to feel better after 24 hours of starting this medication." b) "I should not take this medicine with grapefruit juice." c) "I'll take this medicine with food." d) "I'll take this medicine first thing in the morning." 77) A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include? a) Avoid activities that require alertness such as driving. i) Rationale: The client should avoid driving and other activities that require alertness until the effects of this medication are known. b) Increase caffeine intake. c) Take this medication before bedtime. d) Reduce calorie intake. 78)A client has begun medication therapy with pancrelipase (Pancrease). The nurse determines that the medication is having the optimal intended benefit if which effect is observed? a) Weight loss b) Relief of heartburn c) Reduction of steatorrhea d) Absence of abdominal pain 79) A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following GI changes? a) Decreased fat in stools, as this medication is used to increase digestions of fats, carbs, and proteins. 80) A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? a) Discard regular insulin that appears cloudy. Regular insulin is clear. NPH is cloudy. 81)A HCP should question the use of dimenhydrinate for a patient who has which of the following disorders? a) Angle-closure glaucoma. An antihistamine is inappropriate for patients who have this condition because it has anticholinergic properties, which increase intraocular pressure. 82) A HCP is caring for a patient who is about to begin using dimenhydrinate to prevent motion sickness. Which of the following instructions should the HCP include when talking with the patient? (select all that apply) a) Take the drug 30-60 minutes before activities that trigger nausea; avoid activities that require alertness, as this medication can cause sedation; and increase fluid and fiber intake, as this medication can cause dry mouth and constipation. 83) A nurse is teaching a client who has a new prescription for dimenhydrinate. Which of the following instructions should the nurse include in the teaching? a) Monitor for dizziness. Dimenhydrinate can cause dizziness and drowsiness. 84) A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. The client reports having discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the client's distress? a) The client demonstrated an allergic response to the medication. b) The client experienced a common side effect to the medication. c) The client consumed alcohol while taking the medication. i) Rationale: Disulfiram is given to clients who have a history of alcohol abuse. It produces a sensitivity to alcohol that results in a highly unpleasant reaction when the client ingests even small amounts of alcohol. When combined with alcohol, disulfiram produces nausea and vomiting. d) The client took an overdose of the medication 85)A HCP should monitor an older adult patient who is taking alprazolam for which of the following adverse effects? a) Tolerance, anxiety (a paradoxical reaction), sedation, and respiratory depression. 86) A HCP should question the use of alprazolam (Xanax) for a patient who: a) Drinks two 8-oz. glasses of wine each evening. To prevent severe sedation and respiratory depression, alcohol and other CNS depressants should be avoided. 87)A HCP is caring for a patient who has been taking alprazolam for an extended period of time to treat anxiety. The HCP should recognize that stopping alprazolam suddenly can result in which of the following? a) Withdrawal symptoms. This medication needs to be tapered slowly over several weeks 88) A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls? a) The client takes alprazolam. i) Rationale: Alprazolam is a CNS depressant that can cause dizziness and orthostatic hypotension, which can cause the client to lose his balance and fall. b) The client has a nonslip bath mat in his shower. i) Rationale: A nonslip bath mat should reduce the risk for the client to fall. c) The client uses a raised toilet seat. i) Rationale: A raised toilet seat should reduce the risk for the client to fall. d) The client wears fitted slippers. i) Rationale: Fitted and nonslip slippers should reduce the risk for the client to fall. 89) A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? a) “A headache is is an indication of an allergy to the medication." b) “A headache is an expected adverse effect of this medication” c) “A headache indicates tolerance to this medication” d) “A headache is likely due to the anxiety about the chest pain” 90) A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses? a) Urticaria i) Rationale: For clients who have previously had allergic reactions to blood transfusions, administering an antihistamine such as diphenhydramine prior to the transfusion might prevent future reactions. Allergic reactions typically include urticaria (hives). b) Fever i) Rationale: An antihistamine will not prevent a febrile, non-hemolytic reaction to a blood transfusion. A possible preventive measure is transfusing leucocyte-poor blood products to avoid sensitization to the donor's WBC. c) Fluid overload i) Rationale: An antihistamine will not prevent fluid overload. Transfusing the blood product slowly and not exceeding the volume that is necessary can reduce this risk. d) Hemolysis i) Rationale: An antihistamine will not prevent hemolysis, which results from incompatibility between the donor and the recipient. 91) A nurse is preparing to administer nalbuphine to a postoperative client who is experiencing pain. The nurse should monitor the client for which of the following potential adverse effects of this medication? a) Miosis i) Rationale: Adverse effects of nalbuphine include visual disturbances such as miosis, blurred vision, and diplopia. b) Joint pain c) Diarrhea d) Oliguria 92) A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should tell the patient to report which of the following adverse effects? a) Diarrhea. Other adverse effects include nausea and vomiting. 93)A HCP is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The HCP should recognize that which of the following laboratory tests requires monitoring? a) Liver function, as liver toxicity is a serious side effect of dantrolene. 94) A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching? a) Your doctor might need to reduce your theophylline dose while taking this medication. 95) A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? a) Decreased sodium level i) Rationale: The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium. b) Decreased phosphate level c) Decreased potassium level d) Decreased chloride level 96) A patient recovering from a total knee arthroplasty has been prescribed acetaminophen for mild discomfort that does not require an opioid. The health care professional should tell the patient to report which of the following early indications of acetaminophen overdose? a) Diaphoresis, nausea, and diarrhea. 97)Someone had a arthroplasty for hip, the nurse should anticipate which of the following px: a) aspirin, lovenox/enoxaparin 98) A health care professional is caring for a patient who is about to begin taking celecoxib (Celebrex) to treat RA. The health care professional should tell the patient to report which of the following adverse reactions? a) Chest pain. COX-2 inhibitors can cause cardiovascular or cerebrovascular events. 99) A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? a) Leg cramps, which is a manifestation of hypokalemia. 100) A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? a) Potassium. 101) A nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. Which of the following actions should the nurse plan to take? a) Apply to intact skin, apply the medication 1 hour before the procedure begins, cleanse the skin prior to procedure, and use a visual pain rating scale to evaluate the effectiveness of the treatment 102) A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? a) Shake the container vigorously. This ensures the particles of the medication are evenly distributed. 103) A nurse is providing teaching to a client who has a new prescription for Lisinopril. Which of the following statements by the client indicates an understanding of the teaching? a) I should report a cough to the provider.