A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the
... [Show More] medication will most likely be prescribed
A. once a day.
B. twice a day.
C. three times a day.
D. four times a day. Correct answer- ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for long periods of time. Therefore, this medication can be administered once a day.
A nurse educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses. Medication dosages may need to be decreased for which of the following reasons? (Select all that apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway Correct answer- ANS: C, E
Liver failure decreases metabolism and thus increase the concentration of medication. This may require decreasing the dosage of medication. When two medications are metabolized in the same way, they may compete for metabolism, thereby increasing the concentration of one or both medications.
Increased renal excretion may decrease concentration of the medication, requiring increased dosage. Increased medication-metabolizing enzymes can decrease the concentration of the medication. The dose might need increased. Peripheral vascular disease may impair distribution, and more of the medication may be needed.
A nurse s preparing to administer eye drops to a client. Which of the following are appropriate nursing interventions related to this procedure? (Select all that apply.)
A. Using medical aseptic technique
B. Asking the client to look up at the ceiling
C. Having the client lie in a side-lying position
D. Dropping medication into the center of the client's conjunctival sac
E. Instructing the client to close the eye gently Correct answer- ANS:B, D, E
The medication should be dropped into the center of the conjunctival sac to promote better distribution of the medication. The client should close the eye gently to allow improved distribution of the medication.
Surgical aseptic technique is used to administer eye drops. The client should be sitting or in a supine position to facilitate proper administration of eye drops.
A nurse is completing discharge teaching to a client who has a new prescription for a transdermal medication. Which of the following statements by the client indicates understanding of the teaching?
A. "I will clean the site with an alcohol swab prior to applying the patch."
B. "I will rotate the application site weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch." Correct answer- ANS: C
Transdermal medication should be applied to a hairless area of skin to promote absorption of medication.
The skin should be washed with soap and water and dried thoroughly before applying a transdermal patch. Application sites should be rotated on a daily basis to prevent skin irritation.
A nurse is reviewing a client's health record and notes a new prescription by the provider to verify the trough level of the client's medication. Which of the following actions should the nurse take?
A. Have a blood specimen obtained immediately prior to the next dose of medication.
B. Verify that the client has been on the medication for 24 hr before ordering a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Begin administering the medication, and obtain a blood specimen. Correct answer- ANS: A
To verify trough levels of a medication, a blood specimen is obtained immediately before the next dose of medication.
A nurse is preparing a client's medication. Which of the following are legal responsibilities of the nurse? (Select all that apply.)
A. Maintaining skill competency
B. Determining the dosage
C. Monitoring for adverse effects
D. Safeguarding medications
E. Identifying the client's diagnosis Correct answer- ANS: A, C, D
Determining medication dosage and identifying a diagnosis is the role/responsibility of the provider. The nurse should be informed about a client's diagnosis.
A nurse is reviewing a client's health record and notes a new prescription by the provider for lisinopril (Zestril) 10 mg PO every day. The nurse should recognize this as which of the following types of prescription?
A. Single prescription
B. Stat prescription
C. Routine prescription
D. Standing prescription Correct answer- ANS: C
A routine prescription identifies a medication that is given on a regular schedule. This medication is administered every day until discontinued.
A single prescription is to be given once at a specified time or as soon as possible. A stat prescription is only given once, and it is given immediately. A standing prescription is written for specific circumstances or a specific unit.
A nurse is reviewing a new prescription for ondansetron (Zofran) 4 mg PO PRN nausea and vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?
A. Name
B. Dosage
C. Route
D. Time Correct answer- ANS: D
The time and frequency of medication administration is not included and should be clarified with the provider.
A nurse is orienting a newly hired nurse and discussing how to take telephone prescription. Which of the following statements by the newly hired nurse indicates understanding of the discussion?
A. "A second nurse enters the prescription into the client's health record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
D. "The 'read back' is omitted if this is a one-time prescription." Correct answer- ANS: B
The second nurse should listen to a telephone prescription to prevent errors in communication.
The nurse who takes the telephone prescription should enter it into the client's health record to prevent errors in translation. The nurse verifies the prescription is complete and accurate at the time it is given by reading it back to the provider. A telephone prescription includes reading back all types of medication prescription.
A nurse on a medical unit is admitting a client and completing a preassessment before administration of medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies Correct answer- ANS: A, C, E
Use of herbal product,s which often contains caffeine, should be assessed prior to medication administration because caffeine can affect medication biotransformation. Current health status should be reviewed because new prescriptions can cause alterations in current health status. Food allergies should be included in the preassessment that is completed prior to medication administration to identify any potential interactions.
Daily fluid intake and surgical history is important, but it is not part of the presassessment that is completed prior to medication administration.
A nurse is assessing a client's IV. Which of the following findings is indicative of phlebitis? (Select all that apply.)
A. Tingling sensation below insertion site
B. Tachycardia
C. Palpable, hard mass above insertion site
D. Cool, pale skin
E. Pain at site Correct answer- ANS: C, E
Pain at the IV site and a palpable, hard mass above the insertion site is a clinical manifestation of thrombophlebitis.
A tingling sensation below the insertion site is a clinical manifestation of nerve damage. Tachycardia is a clinical manifestation of fluid volume overload. Cool, pale skin is a clinical manifestation of infiltration.
A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?
A. Performing hand hygiene before and after IV insertion
B. Rotating IV sites at least every 72 hr
C. Minimizing tourniquet time
D. Avoiding reinserting the needle into an IV catheter Correct answer- ANS: D
The nurse manager should remind the members to avoid reinserting a needle to an IV catheter. This action can result in severing the end of the catheter and consequently cause a catheter embolism.
A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse take?
A. Use a disposable razor to remove excess hair on the extremity.
B. Select the back of the client's hand to insert the IV catheter.
C. Distend the veins by using a blood pressure cuff.
D. Direct the client to raise his arm above his heart. Correct answer- ANS: C
The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein, which can result in a hematoma.
The nurse should remove excess hair by clipping it with scissors. Shaving with disposable razors can cause skin damage that lead to infection. In most instances, the nurse inserts the IV catheter into a distal site, such as the back of the client's hand. However, when inserting an IV catheter for an older adult, the nurse should use a site on the arm because older adults typically have fragile veins in the back of their hands. The nurse should direct the client to hold his arm below the level of his heart to distend the vein.
A nurse is caring for a client receiving dextrose 5% in water IV at 250 mL. Which of the following findings are an indication of fluid volume overload? (Select all that apply.)
A. Hypotension
B. Bradycardia
C. Shortness of breath
D. Crackles heard in lungs
E. Distended neck veins Correct answer- ANS: C, D, E
Due to an increase in fluid in the cardiovascular system, hypertension and tachycardia are manifestations of fluid overload.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)
A. A client at 8 weeks of gestation who asks for an influenza immunization.
B. A client who takes prednisone and has a possible fungal infection.
C. A client who has chronic liver disease and reports he is taking hydrocodone.
D. A client who has PUD and takes sucralfate and tells the nurse she has started taking OTC aluminum hydroxide.
E. A client who has a prosthetic heart valve who takes warfarin and reports a suspected pregnancy. Correct answer- ANS: B, C, E
Glucocorticoids should not be taken by a client who has possible systemic fungal infection. Acetaminophen is contraindicated due to toxicity for the client who has a liver disorder. Warfarin is a Pregnancy Category X medication, which can cause severe birth defects in a fetus.
The influenza vaccine is recommended for all people older than 6 months of age and is not contraindicated for pregnant women. There is no contraindication for a client who has PUD and takes sucralfate and also starts taking OTC aluminum hydroxide. The nurse should ensure that the client takes medications 3 min apart.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following is an appropriate nursing action?
A. Administer the prescribed dose.
B. Withhold the medication.
C. Ask the provider to change the prescription to an oral form.
D. Administer an oral antihistamine at the same time. Correct answer- ANS: B
The nurse should withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed.
A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following is an appropriate statement by the nurse?
A. "Be sure to limit your potassium intake while taking this medication."
B. "You should check your blood pressure every 8 hr while taking this medication."
C. "Your medication dosage will be increased if you develop tachycardia."
D. "Change positions slowly when you move from sitting to standing." Correct answer- ANS: D
Orthostatic hypotension is a common adverse effect of antihypertensive medications.
Potassium can actually lower blood pressure, so clients who have hypertension should eat plenty of fresh fruit and vegetables. Clients should check their blood pressure daily on a regular basis. Tachycardia is an adverse effect that would not warrant an increase in a dose of medication.
A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse recognizes that the medication affected the client's
A. cardiovascular system.
B. immune system.
C. central nervous system.
D. gastrointestinal system. Correct answer- ANS: C
Extrapyramidal effects are movement disorders that may be caused by a number of CNS medications, such as typical antipsychotic medications.
A nurse is caring for a client who is taking oral oxycodone. The client states he is also taking ibuprofen three recommended doses daily. The interaction between these two medications will cause which of the following?
A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
C. An increase in the expected therapeutic effect of both medications.
D. An increase in expected adverse effects for both medications. Correct answer- ANS: C
These medications work together to increase the pain-relieving effects of both medications. They work by different mechanisms, but pain is better relieved when they are taken together.
A nurse is preparing to administer medications to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.)
A. Gastric emptying time is more rapid in infants
B. Infants have immature liver function
C. An infant's blood-brain barrier is poorly developed
D. The ability to absorb topical medications is increased in infants
E. Infants have an increased number of protein-binding sites Correct answer- ANS: B, C, D
Infants have immature liver function until 1 year of age. Because infants have a higher blood flow to the skin and their skin is thin, the absorption is increased in infants, making them prone to toxicity from topical medications.
Gastric emptying is longer and is inconsistent in infants. Medications administered orally remain in the stomach for a longer period of time, and absorption is more complex.
A nurse on a medical-surgical unit administers a hypotonic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors may be responsible for the client's drowsiness?
A. Reduced cardiac function
B. First-pass effect
C. Reduced hepatic function
D. Delayed toxic effect Correct answer- ANS: C
Older adults have reduced hepatic function, which may prolong the effects of medications metabolized in the liver. The dosage of the client's hypnotic medication may need to be reduced.
The first-pass effect would cause the hypnotic medication to be metabolized more quickly, thus having a decreased effect.
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following is the priority nursing action?
A. Administer flumazenil.
B. Identify the client's level of orientation.
C. Infuse IV fluids.
D. Prepare the client for gastric lavage. Correct answer- ANS: B
When taking the nursing process approach to client care, the initial step is assessment. Therefore, identifying the client's level of orientation is the priority actin.
Administering flumazenil, infusing IV fluids, and gastric lavage are appropriate actions. However, it is not the priority when taking the nursing process approach to client care.
****ing stupid
A nurse is caring for a client who is to begin taking escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the use of this medication?
A. "I will take the medication at bedtime."
B. "I will need to follow a low-sodium diet while taking this medication."
C. "I need to discontinue this medication slowly."
D. "I probably won't desire intimacy during the first days of treatment." Correct answer- ANS: C
When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome.
The client should take escitalopram in the morning to minimize sleep disturbances. The client is at risk for hyponatremia while taking escitalopram. Sexual dysfunction, including decreased libido, is a late adverse effect that is possible after 5-6 weeks of treatment with escitalopram.
A nurse is providing teaching to a client who has a new prescription to start buspirone in place of diazepam. The client has a history of panic disorder and cirrhosis of the liver. The client asks why his provider is making the medication change. Which of the following statements is an appropriate response by the nurse?
A. "Diazepam can cause seizures as an adverse effect."
B. "Diazepam is not indicated for the treatment of panic disorder."
C. "Buspirone is a safe medication for clients who have liver dysfunction."
D. "Buspirone has less risk for dependency than other treatment options." Correct answer- ANS: D
Buspirone is preferable to diazepam for long-term use due to the decreased risk for dependency.
Diazepam is indicated for the treatment of seizure activity and does not cause seizures as an adverse effect. Both buspirone and diazepam are indicated for the treatment of panic disorder. Buspirone must be used cautiously in clients with liver dysfunction.
A nurse working in a mental health clinic is caring for a client who has OCD and recently started a new prescription for buspirone. The client tells the nurse that the medication has not helped him sleep and that he is still having obsessive compulsions. Which of the following statements is an appropriate response by the nurse?
A. "It may take several weeks before you feel like the medication is helping."
B. "Take the medication just before bedtime to promote sleep."
C. "You should take the medication on an as-needed basis when you experience obsessive urges."
D. "Your provider may need to increase your prescription due to developing tolerance." Correct answer- ANS: A
Buspirone may take 3 to 6 weeks before the client reaches full therapeutic benefit.
Buspirone does not have any sedative effects and therefore will not promote sleep. Buspirone should be taken on a regular basis rather than an as-needed basis. Buspirone does not cause tolerance.
A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder. The client states that he grinds his teeth during the night, which causes jaw pain. The nurse should identify which of the following as possible measures to manage the client's bruxism? (Select all that apply.)
A. Concurrent administration of buspirone
B Administration of a different SSRI
C. Use of a mouth guard
D. Changing to a different class of antianxiety medication
E. Increasing the dose of paroxetine Correct answer- ANS: A, C, D
Concurrent administration of a low dose of buspirone is an effective measure to manage the adverse effects of paroxetine. Using a mouth guard during sleep can decrease the risk for oral damage resulting from bruxism. Changing to a different class of antianxiety medication that does not have the adverse effect of bruxism is an effective measure.
Other SSRIs also will have bruxism as an adverse effect. Increasing the dose of paroxetine can cause the adverse effect to worsen.
A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
A. Orthostatic hypotension
B. Hearing loss
C. Gastrointestinal bleeding
D. Weight loss Correct answer- ANS: A
Orthostatic hypotension is an adverse effect of MAOIs, including phenelzine
Phenelzine is more likely to cause blurred vision than hearing loss. Clients taking phenelzine are at risk for multiple adverse effects, however, this does not include GI bleeding. Clients taking phenelzine are at risk for weight gain rather than weight loss.
A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.)
A. Expect therapeutic effects in 24 to 48 hr.
B. Discontinue the medication after a week of improved mood.
C. Change positions slowly to minimize dizziness.
D. Decrease dietary fiber intake to control diarrhea.
E. Chew sugarless gum to prevent dry mouth. Correct answer- ANS: C, E
Orthostatic hypotension is an adverse effect of amitriptyline. Chewing sugarless gum can minimize dry mouth, an adverse effect.
Therapeutic effects are expected after several weeks of taking amitriptyline. Stopping amitriptyline abruptly can result in relapse. Clients should increase dietary fiber to prevent constipation, an adverse effect.
A nurse is providing follow-up dietary teaching for a client who was recently prescribed phenelzine. When reviewing the client's dietary log, which of the following foods requires a need for further teaching?
A. Cottage cheese
B. Banana bread
C. Apple pie
D. Grilled steak Correct answer- ANS: B
Clients taking phenelzine, an MAOI, should avoid foods containing tyramine. Bananas and yeast products contain tyramine.
The client should avoid aged rather than cottage cheese.
A nurse is providing discharge teaching to a client who is to begin taking fluoxetine for PTSD. Which of the following statements is appropriate for the nurse to include in the teaching?
A. "You may have a decreased desire for intimacy while taking this medication."
B. "You should take this medication at bedtime to help promote sleep."
C. "You will have fewer urinary adverse effects if you urinate just before taking this medication."
D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." Correct answer- ANS: A
Decreased libido is a potential adverse effect of fluoxetine and other SSRIs.
Clients should take fluoxetine in the morning due to CNS stimulation. Clients taking TCA, rather than fluoxetine, should void prior to taking the medication due to the potential for urinary hesitancy or retention. TCA also has potential for photophobia and should advise client to wear sunglasses outdoors.
A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?
A. Bruising
B. Fever
C. Abdominal pain
D. Rash Correct answer- ANS: B
Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline.
Bleeding can result if an SSRI is administered with warfarin. However, this is not an indication of serotonin syndrome.
A nurse is reviewing the laboratory findings and notes that a client's plasma lithium is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
A. Perform immediate gastric lavage.
B. Prepare the client for hemodialysis.
C. Administer an additional oral dose of lithium.
D. Request a stat repeat of the laboratory test. Correct answer- ANS: A
Gastric lavage is appropriate for a client who has severe toxicity, as evidenced by a plasma lithium of 2.1 mEq/L. This action will lower the client's lithium level.
Hemodialysis is appropriate for a client who has a plasma lithium level greater than 2.5 mEq/L.
A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?
A. Avoid the use of acetaminophen for headaches.
B. Restrict the intake of foods rich in sodium.
C. Decrease fluid intake to less than 1,500 mL daily.
D. Limit aerobic activity in hot weather. Correct answer- ANS: D
The client should avoid activities that have potential to cause sodium/water depletion, which can increase toxicity risk.
The client should use acetaminophen, rather than NSAIDs, such as ibuprofen, for headaches because NSAIDs interact with lithium and can cause increased blood levels of lithium. The client should increase sodium intake to reduce risk for toxicity.
A nurse in a primary care clinic is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?
A. Severe hypertension
B. Coarse tremors
C. Constipation
D. Urinary retention Correct answer- ANS: B
Severe hypotension, diarrhea, and polyuria are indications of toxicity.
A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client that while taking this medication he will need to have to which of the following laboratory tests completed periodically? (Select all that apply.)
A. Thrombocyte count
B. Hematocrit
C. Amylase
D. Liver function test
E. Potassium Correct answer- ANS:A, C, D
Treatment with valproic acid can result in thrombocytopenia, pancreatitis (monitoring amylase), and hepatotoxicity. It is not known to have an effect on hematocrit or potassium.
A nurse is teaching a female client who has bipolar disorder about her new prescription for lithium carbonate. Which of the following is appropriate for the nurse to include in the teaching? (Select all that apply.)
A. An adverse effect of this medication is amenorrhea.
B. An antidepressant is combined with lithium therapy during phases of mania.
C. Take this medication with food or a glass of milk.
D. Avoid pregnancy while taking this medication.
E. Thyroid function is assessed prior to lithium therapy. Correct answer- ANS: C, D, E
Taking lithium with food or a glass of milk can help reduce GI distress. Lithium is a Pregnancy Risk Category D medication that is teratogenic, especially during the first trimester. Because lithium can cause goiter and hypothyroidism, the client's thyroid function is assessed prior to lithium therapy.
Lithium does not cause amenorrhea. An antidepressant, combined with lithium, is effective during phases of depression.
A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?
A. Take the medication in the morning to prevent insomnia.
B. Chew sugarless gum to moisten the mouth.
C. Use cooling measures to decrease fever.
D. Take an antacid to relieve nausea. Correct answer- ANS: B
Chewing sugarless gum can help the client cope with dry mouth, a potential anticholinergic effect.
Insomnia, fever, and nausea are not anticholinergic effects.
A nurse is assessing a male client who recently began taking haloperidol. Which of the following findings is the highest priority to report to the provider?
A. Shuffling gait
B. Neck spasms
C. Drowsiness
D. Impotence Correct answer- ANS: B
Neck spasms are an indication of acute dystonia which is a crisis situation requiring rapid treatment.
Shuffling gait is an indication of parkinsonism and should be reported to the provider, however, it is not the greatest risk.
A nurse is providing discharge teaching for a client who has a new prescription for clozapine. Which of the following statements is appropriate for the nurse to include in the teaching?
A. "You should have a high-carbohydrate snack between meals and at bedtime."
B. "You are likely to develop hand tremors if you take this medication for a long period of time."
C. "You may experience temporary numbness of your mouth after each dose."
D. "You should have your white blood cell count monitored every week." Correct answer- ANS: D
Due to the risk for fatal agranulocytosis weekly monitoring of the client's WBC count is recommended while taking clozapine.
Clozapine increases the client's risk of developing diabetes mellitus and weight gain. Clozapine has low risk of EPS such as hand tremors. Asenapine, rather than clozapine, causes temporary numbing of the mouth.
A nurse performs an Abnormal Involuntary Movement Scale (AIMS) assessment on a client who began taking loxapine 2 years ago for the treatment of schizophrenia. Findings include lip smacking, tongue protrusion, and facial grimacing. The nurse should suspect which of the following?
A. Parkinsonism
B. Tardive dyskinesia
C. Anticholinergic effects
D> Akathisia Correct answer- ANS: B
These findings indicate tardive dyskinesia, which can occur months to years after the initiation of therapy.
These findings do not indicate akathisia, which is most common during the first 2 months of therapy. Parkinsonism is most common during first month of therapy.
A nurse is preparing to perform follow-up assessment on a client who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.)
A. Disorganized speech
B. Bizarre behavior
C. Impaired social interactions
D. Hallucinations
E. Decreased motivation Correct answer- ANS:A, B, D
A client who takes a conventional antipsychotic medication should have the greatest improvement in positive symptoms such as disorganizes speech, bizarre behaviors, and hallucinations.
Impaired social interactions and decreased motivation are negative symptoms which conventional antipsythotics are less effective against.
A nurse is teaching the parents of a child who has a new prescription for desipramine about possible adverse effects. The nurse should instruct the parents that which of the following adverse effects is the highest priority to report to the provider?
A. Diaphoresis
B. Confusion
C. Blurred vision
D. Dizziness Correct answer- ANS: B
Confusion is an indication of toxicity, which is the greatest risk to the client.
A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of the following should the nurse teach the client in order to minimize the adverse effect of his medication?
A. Wear sunglasses when outdoors
B. Check temperature daily when taking this medication
C. Take medication first thing in the morning before eating
D. Add extra calories to the diet as between-meal snacks Correct answer- ANS: A
Wearing sunglasses when outdoors will decrease photophobia, an anticholinergic effect associated with TCA use.
Taking the medication at bedtime rather than in the morning is appropriate to prevent daytime sleepiness. Following a low-calorie diet plan rather than adding extra calories as snacks will help prevent weight gain, a common adverse effect of TCAs.
A nurse is caring for a school-age child who recently began a prescription for atomoxetine. For which of the following possible complications should the nurse monitor the child?
A. Renal toxicity
B. Liver damage
C. Seizure activity
D. Adrenal insufficiency Correct answer- ANS: B
Liver damage is a potential complication of atomoxetine. The nurse should monitor for manifestations such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes.
A nurse is teaching a school-age child and his parents about a new prescription for lisdexamfetamine dimesylate (Vyvanse). Which of the following is appropriate for the nurse to include in the teaching? (Select all that apply.)
A. An adverse effect of this medication is CNS stimulation.
B. Administer the medication 1 hr before breakfast.
C. Monitor blood pressure while taking this medication.
D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop.
E. This medication raises the levels of dopamine into the brain. Correct answer- ANS: A, C, E
An adverse effect of Vyvanse is CNS stimulation such as insomnia and restlessness. Monitoring the BP is appropraite due to potential cardiovascular effects. Vyvanse works by raising levels of norepinephrine, serotonin, and dopamine into the CNS.
Atomoxetine, rather than Vyvanse, takes 1 to 3 weeks to fully develop therapeutic effects.
A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following is appropriate for the nurse to include in the teaching?
A. Increases the risk for seizure activity
B. Provides a form of aversion therapy
C. Decreases cravings
D. Results in mild hypertension Correct answer- ANS: C
Propranolol is an adjunct medication used during detoxification to decrease the client's craving for alcohol.
Seizure activity is a potential effect of alcohol withdrawal, however, propranolol does not increase this risk. Disulfiram, rather than propranolol, provides a form of aversion therapy. Propranolol is an antihypertensive medication that can result in hypotension rather than hypertension. [Show Less]