Pharm Assessment 2
Question: 2 of 50
A nurse is caring for a client who reports using the herbal medication garlic along with
prescribed warfarin. The
... [Show More] nurse should identify that which of the following 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.)
Have the client take one puff of albuterol
Have the client rest for 1 min
Have the client take the second puff of albuterol
Have the client rest for 5 min
Have the client take one puff of fluticasone
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 [Show Less]