NUR 1211C Pharm Assessment 2 EXAM / Questions and Answers Provided / Graded A

Document Content and Description Below

Question: 2 of 50 Pharm Assessment 2 A nurse is caring for a client who reports using the herbal medication garlic along with prescribed warfarin. The nurse should identify that which of the f... ollowing is a potential adverse effect of taking both of these products concurrently? Increased ecchymosis The nurse should identify that ecchymosis occurs when there is bleeding under the skin. Additionally, the nurse should recognize that garlic has antiplatelet effects that can result in bleeding. When taken concurrently with an anticoagulant, such as warfarin, there is an increased risk for bleeding. Question: 3 of 50 A nurse is caring for a client who has HIV and a prescription for nevirapine. The nurse should monitor the client for which of the following manifestations as an adverse reaction to nevirapine? Rash The nurse should monitor the client’s skin for a rash as an adverse reaction to nevirapine. A rash can lead to a severe reaction, such as Stevens-Johnson syndrome. If a rash develops, the nurse should notify the provider. Question: 4 of 50 A nurse is caring for a client who requires a transfusion of one unit of packed RBCs. The nurse receives the following prescription: "Diphenhydramine 50 mg by mouth once, one hour prior to transfusion." The nurse should identify this as which of the following types of prescription? Single prescription Single prescriptions are also referred to as one-time prescriptions. Single prescriptions differ from stat prescriptions because they are implemented at a specified time, such as prior to a procedure or on call to surgery. Unlike standing prescriptions, they are used for a single instance, rather than for an ongoing period of time. Diphenhydramine administered prior to transfusion of blood reduces the risk of an allergic reaction. Question: 5 of 50 A nurse is providing teaching to a client who has erectile dysfunction and has a new prescription for tadalafil. Which of the following client statements indicates an understanding of the teaching? "This medication can decrease my blood pressure." The client should understand that tadalafil can cause hypotension. The nurse should instruct the client not to take this medication with nitrates because this can cause a sudden drop in blood pressure. Question: 6 of 50 A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication? Creatinine The nurse should monitor creatinine, BUN, and urine output for a client who is receiving gentamicin, an aminoglycoside antibiotic. Gentamicin is an aminoglycoside that has both nephrotoxic and ototoxic adverse effects. Question: 7 of 50 A nurse is teaching a client who has a seizure disorder and has a new prescription for phenytoin. Which of the following client statements indicates an understanding of the teaching? "I will have my blood checked to monitor the medication levels." MY ANSWERThe client should have serum phenytoin levels tested to maintain therapeutic blood levels and prevent toxicity. Therapeutic phenytoin levels range from 10 to 20 mcg/mL. Once a safe and therapeutic dosage level is established, the client should continue to adhere to the prescribed dosage schedule and continue routine monitoring. Question: 8 of 50 A nurse is assessing a client who has diabetes insipidus and is starting intranasal desmopressin. Which of the following findings should indicate to the nurse that the medication is effective? The client's 24 hr urine output is 1,256 mL. Desmopressin is effective for the treatment of diabetes insipidus, a disorder of the posterior pituitary gland in which large amounts of dilute urine are produced due to a deficiency in vasopressin. The action of desmopressin causes reabsorption of water and a decrease in urine volume. A urine output of 1,256 mL over 24 hr is within the expected reference range and indicates the medication is effective. Question: 9 of 50 A nurse is providing teaching to a client who has fibromyalgia and a new prescription for pregabalin. Which of the following instructions should the nurse include in the teaching? "You should notify your provider if you experience facial swelling." A hypersensitivity reaction, such as angioedema, can be life-threatening. Therefore, the nurse should instruct the client to report manifestations such as swelling of the face, lips, tongue, or throat to the provider. Question 10 loaded rationals provided Question: 10 of 50 A nurse is assessing a group of clients. Which of the following findings is the priority to report to the provider? A client who is receiving continuous IV lidocaine and has a respiratory rate of 10/min Lidocaine is used to treat ventricular dysrhythmias. A decreased respiratory rate is a manifestation of lidocaine toxicity. Therefore, a client who is receiving lidocaine and has a decreased respiratory rate is unstable and this finding is the highest priority to report to the provider. Question: 11 of 50 A nurse is assessing a client who started taking furosemide 2 days ago and has a potassium level of 3.1 mEq/L. Which of the following findings should the nurse expect? Depressed deep tendon reflexes A potassium level of 3.1 mEq/L is lower than the expected reference range of 3.5 to 5 mEq/L and is an indication of hypokalemia. The nurse should expect depressed deep tendon reflexes in a client who has hypokalemia. Question: 12 of 50 A nurse is providing teaching to the parents of a child who is starting to take liquid ferrous sulfate. Which of the following information should the nurse include in the teaching? Monitor your child for constipation. MY ANSWER Constipation is an adverse effect of iron preparations. The nurse should instruct the parents to increase the child's fluid intake to reduce the risk for constipation. Question: 13 of 50 A nurse is reviewing the health history of a client who experiences migraine headaches and has asked about a prescription for sumatriptan. Which of the following conditions should the nurse identify as a contraindication for taking sumatriptan? Coronary artery disease Evidenced-based practice indicates that a client who has a history or risk of coronary artery disease should not take sumatriptan. The medication can cause coronary vasospasm, ECG changes, and hypertension Question: 14 of 50 A nurse erroneously administered a prescribed medication IV instead of IM to a client. Which of the following actions is the nurse's priority? Assess the client. According to the nursing process, the first action the nurse should take is to assess the client for injury due to the medication error. Question: 15 of 50 A nurse is providing teaching to a client who has rheumatoid arthritis and is starting to take hydroxychloroquine. Which of the following client statements indicates an understanding of the teaching? "I will need to have regular eye exams while taking this medication." The nurse should instruct the client that she will need to have eye exams every 6 months by an ophthalmologist. Hydroxychloroquine can cause retinal damage that can eventually lead to blindness. Question: 16 of 50 A nurse is reviewing the medical record of a client who takes lithium. Which of the following findings is the priority to report to the provider? MY ANSWER Sodium 130 mEq/L The nurse should recognize that the greatest risk to this client is injury from lithium toxicity. A sodium level of 130 mEq/L is below the expected reference range of 136 to 145 mEq/L and increases the risk of lithium toxicity. Therefore, this finding is the priority to report to the provider. The nurse should monitor for manifestations of lithium toxicity, such as vomiting, slurred speech, and muscle weakness. Question: 17 of 50 A nurse is providing teaching to a client who is starting to take aspirin. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication? Black, tarry stools A client who takes aspirin can have an increased risk for bleeding because aspirin suppresses platelet aggregation. The nurse should instruct the client to monitor for and report indications of bleeding, such as bruising, petechiae, and blood in stools or urine. Question: 18 of 50 A nurse is assessing a client who has been taking hydrochlorothiazide. Which of the following client statements indicates that the medication is effective? "The swelling in my feet has decreased." Hydrochlorothiazide, a thiazide diuretic, reduces edema and blood pressure by increasing urine output. Therefore, decreased swelling of the feet is an indication that the medication is effective Question: 19 of 50 A nurse is assessing a client who received ondansetron 1 hr ago. Which of the following findings should the nurse identify as a therapeutic effect of the medication? Suppressed emesis Ondansetron suppresses nausea and vomiting induced by chemotherapy, anesthesia, radiation therapy, or morning sickness by blocking serotonin receptors in the upper GI tract and in the CNS Question: 20 of 50 A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy? Peptic ulcer disease Neostigmine, a cholinesterase inhibitor, increases gastric secretions which would further exacerbate the peptic ulcer disease, thereby increasing the risk for erosion and perforation. The nurse should identify that the presence of peptic ulcer disease is a contraindication for the use of neostigmine. Question: 21 of 50 A nurse is teaching a client who has a new prescription for isoniazid to treat tuberculosis. Which of the following information should the nurse include in the teaching? "You will have frequent sputum tests to monitor the effectiveness of this medication." The nurse should instruct the client to provide sputum specimens every 2 to 4 weeks to monitor the effectiveness of this medication. The client is no longer infectious following three consecutive negative sputum cultures. However, the client should continue the antibiotic treatment for 6 to 12 months. Question: 22 of 50 A nurse is reviewing the medication administration record (MAR) of a client who requires fluticasone MDI one puff and albuterol MDI two puffs. Which of the following actions should the nurse plan to take? Place the following steps in the correct order. (Move the steps into the box on the right, placing them in the selected order of performance. All steps must be used.) When the client requires an inhaled beta2-agonist and an inhaled glucocorticoid, the nurse should instruct the client to first administer the beta2-agonist to promote bronchodilation. The nurse should have the client take one puff of albuterol, wait 1 min, and then have the client take the second puff of albuterol. Then, the nurse should have the client wait 5 min before administering the glucocorticoid. These actions promote optimal bronchodilation and anti-inflammatory effects. Question: 23 of 50 A nurse is providing teaching to a client who is starting to take finasteride for the treatment of male pattern baldness. Which of the following statements by the client indicates an understanding of the teaching? "This medication can increase my risk for impotence." The nurse should instruct the client that finasteride can increase the client's risk for impotence. Question: 24 of 50 A nurse is caring for a client who has hyperlipidemia and a new prescription for colesevelam. The nurse should monitor the client for which of the following manifestations as an adverse effect of colesevelam? MY ANSWER Constipation The nurse should monitor the client for constipation and dyspepsia, which are adverse effects of colesevelam. The nurse should also encourage the client to consume a high-fiber diet and increase fluid intake to reduce the risk for constipation. Question: 25 of 50 A nurse is administering bumetanide to a client who has ascites. The nurse should recognize that which of the following findings is an expected therapeutic effect of this medication? Increased urinary output The primary action of bumetanide, a loop diuretic, is to increase the excretion of water and electrolytes through the urine. Bumetanide decreases edema associated with heart failure, liver disease, or renal compromise by increasing urinary output. Question: 26 of 50 A nurse is caring for a client who is having difficulty voiding following surgery. The nurse notes palpable bladder distention. Which of the following medications should the nurse anticipate administering to the client? Bethanechol Bethanechol is a form of treatment for nonobstructive urinary retention, usually due to postoperative or postpartum status. Bethanechol stimulates the muscarinic receptors of the genitourinary tract, which causes relaxation of the trigone and sphincter muscles and contraction of the detrusor muscle. Question 27 loaded rationals provided Question: 27 of 50 A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe? Chlordiazepoxide The nurse should expect the provider to prescribe chlordiazepoxide, a benzodiazepine, to a client who is at risk for alcohol withdrawal delirium. Chlordiazepoxide can prevent the client from experiencing seizures as a result of withdrawal and lessen the effects of withdrawal. Question: 28 of 50 A nurse is providing teaching to a client who has prostate cancer and a new prescription for leuprolide. The nurse should explain to the client that leuprolide treats prostate cancer by which of the following actions? "Leuprolide decreases the production of testosterone." Leuprolide treats prostate cancer by decreasing the production of testosterone. It causes an initial increase in testosterone, which results in desensitization and a subsequent decrease in testosterone production. Question: 29 of 50 INCORRECT FLAG • Time Remaining: 00:36:10 • Pause Remaining: 00:02:22 PAUSE A nurse is monitoring a client who is receiving a continuous IV infusion of dopamine. Which of the following findings requires immediate intervention by the nurse? Heart rate 105/min MY ANSWER An elevated heart rate is an adverse effect of dopamine and can require dose reduction. However, another finding is the priority. Increased blood pressure Increased blood pressure is an expected effect of dopamine therapy due to its inotropic and vasopressor action. If the client develops extreme, persistent hypertension, the nurse might need to discontinue or decrease the infusion. However, another finding is the priority. Infiltration of the peripheral IV The greatest risk to this client is injury from infiltration and extravasation of the dopamine solution, which can cause tissue necrosis. Therefore, the immediate action the nurse should take is to discontinue the infusion. After stopping the infusion, the nurse should treat the infiltration with phentolamine to prevent further tissue damage. Question: 30 of 50 CORRECT FLAG • Time Remaining: 00:35:32 • Pause Remaining: 00:02:22 PAUSE A nurse is reviewing the medical record of a client who has asthma and takes albuterol. Which of the following findings should the nurse identify as an adverse effect of albuterol? Fasting blood glucose 68 mg/dL Although this glucose level is below the expected reference range of 74 to 106 mg/dL, the nurse should recognize that hyperglycemia, not hypoglycemia, is a possible adverse effect of albuterol. Heart rate 110/min MY ANSWER The nurse should identify that a heart rate of 110/min is above the expected reference range of 60 to 100/min. Albuterol can cause tachycardia because it increases the excitability of the beta1 receptors in the heart. More serious cardiac effects include palpitations, chest pain, hypertension, and arrhythmia. The nurse should report these findings to the provider. Question: 31 of 50 INCORRECT FLAG • Time Remaining: 00:34:45 • Pause Remaining: 00:02:22 PAUSE A nurse is providing teaching to a client who has osteoporosis and is starting to take oral ibandronate. Which of the following instructions should the nurse include in the teaching? "Take the medication immediately after a meal." MY ANSWER The nurse should instruct the client to take ibandronate on an empty stomach. Food interferes with the absorption of ibandronate. "Drink 8 ounces of milk when taking the medication." The nurse should instruct the client to take ibandronate first thing in the morning with 6 to 8 oz of water to increase absorption of the medication. The client should avoid food or other liquids for 30 to 60 min following administration. "Take the medication before bedtime." The nurse should instruct the client to take ibandronate after waking up and to remain upright for a minimum of 1 hr after administration to avoid esophageal erosion. "Take one tablet of the medication on the same date each month." The nurse should instruct the client to take ibandronate on the same date each month to maintain therapeutic medication levels. Question: 32 of 50 CORRECT FLAG • Time Remaining: 00:34:00 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for an older adult client who is confirmed positive for HIV and will begin medication therapy. Which of the following instructions should the nurse give the client? (Select all that apply) "You will be prescribed more than one medication to fight the virus." "Your medication dose will need to be slightly stronger than the recommended range." "Your medication plan can also include an antibiotic medication." "You will need to take medication for the rest of your life." "You can take St. John's wort to minimize medication adverse effects." MY ANSWER "You will be prescribed more than one medication to fight the virus" is correct. Highly active antiretroviral therapy (HAART) involves taking more than one medication in order to reduce the risk for developing drug resistance. "Your medication dose will need to be slightly stronger than the recommended range" is incorrect. The older adult client might require a decreased dosage to reduce risk of toxicity. "Your medication plan can also include an antibiotic medication" is correct. The nurse should instruct the client that they might require medications to treat other concurrent infections that are caused by fungal or bacterial sources. "You will need to take medication for the rest of your life" is correct. The nurse should instruct the client that treatment of HIV involves life-long medication administration to minimize the detectable amount of HIV virus in the body. "You can take St. John’s wort to minimize medication adverse effects" is incorrect. St. John's wort can decrease the effectiveness and serum concentration levels of protease inhibitors used in the treatment of HIV. The nurse should instruct the client to consult the provider about taking herbal medication along with their currently prescribed medications. Question: 33 of 50 INCORRECT FLAG • Time Remaining: 00:33:10 • Pause Remaining: 00:02:22 PAUSE A nurse is providing discharge instructions to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching? "This medication kills the bacteria in my stomach." Some gastric and duodenal ulcers are caused by the Helicobacter pylori (H. pylori) bacteria. Antibiotics used to treat H. pylori include clarithromycin, amoxicillin, bismuth, and tetracycline. However, omeprazole is not an antibacterial medication and does not destroy H. pylori. "This medication neutralizes stomach acid." The nurse should instruct that client than antacids, not omeprazole, will neutralize stomach acid. "This medication coats the lining of my stomach." MY ANSWER The nurse should instruct the client that gastrointestinal protectant medications, such as sucralfate, create a thick substance that coats the ulcer to protect it from the acidic environment of the gastrointestinal tract. "This medication reduces stomach acid." GERD is a condition in which gastric acids reflux from the stomach to the esophagus. Omeprazole is a proton pump inhibitor that suppresses the production of gastric acid. The medication reduces baseline acid levels and blocks production of nearly all stimulated acid production within 2 hr of an oral dose. Question: 34 of 50 CORRECT FLAG • Time Remaining: 00:32:21 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who received excessive IV fluids in error. Which of the following actions should the nurse take? (Select all that apply.) Contact the provider. Report the error to the charge nurse. Place an incident report in the client's chart. Auscultate the client's lungs. Check the client for peripheral edema. MY ANSWER Contact the provider is correct. After making initial assessments and stabilizing the client if necessary, the nurse should contact the provider. Report the error to the charge nurse is correct. When an error occurs, the nurse is responsible for assessing the client to assure safety, reporting the incident to the provider and charge nurse, and documenting the error per facility policy. Place an incident report in the client's chart is incorrect. The incident report provides statistical data that is used for quality improvements which can help prevent similar incidents in the future. This report is the property of the facility and might be needed to defend the incident in court. Therefore, the nurse should not place the incident report in the client's chart. Auscultate the client's lungs is correct. A client who has received excessive IV fluids is at risk for fluid volume overload. Therefore, the nurse should auscultate the client's lungs to assess for pulmonary edema. Check the client for peripheral edema is correct. A client who has received excessive IV fluids is at risk for fluid volume overload. Therefore, the nurse should assess the client for the presence of peripheral edema, an indication of fluid volume overload. Question: 35 of 50 INCORRECT FLAG • Time Remaining: 00:31:34 • Pause Remaining: 00:02:22 PAUSE A nurse is assessing a client who is in preterm labor and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse identify as the priority? Flushing MY ANSWER Flushing is an expected adverse effect of magnesium sulfate therapy. Therefore, another finding is the priority. Deep tendon reflexes 1+ When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is deep tendon reflexes 1+, which indicates a depressed CNS and possible magnesium sulfate toxicity. Question: 36 of 50 INCORRECT FLAG • Time Remaining: 00:30:52 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who has a new diagnosis of adrenal insufficiency. Which of the following prescriptions should the nurse anticipate from the provider? Phenytoin MY ANSWER Phenytoin is an anticonvulsant medication used to treat seizure disorders. Calcitonin Calcitonin is a hormone medication used in the treatment of Paget’s disease, hypercalcemia, and postmenopausal osteoporosis. Buspirone Buspirone is an anxiolytic medication used to treat anxiety. Fludrocortisone Fludrocortisone is a mineralocorticoid replacement medication used for the treatment of adrenal insufficiency. The nurse should monitor the client for hypertension and edema. Question: 37 of 50 CORRECT FLAG • Time Remaining: 00:29:43 • Pause Remaining: 00:02:22 PAUSE A nurse is providing teaching to a client who has a new prescription for methimazole for the treatment of hyperthyroidism. Which of the following statements by the client indicates an understanding of the teaching? "This medication can cause constipation." The nurse should inform the client that diarrhea, not constipation, is an adverse effect of methimazole. "I will contact the provider if my throat becomes sore." MY ANSWER Methimazole can cause agranulocytosis. The client should notify the provider immediately if fever, sore throat, or other indications of an infection occur. Question: 38 of 50 CORRECT FLAG • Time Remaining: 00:28:58 • Pause Remaining: 00:02:22 PAUSE A nurse is transcribing a telephone prescription for acetaminophen 650 mg by mouth daily at bedtime. The nurse should identify that which of the following abbreviations are acceptable to use when transcribing the prescription? Abbreviate "by mouth" as "PO" MY ANSWER The nurse should recognize that "PO" is an acceptable abbreviation for "by mouth" according to the recommendations of the Joint Commission. Question: 39 of 50 INCORRECT • Time Remaining: 00:28:15 • Pause Remaining: 00:02:22 PAUSE FLAG A nurse is teaching a client who is to start taking methyldopa for the treatment of hypertension. Which of the following information should the nurse include in the teaching? This medication can cause dizziness. Methyldopa can cause orthostatic hypotension and dizziness when the client is changing positions. Therefore, the nurse should instruct the client to change positions slowly while taking methyldopa. Question: 40 of 50 INCORRECT FLAG • Time Remaining: 00:27:14 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who has hypertension and nephropathy due to type 2 diabetes mellitus. The nurse should expect to administer which of the following medications to slow the progression of the nephropathy? Sitagliptin The nurse should expect to administer sitagliptin, a gliptin, to a client who has type 2 diabetes mellitus to control blood glucose levels and decrease hemoglobin A1C levels. Glipizide MY ANSWER The nurse should expect to administer glipizide, a sulfonylurea, to a client who has type 2 diabetes mellitus to control blood glucose levels and decrease hemoglobin A1C levels. Metoprolol The nurse should expect to administer metoprolol, a beta blocker, to a client who has hypertension to decrease blood pressure and reduce heart rate. Losartan The nurse should expect to administer losartan, an angiotensin II receptor blocker, to a client who has hypertension and type 2 diabetes mellitus to slow the progression of nephropathy. Question: 41 of 50 CORRECT FLAG • Time Remaining: 00:26:41 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who is receiving morphine. Which of the following assessments should the nurse perform first? Apical heart rate The nurse should assess the client's apical heart rate because morphine can cause bradycardia. However, there is another assessment the nurse should perform first. Blood pressure The nurse should assess the client's blood pressure because morphine can cause hypotension. However, there is another assessment the nurse should perform first. Respiratory rate MY ANSWER When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is respiratory rate. Opioid therapy can result in respiratory depression, which can lead to respiratory arrest. The nurse should withhold the morphine and notify the provider if the client's respiratory rate is less than 12/min. Question: 42 of 50 INCORRECT FLAG • Time Remaining: 00:26:00 • Pause Remaining: 00:02:22 PAUSE A nurse is teaching a client who has a new prescription for benzonatate. Which of the following statements by the client indicates an understanding of the teaching? "I should not drive while taking this medication." Adverse effects of benzonatate can include sedation and dizziness. Therefore, the nurse should instruct the client to avoid driving or engaging in activities that require alertness while taking this medication. Question: 43 of 50 INCORRECT FLAG • Time Remaining: 00:25:26 • Pause Remaining: 00:02:22 PAUSE A nurse is assessing a client who has a prescription for haloperidol 0.5 mg PO three times daily. The medication administration record shows that the client received 5 mg per dose on the previous day. Which of the following manifestations is the nurse's priority to assess? Muscle stiffness The nurse should recognize that the greatest risk to the client is developing neuroleptic malignant syndrome, an adverse reaction to haloperidol that is potentially fatal if not treated promptly. Manifestations of neuroleptic malignant syndrome include extreme muscle stiffness, sudden increase in temperature, diaphoresis, dysrhythmias, and fluctuations in blood pressure. Question: 44 of 50 CORRECT FLAG • Time Remaining: 00:24:50 • Pause Remaining: 00:02:22 PAUSE A nurse is preparing to administer medications to a client who has type 1 diabetes mellitus. The client takes lispro insulin and has a new prescription for pramlintide. Which of the following actions should the nurse take? Monitor the client for weight gain. Weight gain is not an adverse effect of pramlintide. However, nausea is a common adverse effect especially for clients who have type 1 diabetes mellitus. Monitor for hypoglycemia for 3 hr after pramlintide administration. MY ANSWER The nurse should monitor the client for manifestations of hypoglycemia for 3 hr after administering pramlintide. Pramlintide does not cause hypoglycemia. However, when combined with insulin, hypoglycemia can occur within 3 hr of administration. The client should take pramlintide before meals along with lispro insulin. Question: 45 of 50 INCORRECT FLAG • Time Remaining: 00:24:05 • Pause Remaining: 00:02:22 PAUSE A nurse is providing teaching to a client who has angina and a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching? "Repeat up to four doses until pain is relieved." The nurse should instruct the client to take no more than three sublingual tablets when experiencing chest pain. The client should first put one tablet under the tongue and let it dissolve. If pain is not relieved within 5 min, the client should call 911 and take a second tablet. If the pain is still not relieved after an additional 5 min, the client should take a third tablet. "Store unused tablets at room temperature." The nurse should instruct the client to store unused nitroglycerin tablets at room temperature in the original container. The client should not expose tablets to moisture, heat, or air, and should replace the tablets 6 months after they are opened to retain potency. Question: 46 of 50 CORRECT FLAG • Time Remaining: 00:23:28 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who has chemotherapy-induced anemia. The nurse should expect to administer which of the following medications to treat the anemia? Sargramostim Sargramostim is a hematopoietic growth factor used to stimulate bone marrow production in clients who have undergone a bone marrow transplant. Filgrastim Filgrastim stimulates white blood cell production to decrease the risk of infection. Epoetin MY ANSWER The nurse should expect to administer epoetin to a client who has chemotherapy-induced anemia. This medication stimulates red blood cell production and can reduce the need for periodic blood transfusions Question: 47 of 50 CORRECT FLAG • Time Remaining: 00:22:42 • Pause Remaining: 00:02:22 PAUSE A nurse is completing an admission assessment for a client who has been taking St. John's wort. The nurse should identify that which of the following medications can interact with St. John's wort? Rifampin There is no evidence that St. John's wort interacts with rifampin, an antibiotic used for tuberculosis. St. John’s wort does decrease the effectiveness of birth control pills, warfarin, cyclosporine, digoxin, calcium channel blockers, steroids, HIV protease inhibitors, and some chemotherapy agents. Furosemide There is no evidence that St. John's wort interacts with furosemide, a loop diuretic. St. John’s wort does decrease the effectiveness of birth control pills, warfarin, cyclosporine, digoxin, calcium channel blockers, steroids, HIV protease inhibitors, and some chemotherapy agents. Citalopram MY ANSWER St. John's wort interacts with many medications and can cause serotonin syndrome when combined with cocaine, amphetamines, and antidepressants, such as citalopram. St. John's wort decreases effectiveness of birth control pills, warfarin, cyclosporine, digoxin, calcium channel blockers, steroids, HIV protease inhibitors, and some chemotherapy agents. Question: 48 of 50 INCORRECT FLAG • Time Remaining: 00:21:47 • Pause Remaining: 00:02:22 PAUSE A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills. Which of the following actions should the nurse take? Apply a warming blanket prior to administration. If the client begins to experience chills, the nurse might need to provide additional blankets. However, applying a blanket prior to administration can contribute to an increase in body temperature. Infuse the medication over 1 hr. The nurse should infuse the medication slowly over 4 to 6 hr to reduce the risk for a transfusion reaction, manifested by fever, chills, nausea, and vomiting. Administer diphenhydramine prior to administration. Infusion reactions often occur following the administration of amphotericin B. The nurse should administer an antipyretic, corticosteroid, antihistamine, or antiemetic prior to administration of amphotericin B to minimize these effects. • Pharm Assessment 2 CLOSE Question 49 loaded rationals provided Question: 49 of 50 CORRECT FLAG • Time Remaining: 00:21:01 • Pause Remaining: 00:02:22 PAUSE A nurse is providing teaching to a client who has a duodenal ulcer and is starting to take sucralfate. Which of the following instructions should the nurse include in the teaching? "Take this medication with meals." The nurse should instruct the client to take sucralfate on an empty stomach. It is an antiulcer medication that creates a thick, viscous substance that coats the ulcer with a protective barrier. Therefore, the client should take sucralfate at least 1 hr prior to meals. "Reduce dietary fiber while taking the medication." The nurse should instruct the client to increase fluid and dietary fiber intake to prevent constipation, a potential adverse effect of sucralfate. "Administer an antacid with the medication." The nurse should instruct the client not to take sucralfate with any other medication. Administration of sucralfate with antacids will decrease the protective properties of the mucosal protectant. The nurse should instruct the client to take sucralfate and antacids at least 30 min apart. "Increase fluid intake while taking the medication." MY ANSWER The nurse should instruct the client to increase their fluid and dietary fiber intake to prevent constipation, a potential adverse effect of sucralfate. Question: 50 of 50 CORRECT FLAG • Time Remaining: 00:20:15 • Pause Remaining: 00:02:22 PAUSE A nurse is reviewing laboratory data for a client who is taking niacin to correct plasma lipid levels. Which of the following findings should the nurse identify as an adverse effect of this therapy? Elevated alanine aminotransferase (ALT) MY ANSWER An adverse effect of niacin is hepatotoxicity, indicated by an elevated ALT, aspartate aminotransferase, or lactic dehydrogenase level. Clients who take niacin should have regular screenings of liver function to monitor for hepatotoxicity. [Show More]

Last updated: 1 year ago

Preview 1 out of 27 pages