ATI Pharm Practice B with complete solution
ATI Pharm Practice B with complete solution
A nurse is reviewing the medication administration record
... [Show More] for a client who has a new prescription for tobramycin to treat a pulmonary infection. Which of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin?
A. Furosemide
B. Propranolol
C. Gabapentin
D. Guaifenesin
Correct ans - A. Furosemide
Rationale: Tobramycin is an aminoglycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time.
B. Propranolol
- Propranolol is a beta blocker that does not interact with tobramycin.
C. Gabapentin
- Gabapentin is an anticonvulsant that does not interact with tobramycin.
D. Guaifenesin
- Guaifenesin is an expectorant that does not interact with tobramycin.
A nurse is reinforcing teaching with a client who is newly diagnosed with HTN and is taking metoprolol. The nurse should instruct the client to report which of the following manifestations to the provider as an AE of this medication?
A. Tachycardia
B. Tinnitus
C. Peripheral edema
D. Urinary retention
Correct ans - C. Peripheral edema
Rationale: The nurse should instruct the client to monitor for and report the development of peripheral edema because this can be an indication of heart failure, which is an adverse effect of metoprolol.
A. Tachycardia
- Bradycardia
B. Tinnitus
- Blurred vision
D. Urinary retention
- Urinary frequency
A nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the tx is effective?
A. Improved social interactions
B. Decreased obsessive-compulsive thoughts
C. Decreased hand tremors
D. Improved urinary control
Correct ans - A. Improved social interactions
Rationale: Clients who have schizophrenia typically have difficulty interacting with others and maintaining relationships. Manifestations can include dull affect and speech deficiency. Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.
B. Decreased obsessive-compulsive thoughts
- Risperidone does not decrease obsessive-compulsive thoughts. Clients who have obsessive-compulsive disorder might take an SSRI, such as fluoxetine, to decrease obsessive-compulsive thoughts.
C. Decreased hand tremors
- Risperidone does not decrease hand tremors. Clients who have bipolar disorder might take a beta-adrenergic blocking agent, such as propranolol, to decrease hand tremors.
D. Improved urinary control
- Risperidone does not improve urinary control. Clients who have an overactive bladder might take oxybutynin to reduce urinary urgency and frequency, nocturia, and urge incontinence.
A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?
A. Digoxin level 0.9 ng/mL
B. Blood pressure 142/80 mm Hg
C. Potassium 4.4 mEq/L
D. Apical pulse 52/min
Correct ans - D. Apical pulse 52/min
Rationale: The nurse should check the client's apical pulse prior to administering digoxin because it can cause bradycardia. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.
A. Digoxin level 0.9 ng/mL
- Within expected range
B. Blood pressure 142/80 mm Hg
- HTN, does not require withholding digoxin.
C. Potassium 4.4 mEq/L
- Hypokalemia places clients at risk for cardiac dysrhythmias when taking digoxin. However, the client's potassium level is within the expected reference range and does not require the nurse to withhold the digoxin.
A nurse is caring for a client who has a 10-year hx of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority?
A. Suggest the client attend a support group.
B. Administer naltrexone.
C. Implement seizure precautions.
D. Assist the client to identify triggers of alcohol use.
Correct ans - C. Implement seizure precautions.
Rationale: The greatest risk to the client is injury from seizures and falls. Grand mal seizures can occur during severe alcohol withdrawal. Therefore, the nurse's priority is to implement seizure precautions to reduce the risk of injury if the client experiences a seizure.
A. Suggest the client attend a support group.
- The nurse should suggest the client attend a support group to provide ongoing support assistance with maintaining abstinence after detoxification. However, another intervention is the nurse's priority.
B. Administer naltrexone.
- The nurse should administer naltrexone to the client to assist with maintaining abstinence after detoxification. However, another intervention is the nurse's priority.
D. Assist the client to identify triggers of alcohol use.
- The nurse should assist the client with identifying triggers of alcohol use to assist with maintaining abstinence after detoxification. However, another intervention is the nurse's priority.
A nurse is reviewing the medication administration record of a client who has a hx of Stevens-Johnson syndrome when taking sulfamethoxazole-trimethoprim. Which of the following medications should the nurse identify as contraindicated for the client?
A. Prednisone
B. Furosemide
C. Lansoprazole
D. Digoxin
Correct ans - B. Furosemide
Rationale: A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.
A. Prednisone
- A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is not at risk for an allergic reaction with prednisone.
C. Lansoprazole
- A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is not at risk for an allergic reaction with lansoprazole.
D. Digoxin
- A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is not at risk for an allergic reaction with digoxin.
A client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has a prescription for morphine 15 mg orally every 4hr. The client's adult children express concern that the client is receiving too much of the medication? Which of the following responses should the nurse make? [Show Less]