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Part 2 Prep U
Terms in this set (65)
A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what?
Which of the following can occur if the nurse administers naloxone (Narcan) as a rapid IV bolus? Select all that apply:
The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply.
While caring for a client who is prescribed an opioid antagonist for treatment of respiratory depression caused by opioid therapy, the nurse would assess the client for which adverse reaction? Select all that apply.
A nurse monitoring a client taking an opiate for diarrhea should notify the health care provider immediately if what occurs? Select all that apply:
blood is noted in the stool
client reprots severe abdominal pain
diarrheas not relieved
A postsurgical client has been prescribed morphine to address the pain that is anticipated over the next 24 to 48 hours. What is the most effective strategy to manage a client's postsurgical pain for the initial 24 to 48 hours?
administering morphine on a scheduled basis and supplementing with additional morphine when the pain worsens
When assessing a client who is to receive celecoxib, a history of which disease process or condition would be most important to assess?
The client has been taking acetaminophen daily for two years. The health care provider has now prescribed ketoprofen in addition to the acetaminophen. The nurse plans to educate the client on NSAIDs and acetaminophen and that their interaction can cause what condition?
Which medication is prescribed parenterally for severe pain?
A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply.
admin of activated charcoal
life support, if indicated
Which medication will be administered for the treatment of salicylate overdose?
intravenous sodium bicarbonate
Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose?
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome?
acetylsalicylic acid (asprin)
Which of the following is a serious risk involved in the use of NSAIDs?
What effects are exerted by aspirin? (Select all that apply.)
A nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved?
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?
to inhibit platelet aggregation
What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.)
A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching?
drink at least 8 oz of fluid with the medication
A 73-year-old woman is experiencing recurrent constipation. The woman reports to the nurse that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this client's statements?
"Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation."
A client needing to evacuate the colon for endoscopy would likely be prescribed which medication?
polyethylene glycol electrolyte solution
When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?
2-year-old child from Nigeria is reported to have excellent health, except for the diarrhea that started within days of the family's arrival in the United States 3 weeks ago. History reveals nothing remarkable, but the mother comments on her child's love of (and continual consumption of) ice cream, something not available in their native country. This history supports what possible cause of the child's diarrhea?
What is first-line therapy for infants and children 1 to 4 years of age with diarrhea?
An adult client has a fecal impaction. Which are effective medications a nurse can suggest to a prescriber for a fecal impaction? Select all that apply.
Which of the following produce their laxative effect by direct action on the intestine to increase peristalsis? Select all that apply:
For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply.
a client who is recovering from a myocardial infraction
a client who has competed anthelminthic therapy
Lactulose (Chronulac, Cephulac) is prescribed for a client. The nurse knows that which of these statements regarding lactulose are correct? Select all that apply.
Lactulose is used to manage hepatic enecephalopathy
lactulose can cause electrolyte imbalance
The nurse is caring for a client who has had impacted stools twice in the past month. What is the most appropriate laxative for this client?
Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake?
The nurse collects the past medical history of a client new to the clinic. The client reports an allergy to penicillin. What questions about the allergy should the nurse ask the client? Select all that apply.
"Had the medication ever been prescribed before the time when the reaction occurred?"
"What signs and symptoms were displayed with the reaction?"
"How many doses were administered before the reaction occurred?"
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?
The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent doesn't know why the teeth are discolored and reports that the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask?
"Have they ever received tetracycline?"
Your client receives IV vancomycin every 12 hours. You know that this infusion should run over:
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:
can cause allergic reactions in clients who are allergic to penicillins.
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply.
obtain baseline assessment of cranial nerve 8 and periodic measurements during therapy
monitor creatine and BUN at baseline and periodically during therapy
provide the client with 2-3L of non caffeinated oral fluids daily, unless contraindicated
A client has been prescribed metronidazole for treatment of Giardia. What instruction is most important for the nurse to give to this client?
do not drink alcohol while taking this medication
The nurse should monitor the client for which common side effects of erythromycin therapy?
nausea, vomiting, and diarrhea
A client received erythromycin before dental surgery. The client has a past history of a cardiac surgery. The rest of the client's history is unremarkable. What does the nurse teach the client about this medication?
"You are receiving this medication to prevent infection that may affect your heart."
Linezolid can be used to treat which of the following infections? Select all that apply.
Community-acquired pneumonia (CAP)
Vancomycin-resistant Enterococcus faecium (VREF)
Methicillin-resistant Staphylococcus aureus (MRSA)
A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply.
take the drug with food or milk to improve absorption
notify PHCP in case of fever chills or cough
continue therapy for at least 1 week
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside?
the fluoroquinolone can be given orally
he client returns to the unit following surgery. The client reports being in pain. After checking the medication administration record in the client's chart, the nurse sees that the client has not received the morphine the health care provider has ordered for over an hour. As the order reads q 1-2 hours, the nurse administers the low dose of the morphine. The PACU nurse calls to tell the floor nurse that the nurse forgot to chart the last dose of morphine the client had received just before the client was transferred to the floor. What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids?
Naloxone hydrochloride (Narcan) tartrate
A client is in the hospital recovering from surgery and is using a client-controlled anesthisia (PCA) pump. The client's adult child tells the nurse they are concerned about the possibility of morphine overdose because their parent keeps pressing the button on the PCA. In addition to reassessing the client's pain, what is the nurse's best response?
"The device has maximum limits programmed, so your parent cannot get more than a specific amount."
The nurse is providing education to a client who has been prescribed naltrexone. What effect should the nurse teach the client to expect if an opioid is taken?
The absence of usual physiological effects
How do opioid analgesics relieve moderate-to-severe pain?
inhibiting the transmission of pain signals from peripheral tissues to the brain
Clients diagnosed with chronic pain should be given what information regarding opioids' effectiveness?
They should be given on a regular schedule, around the clock.
A nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate?
Consult with the prescriber about lowering the dosage of the drug
A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit?
Put side rails up and place bed in low position.
What drugs are examples of second-line opioid agonists/antagonists prescribed for the treatment of moderate-to-severe pain? Select all that apply.
The nurse is reviewing the discharge instructions with the client going home on an opioid analgesic for pain management. What would the nurse include in the instructions? Select all that apply.
keep the room well lit during the day
keep a record of bowel movements
rise slowly from a sitting or lying position
take a laxative/stool softener
A 23-year-old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. During the assessment, she informs the nurse that she has been experiencing these symptoms for the last three months on a weekly basis. These symptoms are those of
A caregiver asks the nurse what the caregiver can give a 9-year-old child for a headache. What is the nurse's best response?
acetaminophen is appropriate
A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug?
take this drug as soon as you feel the first signs of a migraine
What nursing intervention would not be effective in assisting the client in stopping his or her migraine headache?
keeping the room well lit
A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis?
increased risk of GI bleeding
A nurse is assessing a female client who has been taking NSAIDs. What statement by the client indicates a good understanding of the use of NSAID therapy?
I asked my provider to check for blood in my stool on a regular basis
Acetaminophen overdose has the potential to cause fatal:
A female client asks why she must consult with the health care provider when she uses cold products for her children. What is the nurse's best response?
"There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies."
A client is receiving acetaminophen for fever. The client also has inflammation in the knees and elbows with pain. Why will acetaminophen assist in reducing fever but not in decreasing the inflammatory process?
prostaglandin inhibition is limited to the central nervous system
A patient is taking acetylsalicylic acid (aspirin) to prevent platelet aggregation. Which dose of aspirin will irreversibly acetylate circulating platelets within a few minutes, with effects lasting for the lifespan of the platelets?
A client is taking a nonsteroidal anti-inflammatory agent. Which instruction should the client be given in regard to administration?
administer the medication with food
Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?
drink a full glass of water when taking a dose of the drug
What is a contraindication to use of a fluoroquinolone?
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