Pharmacology Final Review 2020 Part 3

47)nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication? a) Give the medication in the morning daily. i) Rationale: Montelukast is a leukotriene receptor antagonist that is used to prevent asthma symptoms. It works by blocking the action of leukotrienes (substances that cause inflammation, fluid retention, mucous secretion, and constriction) in the client's lungs. Due to the side effect of drowsiness, it is usually taken once a day in the evening. b) Administer the medication 2 hr before exercise. i) Rationale: Montelukast should be given daily during the evening, except when being used for exercise-induced bronchospasm. It should then be given 2 hr before exercise, and not given again for 24 hr. c) Give the medication at the onset of wheezing. i) Rationale: Montelukast is ineffective as a rescue medication. d) Administer the granules mixed with 20 oz of water. i) Rationale: Montelukast granules should be taken directly or mixed with certain soft foods (applesauce, carrots, rice or ice cream). 48) A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? a) Explain to the client that this is an expected adverse effect. b) Check the value of the client's current platelet count. c) Instruct the client to use an electric toothbrush. d) Have the client make an appointment to see the dentist. 49) A nurse is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understanding of the teaching? a) "I will report any loss of appetite." b) "Increased flatulence is an indication of toxicity." c) "Vomiting is an indication of toxicity." d) "I will call my provider if I experience any headaches." 50) Bacterial conjunctivitis, know to apply a) Thin line into the conjunctival sac 51) A nurse in a public clinic is planning a health fair for older adult clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking their prescriptions? a) Carbonated beverage b) Milk c) OJ d) Grapefruit juice 52)A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? a) "The medication relieves nausea by promoting gastric emptying." i) Rationale: Reglan is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and a persistent feeling of fullness after meals. Reglan works by promoting gastric emptying. b) "The medication works by decreasing gastric acid secretions." i) Rationale: Reglan does not decrease gastric acid secretions. c) "The medication relieves nausea by slowing peristalsis." i) Rationale: Reglan does not slow peristalsis. d) "The medication works by relaxing gastric muscles. i) Rationale: Metoclopramide increases gastric muscle contraction. 53)A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? a) Zolpidem b) Alprazolam c) Spironolactone d) Allopurinol . 54)A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? a) A decrease in blood sugar b) A decrease in blood pressure c) A decrease in urine output i) Rationale: The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response. d) A decrease in specific gravity 55)A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) a) Furosemide b) Telmisartan c) Duloxetine d) Clopidogrel e) Atorvastatin 56)A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider? a) The client has a history of hypothyroidism. b) The client has a history of bronchial asthma. i) Rationale: Beta-adrenergic blockers can cause bronchospasm in clients who have bronchial asthma; therefore, this is a contraindication to its use and should be reported to the provider. c) The client has a history of hypertension. d) The client has a history of migraine headaches. 57)Ophthalmic ointment for pre-k age child w pink eye, what should nurse include in instructions a) Discard first few drops 58)A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a) "I have started taking ginger root to treat my joint stiffness." i) Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b) "I take this medication at the same time each day." i) Rationale: The client should take warfarin at the same time each day to maintain a stable blood level. c) "I eat a green salad every night with dinner." i) Rationale: Green leafy vegetables are a good source of vitamin K, which can interfere with the clotting effects of warfarin. Clients who are taking warfarin do not need to restrict dietary vitamin K intake but rather should maintain a consistent intake of vitamin K in order to control the therapeutic effect of the medication. d) "I had my INR checked three weeks ago." i) Rationale: Clients who have been taking warfarin for more than 3 months should have their INR level checked every 2 to 4 weeks. 59)A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? a) Tinnitus b) Constipation c) Hyperkalemia d) Weight gain 60) nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations? a) Metabolic acidosis b) Metabolic alkalosis i) Rationale: Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid. c) Respiratory acidosis d) Respiratory alkalosis 61) A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? a) The client follows a low-fat diet to reduce cholesterol. b) The client drinks a glass of grapefruit juice every day. c) The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. d) The client uses garlic to lower cholesterol levels. i) Rationale: The nurse should recognize that garlic can potentiate the action of the warfarin. 62)A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for irondeficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? a) "Taking the medication between meals will help you avoid becoming constipated." b) "Taking the medication with food increases the risk of esophagitis." c) "Taking the medication between meals will help you absorb the medication more efficiently." i) Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron. d) "The medication can cause nausea if taken with food." 63) Status asmaticus a) Severe acute asthma attack --give SABA 64) A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? a) Mild nosebleeds are common during initial treatment. b) Use an electric razor while on this medication. i) Rationale: Warfarin, an anticoagulant, increases the client’s risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding. c) If a dose of the medication is missed, double the dose at the next scheduled time. d) Increase fiber intake to reduce the adverse effect of constipation. 65)A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of the following actions should the plan to nurse take? a) Leave the client 5 min after beginning the transfusion. b) Infuse the transfusion at a rate of 200 mL/hr c) Check the client's vital signs every hour during the transfusion. d) Flush the blood tubing with dextrose 5% in water. 66) A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed RBC. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse? a) The nurse initiates an infusion of 0.9% sodium chloride. b) The nurse collects a urine specimen. c) The nurse sends a blood specimen to the laboratory. d) The nurse starts the transfusion of another unit of blood product. i) When suspecting a hemolytic reaction, the nurse should immediately stop the transfusion of all blood products. The transfusion of additional products can increase the client's risk for further complication