1. Calcium supplement for osteoporosis--why would they have flank pain
2. A nurse is preparing to administer a dose of lactulose to a client who has
... [Show More] cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?
a. Glucose
b. Ammonia
i. Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.
c. Potassium
d. Bicarbonate
3. 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
4. Someone has a-fib on coumadin, know what normal PT is
5. Someone is on atorvastatin (statin) what kind of labs do we look at
a. Liver function
6. CKD nephrotoxicity
a. Antibiotic
7. Heart failure and on Lasix, what are adverse effects of Lasix and what would happen if hypokalemic
8. Celecoxib for osteoarthritis (adverse effects??)
a. Not stroke
9. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?
a. "Crushing the medication might cause you to have a stomachache or indigestion.
i. Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection.
b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.”
c. "Crushing the medication would release all the medication at once, rather than over time."
d. "Crushing is unsafe, as it destroys the ingredients in the medication."
10. A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide?
a. "Glipizide absorbs the excess carbohydrates in your system."
b. "Glipizide stimulates your pancreas to release insulin."
i. Rationale: Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. These medications help to lower blood glucose levels in clients who have type 2 diabetes mellitus using several methods, including reducing glucose output by the liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas.
c. "Glipizide replaces insulin that is not being produced by your pancreas."
d. "Glipizide prevents your liver from destroying your insulin."
11. Having transdermal analgesic-- look up emla cream
12. SAA--how to use cream with child ^^^
a. Use visual pain rating scale
13. A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects?
a. Constipation
b. Black colored stools
c. Staining of teeth
d. Body secretions turning a red-orange color
i. Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva
14. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?
a. A. Check the client's vital signs.
i. Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm.
b. Request a dietitian consult.
c. Suggest that the client rests before eating the meal.
d. Request an order for an antiemetic.
15. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?
a. Thyroid hormone assay
i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.
b. Liver function tests:
i. Rationale: LFTs must be monitored before and during valproic acid therapy
c. Erythrocyte sedimentation rate
i. Rationale: This is not a necessary test related to lithium therapy.
d. Brain natriuretic peptide
16. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
b. "A pharmacist is the person to answer that question."
c. "Heparin does not dissolve clots. It stops new clots from forming."
i. Rationale: This statement accurately answers the client's question.
d. "The oral medication you will take after this IV will dissolve the clot.
17. Suspension --vigorously shake for 5 minutes , room temp
18. A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?
a) Asthma
1. Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation.
b) Glaucoma
c) Depression
d) Migraines
19. A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include?
a. "Take this medication with food if nausea develops."
b. B. "Monitor for muscle pain."
i. Rationale: This medication can cause rhabdomyolysis. The client should monitor and report muscle pain.
c. "Expect to have increased bruising."
d. "Increase your intake of grapefruit juice”
20. A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client?
a. "If the medicine causes an upset stomach, take an antacid at the same time."
b. "Limit your daily fluid intake while taking this medication."
c. "This medication can cause photophobia, so be sure to wear sunglasses outdoors."
d. "You should report any tendon discomfort you experience while taking this medication."
i. Rationale: The nurse should instruct the client to report any tendon discomfort as well as swelling or inflammation of the tendons due to the risk of tendon rupture.
21. A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client?
a. "If the medicine causes an upset stomach, take an antacid at the same time."
b. "Limit your daily fluid intake while taking this medication."
c. "This medication can cause photophobia, so be sure to wear sunglasses outdoors."
d. "You should report any tendon discomfort you experience while taking this medication."
i. Rationale: The nurse should instruct the client to report any tendon discomfort as well as swelling or inflammation of the tendons due to the risk of tendon rupture.
22. 17. A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor?
a. Headache
Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required.
b. Dependent edema
c. Polyuria.
d. Photosensitivity
23. A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication?
a. Hyperthermia
b. Hypotension
i. Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator and antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood pressure and pulse must be monitored before and during parenteral administration.
c. Ototoxicity
d. Muscle pain
24. A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?
a. Constipation
i. Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed
b. B. Metallic taste
c. Headache
d. Muscle spasms
25. A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?
a. Decrease in level of thyroxine (T4)
b. Increase in weight
c. Increase in hr of sleep per night
d. Decrease in level of thyroid stimulating hormone (TSH).
i. Levothyroxine OD = insomnia
26. A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
a. Hyperglycemia
b. Adrenocortical insufficiency
Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency.
c. Severe dehydration
d. Rebound pulmonary congestion
27. A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
a. Hyperglycemia
b. Adrenocortical insufficiency
Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency.
c. Severe dehydration
d. Rebound pulmonary congestion
28. A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications? (Select all that apply.)
a. Controlling emesis b. Diminishing anxiety
c. Reducing the amount of narcotics needed for pain relief
d. Preventing thrombus formation e. Drying secretions
29. A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?
a. Decrease chest wall compliance
b. Suppress respiratory effort
i. Rationale: Neuromuscular blocking agents, such as pancuronium, induce paralysis and suppress the client's respiratory efforts to the point of apnea, allowing the mechanical ventilator to take over the work of breathing for the client. This therapy is especially helpful for a client who has ARDS and poor lung compliance.
c. Induce sedation
d. Decrease respiratory secretions
30. Lisinopril (ace inhibitor) side effect
31. Poison ivy and give benadryl (side effects of ben) dry mouth?
32. A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?
a. Decrease in level of thyroxine (T4)
b. Increase in weight
c. Increase in hour of sleep per night
d. Decrease in level of thyroid stimulating hormone (TSH).
33. A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?
a. An excess amount of doxorubicin can lead to myelosuppression.
b. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation.
c. An excess amount of doxorubicin can lead to cardiomyopathy.
i. Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450
mg/m with a history of radiation to the mediastinum.
d. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
34. A nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide?
a. The medication is to be applied when the client is experiencing eye pain.
b. The medication will be used until the client's intraocular pressure returns to normal.
c. The medication should be applied on a regular schedule for the rest of the client's life.
d. The medication is to be used for approximately 10 days, followed by a gradual tapering off.
35. Thympolin (like caffeine)
36. A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?
a. "I signed up for a swimming class."
b. "I've been taking an antacid to help with indigestion."
i. NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations. [Show Less]