1. A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include?
•A. "Rinse
... [Show More] your mouth after each use of this medication."B. "Limit fluid intake while taking this medication."C. "Increase your intake of vitamin B12 while taking this medication." D. "You can take the medication as needed." - ✔✔A. CORRECT: The client should rinse their mouth after each use to reduce the risk of oral fungal infections.
2. A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
A. Take the albuterol at the same time each day.
B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
C. Use beclomethasone if experiencing an acute episode. D. Avoid shaking the beclomethasone before use. - ✔✔B. CORRECT: When a client is prescribed an inhaled beta2-agonist
(albuterol) and an inhaled glucocorticoid (beclomethasone), the client should take the beta2-agonist first. The beta2-agonist promotes bronchodilation and enhances absorption of the glucocorticoid.
3. A nurse is teaching a client who has a prescription for long-term use of
oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?
A. Weight gain
B. Nervousness C. Bradycardia D. Constipation - ✔✔B.
(Don't forget weight gain is just one side effect. Refer to slide that has a picture of Cushings for the additional side effects. You want to be aware of them all.)
4. A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication?
A. SedationB. Nasal congestion C. Productive cough D. Constipation
8 - ✔✔B. CORRECT: When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications (phenylephrine).
5. A nurse is teaching a client who has a new prescription for
dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?
A. DiarrheaB. AnxietyC. SedationD. Palpitations - ✔✔C. CORRECT: Dextromethorphan can cause sedation (contains opioid- derivative). Advise the client to avoid activities that require alertness. (Remember, only give for NON-PRODUCTIVE COUGHS)
6. A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? (Select all that apply.)
A. Dry mouthB. Nonproductive cough C. Skin rashD. DrowsinessE. Urinary retention - ✔✔A. CORRECT: Dry mouth is an anticholinergic manifestation that can occur when a client takes diphenhydramine.A.D. CORRECT: Drowsiness is an adverse reaction of this medication. Diphenhydramine is administered to treat insomnia.
E. CORRECT: Urinary retention is an anticholinergic manifestation that can occur when a client takes diphenhydramine
7. A nurse is teaching a client who has a new prescription for omeprazole. Which of the following information should the nurse include in the teaching?
A. Take this medication at bedtime.B. This medication decreases the production of gastric acid. C. Take this medication 2 hr after eating.D. This medication can cause hyperkalemia. - ✔✔B. CORRECT: Omeprazole reduces gastric acid secretion by inhibiting the enzyme that produces gastric acid.
8. A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate. Which of the following instructions should the nurse include?
A. Take an antacid with the sucralfate.B. Take sucralfate with a glass of milk.C. Allow a 2-hr interval between these medications. D. These medications can be taken together. - ✔✔C. CORRECT: Sucralfate can interfere with the absorption of phenytoin, so the client should allow a 2-hr interval between the sucralfate and phenytoin.
(Always on an empty stomach: 30-60 min before meals. Remember too, this medication coats the stomach. Do not eat or drink right away or else you wash the medication away).
9. A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.)
A. HeadacheB. DiarrheaC. Shortened PR interval D. HyperglycemiaE. Prolonged QT interval - ✔✔A. CORRECT: Headache is a common adverse effect of ondansetron.
B. CORRECT: Diarrhea or constipation are both adverse effects of ondansetron.
E. CORRECT: A prolonged QT interval is a possible adverse effect of ondansetron that can lead to torsades de pointes, a serious dysrhythmia.
10. A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)•
A. Assess for tinnitus.B. Report urine output 50 mL/hr to the physician.C. Monitor blood potassium levels.D. Elevate the head of bed slowly before ambulation. E. Recommend eating a banana daily. - ✔✔A. CORRECT: An adverse effect of furosemide is ototoxicity. Manifestations of tinnitus should be reported to the provider. Remember, administer IV at a rate of 20mg/min.•
B. CORRECT: A decrease in blood potassium levels is an adverse effect of furosemide, and the provider should be notified.•D. CORRECT: Slowly elevating the head of the bed will prevent the client from developing orthostatic hypotension, which is a manifestation of hypovolemia.
•E. CORRECT: A banana has potassium. Encourage the client to eat foods high in potassium to help prevent hypokalemia.
11. A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
A. Blood sodium 144 mEq/LB. Urine output 120 mL in 4 hrC. Blood potassium 5.2 mEq/LD. Blood pressure 140/90 mm Hg - ✔✔C. CORRECT: Blood potassium of 5.2 mEq/L indicates hyperkalemia.
12. A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?
A. AsthmaB. GlaucomaC. Hypertension D. Tachycardia - ✔✔A. CORRECT: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is contraindicated in clients who have asthma.
13. A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include?
A. Increase the amount of fiber and fluid in the diet.B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet.D. Withhold food for 1 hr after the medication is taken. - ✔✔A.CORRECT: Increasing dietary fiber intake can help prevent
constipation, an adverse effect of verapamil. B.
Know Verapamil and Nifedipine side effects. NOTE THE DIFFERENCES (they work differently in the body; they are both CCBs, but different sub-classes).
14. A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.)
A. SimvastatinB. Hydrochlorothiazide C. PhenytoinD. ClonidineE. Aliskiren - ✔✔B. CORRECT: Hydrochlorothiazide, a thiazide diuretic, is often used to treat hypertension. Diuretics can intensify first-dose orthostatic hypotension caused by captopril and can continue to interact with antihypertensive medications to cause hypotension. Monitor clients carefully for hypotension, especially after the first dose of captopril and keep the client safe from injury.
D. CORRECT: Clonidine, a centrally acting alpha2 agonist, is an antihypertensive medication that can interact with captopril to intensify first-dose orthostatic hypotension.
E. CORRECT: Aliskiren, a direct renin inhibitor, is an antihypertensive medication that can interact with captopril to intensify its first-dose orthostatic hypotension
15. A nurse in a provider's office is monitoring blood electrolytes for four
clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity?
••A. Calcium 9.2 mg/dL •B. Calcium 10.3 mg/dL •C. Potassium 3.2 mEq/L •D. Potassium 4.8 mEq/L - ✔✔C. CORRECT: Potassium 3.2 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium can cause fatal dysrhythmias, especially in older clients who take digoxin. Notify the provider, who might prescribe a potassium supplement or a potassium-sparing diuretic for the client.
16. A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
A. Contact provider if heart rate is less than 60/min.B. Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium.D. Take with food if nausea occurs. - ✔✔A. CORRECT: The client should contact the provider for a heart rate less than 60/min.
17. A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?
A. Hold propranolol for an apical pulse greater than 100/min.B. Administer propranolol to increase the client's blood pressure. C. Assist the client when sitting up or standing after taking this medication.D. Check for hypokalemia frequently due to the risk for propranolol toxicity - ✔✔C. CORRECT: Propranolol can cause orthostatic hypotension, so it is important assess for dizziness during ambulation or when moving to a sitting position.Remember, beta-blockers also block Renin (RAAS) so a side effect could be hyperkalemia.
18. A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching?
A. Take this medication in the evening.B. Change position slowly when rising from a chair.C. Maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L/day of fluid - ✔✔A. CORRECT: The client should take simvastatin in the evening because nighttime is when the most cholesterol is synthesized in the body. Taking statin medications in the evening increases medication effectiveness. MOST OFTEN GIVEN WITH DINNER.
19. A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse effect of this medication?
A. Mental status changes B. TremorC. JaundiceD. Pneumonia - ✔✔C. CORRECT: Jaundice, anorexia, and upper abdominal discomfort
can be findings in liver impairment, which can occur in clients taking gemfibrozil.
20. A nurse is completing a nursing history for a client who takes
simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications?
A. History of severe constipation B. History of hypertensionC. Active hepatitis CD. Type 2 diabetes mellitus - ✔✔C. CORRECT: Ezetimibe is contraindicated in clients who have an active moderate-to-severe liver disorder, especially if the client is already taking a statin (simvastatin). STATINS ALONE CAN CAUSE HEPATOTOXICITY TOO. Check liver enzymes.
21. A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take?
A. Expel the air bubble from the prefilled syringe before injecting. B. Insert the needle completely into the client's tissue.C. Administer the injection in the client's thigh.D. Aspirate carefully after inserting the needle into the client's skin - ✔✔B. CORRECT: Inject the needle on the prefilled syringe completely when administering enoxaparin in order to administer the medication by deep subcutaneous injection.
22. A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
•A. Vitamin K1B. AtropineC. Protamine Sulfate D. Calcium gluconate - ✔✔C. CORRECT: Protamine sulfate reverses the anticoagulant effect of heparin.
With warfarin and heparin antidotes, you as the nurse will never just up and give them. You will need to contact the provider first who will then decide if to give, when to give, or how much to give. IT IS NOT YOUR DECISION.
23. A nurse is planning to administer IV alteplase to a client. Which of the following interventions should the nurse plan to take?
A. Administer IM enoxaparin along with the alteplase dose.B. Obtain the client's actual weight.C. Administer aminocaproic acid IV prior to alteplase infusion.D. Prepare to administer alteplase within 8 hr of manifestation onset. - ✔✔B. CORRECT: An accurate weight is required to calculate the dosage for alteplase administration.
24. A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication?
A. HemoglobinB. Absolute neutrophil count C. Platelet countD. Total white blood count - ✔✔C. CORRECT: The expected outcome for oprelvekin is a platelet count greater than 50,000/mm3.
25. A nurse is monitoring a client who is receiving epoetin alfa for adverse
effects. The nurse should identify which of the following findings as an adverse effect of this medication?
A. Leukocytosis B. Hypertension C. EdemaD. Blurred vision - ✔✔B. CORRECT: Hypertension is an adverse effect of epoetin alfa that the nurse should monitor for throughout treatment.
26. A nurse is evaluating a group of clients at a health fair to identify the need for folic acid therapy. Which of the following clients require folic acid therapy? (Select all that apply.)
A. 12-year-old child who has iron deficiency anemia B. 24-year-old female who has no health problems C. 44-year-old male who has hypertensionD. 55-year-old female who has alcohol use disorder E. 35-year-old male who has type 2 diabetes mellitus - ✔✔B. CORRECT: The client of childbearing age should take folic acid to prevent neural tube defects in the fetus.
•
D. CORRECT: The client who has alcohol use disorder can require folic acid therapy. Excess alcohol consumption leads to poor dietary intake of folic acid and injury to the liver.
27. avoid taking when serum potassium is low - ✔✔poatassium wasting diuretic
28. Avoid doing this if triglyceride levels are high. - ✔✔taking in more calories than needed
29. Avoid taking these classes of medications if SBP <90. - ✔✔what are antihypertensive and diuretics
30. avoid adding this to your food if you are taking potassium sparing diuretics like spironolactone aldactone - ✔✔what are salt substitutes
31. sildenafil (viagra) should be avoided in patients taking this - ✔✔nitrates
32. this is a common range for warfarin - ✔✔2-3
33. Lanoxin (digoxin) should be held if the HR is less than - ✔✔60
34. An inotropic, chronotropic medication that will decrease heart rate but not blood pressure. - ✔✔Lanoxin digoxin
35. beta blocker should be held for these common parameters - ✔✔hr < 60
SBP < 90
36. antidote is used for ptt of 145 - ✔✔protamine sulfate
37. immediately after using steroid inhalers the patient should be taught do this to avoid thrush - ✔✔rise mouth out w water
38. this is the best time of day to take diuretics - ✔✔morning
39. patient should be taught to take steroid and Saba inhalers in this order - ✔✔Saba than steroids
40. When taking diuretics, the patient should be taught to notify the physician when his/her weight does this. - ✔✔+/- 2 lbs in 24 hrs
41. salmeterol should not be used as this - ✔✔rescue drug
42. a dry hacking cough is a side effect of this class of medication - ✔✔ace inhibitors
43. name the two classes of diuretics most likely to cause hypokalemia - ✔✔loop and thiazide diuretics
44. a painful side effect common with vasodilation nitrate medication - ✔✔server headache
45. muscle weakness can be serious side effects associated with taking this class of medication - ✔✔statins
46. constipation and ruin retention can be side effects of this antidyserhthmic medication - ✔✔atropine
47. peripheral edema and orthostatic hypotension can be side effects of this class of antihypertensives - ✔✔calcium channel blocker
48. n/v/visual disturbance can be a side effect of - ✔✔Lanoxin dioxin [Show Less]