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Kaplan Pharm integrated

Terms in this set (75)

The nurse prepares to administer digoxin 0.01 mg/kg PO to a 2-month-old infant. The infant weighs 5 kg.The sleeping infant's apical pulse is 70 bpm. The nurse takes which most appropriate action?
Withholds the medication and notifies the health care provider immediately.
The nurse instructs a client who is to take rifampin. The nursing informs the client that which adverse effect may occur?
Orange-colored urine
The nurse provides care for a client diagnosed with Hodgkin's disease. The client received cyclophosphamide. Which laboratory value does the nurse report to the healthcare provider?
Platelets 40,000 mm3 (40x10^9/L)
Th nurse reviews laboratory reports for a client receiving digoxin and furosemide. Which laboratory values most concern the nurse?
K= 3.2 mEq/L (3.2 mmol) ; digoxin level= 2.2 ng/mL (2.8 n mmol/L)
The nurse instructs the client who is to take risperidone daily. Which adverse effects are included in the teaching?
Diarrhea and increased salivation
The nurse provides care for a client diagnosed with bipolar disorder. The client receives lithium. Which sign or symptom indicates lithium toxicity?
Unsteady gait
The nurse teaches the client about sublingual nitroglycerin administration. Which client statement indicates further teaching is necessary?
I will swallow frequently until the tablet completely dissolves.
A client is receiving 5% dextrose in 0.45% saline IV at 150 mL per hour in the forearm. Which finding best indicates to the nurse the IV is infiltrated?
The client reports the arm is painful.
The client is diagnosed with rheumatoid arthritis. The nurse instructs the client about taking methotrexate. The nurse includes which statement?
Report any temperature increases to your health care provider immediately.
A school-aged child is to receive 1.2 million units of penicillin G potassium IV daily. The medication is divided and given every 6 hours. The medication vial contains 300,000 units/mL. How many mL does the nurse minister per dose?
1 mL
A health care provider's prescription reads, "Diphenhydramine 25 mg at hour of sleep." Which is the most appropriate action for the nurse to take?
Ask the health care provider for clarification of the prescription
A toddler is diagnosed with cystic fibrosis. The nurse instructs the family about pancreatic enzymes. At which time is the medication to be given?
immediately before meals.
The nurse teaches a client about isoniazid. Which client statement indicates the need for further teaching?
I will stop the medication if I have fatigue and nausea.
The client takes oral ibandronate 150 mg once a month. The nurse includes which instructions in the teaching ?
-Take the medication the same day of each month.
-Sit or stand 60 minutes after taking the medications.
The nurse cares for a client diagnosed with acute salicylate poisoning. Which signs and symptoms does the nurse expect to observe?
Disorientation or increased pulse rate
A client starts chemotherapy for treatment of colon cancer. The client returns four days later. It is most important for the nurse to take which action?
Observe the skin
The nurse cares for an older client who is confused. The nurse notes the client charges the settings on the IV infusion pup. The client received 250 ml of IV fluid in one hour. The nurse makes which priority assessment ?
Distended hand veins, elevated blood pressure, and moist lung crackles.
A client is to self-administer enoxaparin. The nurse instructs the client to avoid which herbal preparation.
Ginkgo biloba
A client is diagnosed with Parkinson disease. The nurse teaches about benztropine. Which client statement requires additional teaching?
I can expect to have increased sweating and diarrhea while taking benzotropine.
The nurse instructs a client who is to take captopril daily. Which statement is included in the instructions?
Change the positions slowly.
The nurse questions the dosage of a pain medication prescription. The health care provider tells the nurse to give the medication. The nurse still has concerns about the safety of the dose. Which is the best action for the nurse to take?
Refuse to administer the medication.
The health care provider orders pilocarpine eye drops for a client. The nurse is aware the client has which disorder ?
Primary open-angle glaucoma
The nurse monitors a client taking nifedipine. Which client statement requires immediate follow up by the nurse ?
"Since I started the medication, I feel a little stiff when I get out of bed."
The nurse administers morphine sulfate 4 mg intravenously every 4 hours PRN to a client. The nurse monitors for which adverse reactions? Select all that apply .
Constipation
Decreased urinary frequency
Nausea and vomiting
The nurse instructs a client to take diphenhydramine daily. Which statement by the client indicates a need for further instructions ?
I will take the diphenhydramine in the morning before I drive to work.
A client is diagnosed with osteoarthritis. The client takes naproxen sodium 250 mg PO twice a day. It is most important for the nurse to teach the client to report which symptom?
Stomach pain over a 3-day period.
A client receives 2 mg of a medication every 2 hours. The medication is available in 250 mg capsules. The client takes the medication every 6 hours. How many capsules does the client take for each dose?
2 capsules
A client takes isoniazid and vitamin B6. The client asks why vitamin B6 (pyridoxine) is also given. Which is the most appropriate response by the nurse ?
Vitamin B6 prevents inflammation o nerves caused by isoniazid.
The nurse provides care for a client who takes carbamazepine daily. Which assessment indicates an adverse reaction ?
Diplopia
The nurse instructs instructs the client taking atenolol. The nurse includes which instructions?
"Report any wheezing or shortness of breath to the heath care provider."
The nurse cares for a pregnant client. The client is HIV positive. Which medication taken during pregnancy decreases transmission of HIV infection from the mother to the fetus?
Zidovudine
The nurse instructs a client about taking 500 mg metformin PO daily. Which client statement indicates a need for further teaching ?
"I will take this medication on an empty stomach."
The nurse provides care for a client diagnosed with severe preclampsia. The client receives magnesium sulfate IV. Which medication must be available for the treatment of magnesium toxicity ?
Calcium gluconate
The nurse cares for a client receiving a blood transfusion. The client develops circulatory overload. Which signs and symptoms does the nurse expect to observe ?
Wheezing, chest pain, and fever.
The nurse instructs the client taking clonidine hydrochloride. It is most important for the nurse to include which statement in the teaching ?
Rise slowly from the bed to the chair.
The nurse administers an angiotensin converting enzyme inhibitor to a client. Which assessment data indicates an adverse effect of he medication ?
A dry, annoying cough
A client is to have timolol 0.25% 1 drop in each eye twice daily. The nurse instructs the client to self-administer the eye drops. Which client assessment indicates a need for further instruction?
"After j out the eye drops in my eye, I should put pressure on the outside corner of my eye."
The nurse cares for a client diagnosed with type 1 Diabetes mellitus. The nurse instructs the client to administer rapid-acting insulin. Which client statements indicate understanding of the teaching ?
I know that insulin is most rapidly absorbed from my abdominal tissue.
I will inject the insulin within 15 minutes of eating.
I will monitor my blood glucose levels when I am sick.
I will keep my insulin in the refrigerator after I open the vial.
The nurse instructs a client to apply a 25 mcg/hr fentanyl transdermal patch every 72 hours. Which statement is included in the teaching ?
After your remove a patch, flush it down the toilet immediately.
The nurse teaches a client to use the metered-dose inhaler. The client is to have 2 inhalation's of albuterol every 4 hours. Which action indaicates the teaching is effective?
The client exhales completely before closing mouth around the spacer mouthpiece.
A client is to receive 4.5 ounces of a liquid medication. How many milliliters (mL) does the nurse administer ?
135 mL
The nurse prepares to administer 18 units of intermediate-acting and 10 units of short-acting insulin to a client. The nurse takes which action first?
Draws up to 10 units of air into the syringe
The nurse is to administer a medication that is classified by the Federal Drug Administration (FDA) as a schedule II drug. What does this mean?
The medication has high potential for abuse.
The first time parent asks the nurse why the newborn was given a vitamin K injection. Which statement by the nurse is best?
Your baby needs Vitamin K to manufacture clotting factors.
A client chives vitamin B1 for the treatment of acute alcohol withdrawal. The client's adult child asks the nurse why. Which response by the nurse is best?
Vitamin B1 reduces the neurological symptoms your parent may experience.
A client receives cimetidine. The client asks the nurse how the medication works. Which nurse's response is best?
Cimetidine decreases acid secretion.
The health care provider prescribes levothyroxine for a client. Which statement requires immediate follow up by the nurse ?
"Sometimes I feel dizzy and my heart pounds."
A client is diagnosed with bacterial pneumonia. The nurse prepares to administer 80 mg of gentamicin intravenously. Which laboratory test is the priority to review prior to the first dose?
Serum creatinine
A client receives 20 mEq of potassium chloride added to 1000 mL of 0.9% saline. Which assessment does the nurse make first?
Urine output
A client is diagnosed with systemic lupus erythematosus (SLE). The client has taken corticosteroid therapy for several years . The nurse knows the client is at high risk to develop which clinical manifestations ?
Truncal obesity and purple striations on the skin
The nurse cares for a client who takes lorazepam daily. The nurse expects the client to make which statement ?
I am feeling less anxious
A client developed wheezing when given ampicillin and co - trimoxazole. Which additional order does the nurse question ?
Cefaclor 500 mg q 8 hours.
The nurse instructs a client how to take oral iron supplements. Which client statement indicates the need for further teaching?
"I will stop taking this medication between meals."
The nurse administers albuterol 2 puffs every 4 to 6 hours PRN to the client. The client is carefully assessed for which adverse reaction?
Tremors
The nurse instructs a client about taking aluminum hydroxide. Which client statement indicates understanding of the instructions?
I will take the medication between meals and at bedtime.
The nurse sets an infusion pump to deliver 4 mcg/kg/min of a medication. The client weighs 50 kg. How many micrograms does the client receive in one hour?
12000 mcg
The nurse instructs a client about the use of transdermal nitroglycerin patch. Which instruction is included?
Remove the patch 12 to 14 hours
The nurse instructs a client to take oral baclofen daily. Which is the most appropriate statement for the nurse to make?
It is common to experience some drowsiness and dizziness.
The nurse administers 5000 units of heparin subcutaneously to a client. Which action is most important for the nurse to take?
Give the injection in the abdomen.
A client is diagnosed with thrombophlebitis. The client receives heparin sodium IV. Which is the most appropriate laboratory test for the nurse to monitor?
Activated partial thromboplastin time
The nurse cares for a client who has been taking prednisone for several months. Which finding indicates a complication of the medication?
Black, tarry stools.
A client is diagnosed with schizophrenia. The nurse administers haloperidol. Which assessment indicates a therapeutic response to the medication ?
The client has become more quiet and unobtrusive.
An adult client receives chemotherapy. The client asks the nurse if all the hair will be lost. Which action does the nurse take first?
Assesses the client's understanding of the adverse effects of the medication.
The nurse administers warfarin to a client. The nurse informs the client it will be necessary to monitor which laboratory test regularly?
International normalized ratio.
A 14-month-old toddler receives 250 mg of a liquid mediation. The nurse instructs the parent about administration using a syringe without a needle. The label on the medication bottle reads: 2 teaspoons = 250 mg. How many mL of the medication is drawn into the syringe?
10 mL
A client has labor induced with oxytocin. The client's cervix is 7 cm dilated. Which assessment causes the nurse to stop the oxytocin infusion?
The client's contractions last 90 to 110 seconds.
The nurse instructs a client taking potassium chloride 40 mEq daily. Which statements indicate understanding of the instructions? Select all that apply.
-If my urine output decreases, I will notify my health care provider.
-I will take the medication with a full glass of water. - I will need to have periodic blood test done while taking this medication.
The nurse administers an IV infusion of a medication at 10 units/kg/hour. The client weighs 50 kilograms. The medication concentration is 50,000 units per 1000 mL. The infusion pump is set at how many mL/hr?
10 mL/hr
A client takes atorvastatin daily. Which client statement most concerns the the nurse?
I have muscle aches that seems to be getting worse.
The nurse prepares to administer medications. Which order does the nurse question?
Metoprolol to a client with a blood pressure 118/78.
A client receives warfarin. The client asked why am I taking this medication? Which is the best response by the nurse?
Warfarin blocks the formation of clotting factors in your blood.
A client is to receive 1000 mL of 5% dextrose in 0.9% saline over a 4 hour period. The infusion set delivers 15 drops per milliliter. The nurse sets the IV to administer how many drops per minute?
63 drops per minute
Sodium polystyrene sulfonate 15 g PO BID is ordered for a client. The medication comes in a 1.25 g/5 mL suspension. How many mL does the nurse administer ?
60 mL.
A client is admitted to a psychiatric unit. The client has symptoms of depression, anorexia., low self esteem, and suicidal idealization. Th nurse expects to administer which medication?
Bupropion
The nurse instructs the parents of a 6-year-old child taking phenytoin. Which parental statement indicates the the teaching is effective ?
I will give the medication to my child at the same time every day.
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