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A client with open angle glaucoma is using pilocarpine ophthalmic solution, a mitotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?
Check amount of drainage from each eye
The nurse is preparing medication for a client with bipolar disorder and notice that the antipsychotic medication was discontinued several days ago. Which medication should also be discontinued?
The nurse is teaching the client about the rationale for administering a dose of desmopressin acetate (DDVAP) intranasally at bedtime. Which client goal is achieved is achieved by having the client administer this medication as described by the nurse?
One hour after receiving the initial dose of doxazosin, a male client with benign prostate hypertrophy complains of a rapid heartbeat and dizziness. He is sitting at the side of the bed finishing his bedtime snack. His radial pulse is 144 beats/minute. What action should the nurse take first?
Obtain his blood pressure and apical pulse rate
A client reports epigastric pain an hour after receiving an oral dose of ketorolac (Toradol). Which action should the nurse implement?
Continue to monitor the client for GI distress.
A client with Type 2 diabetes mellitus is managed with glimepiride (Amaryl), an oral hypoglycemic agent. The primary healthcare provider prescribes an additional medication, injectable exenatide (Byetta). Which information is most important for the nurse to teach this client?
Watch for signs of jitteriness or diaphoresis
The nurse is caring for a client who is taking diclofenac (Zipsor), a nonsteroidal anti-inflammatory drug (NSAID) for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?
A client is receiving fentanyl (Duragesic) 25 mcg/hr via transdermal patch. Which nursing intervention is most important for the nurse to imitate?
Assess the client's level of consciousness
A client receiving orlistat (Xenical) as part of a weight management system. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?
Daily calorie count
A client with multiple sclerosis starts a new prescription, baclofen (Lioresal), to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. What instruction should the nurse provide?
Avoid hazardous activities until symptoms subside
A client is receiving metronidazole (Flagyl) for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?
Avoid the use of alcohol
To detect common untoward effects of the anticonvulsant phenytonin (Dilantin) the nurse should assesses a client with a seizure disorder for which signs or symptom?
A client on mechanical ventilation is receiving ranitidine HC3 (Zantac) intravenously. Which explanation should the nurse provide the family regarding the purpose of this medication?
It will prevent infection by ulcer-producing bacteria
A client who is taking an oral dose of a tetracycline reports gastrointestinal upset. Which snack should the nurse instruct the client to take with the tetracycline?
Toasted wheat bread and jelly
Dairy products decrease effect
What action should the nurse take prior to administering Digoxin (Lanoxin) PO?
Listen to the heart at the left 5th intercostal space
A client receiving filgrastim (Neupogen) reports increasing bone pain. Which action should the nurse implement?
Administer a prescribed PRN analgesic
A client with chronic asthma receives a prescription for montelukast (singulair), a leukotriene modifier. Which statement by the client indicates to the nurse that the medications teaching was effective?
I will take the tablet every evening to control my asthma"
Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?
Determine the frequency and consistency of bowel movement
When conducting drug education about an oral preparation for cyclosporine (Gengraf), which juice should the nurse instruct the client to avoid because it can increase the serum cyclosporine level?
The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. What instruction is most important for the nurse to provide the client?
Hold one nostril close while spraying the other nostril
A client has a new prescription for the maximum recommended dosage of piperacillin/tazobactum (Zosyn) for nosocomial pneumonia. The nurse should report which laboratory finding to the healthcare provider before administering the prescribed dose?
Decreased creatinine clearance
A client with heart failure (HF) develops hyperaldosternism and spironolaxtone is prescribed. Which instruction should the nurse include in this client's plan of care
Limit intake of high potassium foods
An older male client is being discharged after a myocardial infarction (MI) and receives a new prescription for atenolol. Which instruction is most important for the nurse to include in the client's teaching plan?
Standing slowly when getting up from bed
One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues. These patients have a type of tumor referred to as a
A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem?
Be sure to examine your mouth daily for bleeding, painful areas, and ulcerations."
When administering chemotherapy for treatment of cancer, the nurse implements which intervention that treats or even prevents chemotherapy-induced nausea and vomiting?
Giving an antiemetic 30 to 60 minutes before the chemotherapy is started.
The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy?
Increased cancer cell killing will occur
Nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered an early sign of infection?
When giving chemotherapy as cancer treatment, the nurse recognizes that toxicity to rapidly growing normal cells also occurs. Which rapidly growing normal cells are also harmed by chemotherapy? (Select all that apply.)
Hair follicle cells
Gastrointestinal mucous membrane cells
Bone marrow cells
What is the nurse's priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration?
Stop the infusion immediately, but leave the IV catheter in place
A patient is receiving a third session of chemotherapy with daunorubicin (Cerubidine). The nurse will assess the patient for which signs of a potential severe toxic effect of this drug?
A weight gain of 2 pounds or more in 24 hours
The nurse is providing education regarding chemotherapy to a patient who is about to receive the first course of treatment. Which statement by the nurse is appropriate?
Report black, tarry stools if they occur
The nurse is teaching a class about the various chemotherapy drugs and explains that alkylating drugs are also called "cell cycle-nonspecific drugs" because they are
Cytotoxic in any phase of the cell cycle
When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?
The penicillin will cause an enhanced anticoagulant effect on the warfarin
The nurse is preparing to administer morning meds to a pt who has been newly diagnosed with tuberculosis. The patient ask, "Why do I have to take so many different drugs?" Which response by the nurse is correct?
Taking multiple drugs reduces the chance that tuberculosis will become drug resistant
Tetracycline, 8 year old boy, mother says something like "I was fine I took it why can't my son?" or whatever- something with
Drugs that interact poorly with tetracylcines
Antacids contain magnesium that reacts poorly with tetracylcines
Photosensitivity occurs with use of
Main adverse effect of clindamycin
Doctor prescribed to give a certain med STAT but pharmacy sent it an hour late, what should the nurse do?
Hold medication and call doctor
should not be stopped abruptly
Something about giving chemotherapy, it included "500 neutrophil
Administer the prescription as ordered
Oral vs sublingual
sublingual absorbs faster
Gentamicin, patient asks to repeat questions, imbalanced
Patient is experiencing ototoxicity from the gentamicin.
Patient has painful mouth sores, what should the patient do?
Avoid acidic juices
What is right about cephalosporins?
Cannot administer if pt has a past history of penicillin allergy
Nurse is about start on patient's first chemotherapy session, patient says something where she needs further teaching on
I plan on getting pregnant soon
Patient asks why she's getting meds through IV, what should nurse respond?
IV meds are faster
After taking lactulose (cholac) for several days. What therapeutic response for a patient with hepatic encephalopathy?
Improved mental status
A female client has a hemoglobin of 9 grams/dL or 90 grams/L (SI) and iron supplements are prescribed. When teaching this client about the administration of iron supplements, how should the nurse instruct her to take the iron tablets>
Before breakfast with a glass of orange juice
After receiving the first dose of penicillin, the client begins wheezing and has trouble breathing nurse notifies the healthcare provider immediately and receives several prescriptions. Which medication prescription should the nurse administer first?
A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa (epogen) two months ago, which client finding best indicates that the medication is effective?
Hemoglobin level increased to 12 grams /dL
Thirty minutes after administering trimethobenzamide (tigan) to a client with nausea, the nurse observes that the client is sedated, but arouses, easily and denies further nausea. Which action should the nurse implement?
Encourage the client to rest until feeling more alert.
A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing "hearburn." How should the nurse respond?
Advise the client to go to the nearest emergency department
An adolescent receives a new prescription for isotretinoin (claravis) for cystic acne. Which information is most important for the nurse to provide?
Consider an alternative summer job, other than life-guarding
The nurse is teaching a male client with type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine (lantus) insulin. The the insulin is self-administered at 0800, when is the client most likely to experience hypoglycemia?
No peak occurs
Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?
Instruct the client to request assistance when ambulating to the bathroom
A male client reveives a scopolamine transdermal patch 2 hours prior to surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. What action should the nurse take?
Explain that the medication is not given to prevent pain.
The nurse is administering the muscle relaxant baclofen (lioresal) PO to a client diagnosed with multiple sclerosis. Which intervention should then nurse implement?
Advise the client to move slowly and cautiously when rising and walking.
during a home visit, the nurse assesses a client with Alzheimer's Disease who recently started a new prescription for rivastigmine (exelon). The caregiver reports that the client seems to be thinking more clearly, but is not sleeping well at night. Which action should the nurse take?
Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
The nurse is administering IV fluconazole (Diflucan) to a client who has systemic candidiasis. After reviewing the client's diagnostic studies, then nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST, also called SGOT). What action should the nurse implement?
Hold the dose and notify the healthcare provider of the changes in the laboratory studies.
A client with a history of asthma is experiencing an acute episode of wheezing and shortness of breath four hours after returning from surgery. Which prescription should the nurse administer at this time?
A client with hear failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?
Limit intake of high-potassium foods.
A client receiving the urinary antispasmodic oxybutynin CL (Ditropan XL) reports having an extremely dry mouth. How should the nurse respond?
You can suck on hard candy to help relieve the mouth dryness, which is a common side effect.
A female client is being treated for tuberculosis with rifampin (rifadin). Which statement indicates that further teaching is needed?
I'll take my usual oral contraceptives for birth control."
The nurse suspects that a client has experienced an adverse reaction to a prescribed medication. Which action should the nurse take first?
Complete a focuses system assessment of the client
A client asks the nurse about using zinc as a complementary therapy for treatment of cold symptoms. What should the nurse explain to the client regarding the use of zinc?
There is very limited evidence it reduces cold symptoms
The nurse is preparing a discharge teaching plan for a client who is taking Ciprofloxacin hydrochloride (Cipro) tablets, which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all)
• Limit exposure to sunlight
• Avoid tanning beds
• Increase fluid intake while on medication
• Report any tendon pain or swelling to PCP immediately
Ferrous Sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking liquid medication?
Use a straw to ingest
A client with chronic kidney disease (CKD) is receiving calcium acetate (PhosLo) 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?
A client who is obtunded arrives in the ER center with a suspected drug overdose. The client becomes responsive after the administration of intravenous naloxone, but within a short period, the client's level of consciousness decreases again and the respiratory rate decreases to 6 breaths per minute. Which action should the nurse take first
Administer an additional dose of Naloxone
A nitroglycerin infusion is prescribed for a client whose blood pressure is 210/112. Ten minutes after initiating the infusion at 10mcg/minute, the client complains of a severe headache and numbness of the left arm. Which intervention should the nurse implement?
Avoid going barefoot, especially outside
A client who is receiving pregabalin (Lyrica) for fibromyalgia complains of tremors in the hands. What action should the nurse implement?
Administer a PRN dose of an anti-anxiety drug"
A client with TB, whose antitubercular drugs include rifampin (Rifadin), reports to the nurse that his urine is reddish-orange. What reponse should the nurse provide to this client?
This is an expected side effect and is harmless
Hormone replacement therapy with levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much of the hormonal agent. Synthroid?
The wife of a client diagnosed with Parkinson's disease calls the clinic and tells the nurse her husband is having involuntary jerky movements of the legs and arms and is confused. Which action should the clinic nurse implement first?
Ask the clients wife to list all medications her husband is currently taking
A client has been taking ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), by mouth, twice a day for chronic lower back pain for several months. Which assessment is most important for the nurse to complete?
Determine the presence of abdominal pain
To assess for the effectiveness of amlodipine (Norvasc), a calcium channel blocker, what action should the nurse implement?
Measure the clients blood pressure
Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?
"Follow medication administration with an additional glass of water"
A peak and trough level was obtained from a client receiving an aminoglycoside IV piggyback every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?
Decreased peak, decreased trough
A client with a history of angina is taking diltiazem, a calcium channel blocker. The client reports increasing fatigue with periods of feeling "faint". Which client assessment should the nurse complete first?
" Measure pulse and blood pressure for changes"
A female client who has trichomonas vaginalis receives a prescription for metronidazole (Flagyl). Which instruction should the nurse provide this client?
Male partners must also be treated
A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
Advise the client to schedule an appointment for LFT's
A male client who has been taking a high dose of nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic complaining of gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomepraxole (Nexium). Which information should the nurse include in this clients teaching plan?
Notify healthcare provider of passage of black stool
Prior to administering oral doses of calcitriol (Rocaltrol) and calcium carbonate (os-cal) to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dl or 3.5 mmol/L (SI). Which action should the nurse implement?
Hold both medications until contacting the healthcare provider
The nurse is administering the muscle relaxant baclofen (Lioresal) PO to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?
Advise the client to move slowly and cautiously when rising and walking
Fifteen minutes after receiving Sulfamethoxazole (Gantantol), a male client reports a burning sensation over his abdomen, chest, and groin. Which intervention is most important for the nurse to implement?
Auscultate lung sounds for wheezing
Twenty minutes after the nurse starts a secondary IV infusion of Cefepime (Maxipime) 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseated. What action should the nurse implement?
Continue infusion and administer a PRN antiemetic prescription
A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9:00pm dose. What action can the nurse take to alleviate this side effect?
Administer the dose with a snack
A client with a respiratory infection has been receiving an antibiotic and an antipyretic for 5 days. What current datum is the best indication that the antibiotic is effective?
The sputum specimen culture report shows no growth
The nurse notes that a client has a new prescription for 20 mEq of potassium chloride (Kcl) to be administered IV push STAT. The client's IV site is slightly inflamed but it not tender and has a blood flashback. What action should the nurse take?
Contact the healthcare provider to clarify the prescription
A client is receiving tamsulosin (Flomax), an alpha adrenergic blocking agent, for the management of urinary retention due to benign prostate hyperplasia (BPH). Which instruction is most important for the nurse to provide?
" Stand and sit up slowly"
A client with Emphysema is complaining of difficulty breathing and is exhibiting audible wheezing. The nurse administers albuterol (Proventil) as prescribed for the third time within the last 12 hours. Which assessment finding warrants immediate intervention by the nurse?
Irregular heart beat"
A nurse administered a second dose of an opioid containing codeine and acetaminophen to a client 15 minutes after a first dose was administered by another nurse, because the first dose was not documented in the medication record. Which intervention is most important for the nurse to implement?
Evaluate the clients vital signs
A client diagnosed with Myasthenia Gravis receives a prescription for the anticholinesterase medication, pyridostigmine (Mestinon). Which intervention should the nurse implement when preparing to administer this medication?
Administer the medication 30 mins before meals
When preparing to administer the next scheduled dose of Fentanyl (Sublimaze) transdermal patch to a client with metastatic cancer and renal insufficiency, the nurse notes that the client has shallow respirations at 8 breaths/minute. What action should the nurse take first?
Notify the healthcare provider
The home health nurse observes that a female client is using a topical preparation that contains Echinacea to treat a canker sore. Her husband expresses concern regarding the effectiveness and safety of using herbs. How should the nurse respond?
"Echinacea seems to be useful in the treatment of some infections, such as canker sores."
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